This is a story about primary care...

Primum non nocere is in and of itself a non sequitur because the use of Latin and other languages of classical antiquity is primarily intended to deter the hoi polloi from becoming educated. The number of doctors who are able to train, qualify and practice, is something that is tightly controlled in order to maintain high salaries - artificial scarcity - as opposed to allowing the unrestricted proliferation of medical knowledge which might improve the health of the nation.

Those who profess the Hippocratic Oath might be able to stay true to the vow they have sworn if they practice the treatment of acute illness in a hospital - dealing with curable disease and injury - but in the treatment of chronic illness in the community, as General Practitioners (GPs), can we say the same?

If we look at a few obvious statistics, we can see that medicine is failing. Average life expectancies have started to fall and chronic illness has seen a dramatic rise. There is an epidemic of mental health problems, and suicide is the biggest killer of men under the age of 45.

Of course, one might say that the root causes of these conditions are non-medical.

It occurred to me that a significant piece of the NHS has already been privatised, in that many general practice surgeries are owned and operated as private profit-making enterprises. This seemed to present a significant conflict of interest, so I decided to conduct an experiment.

I asked a GP a simple question: when you're treating a patient, do you think about their healthcare needs, or do you think about other things? The reply was shocking.

"It's not about [the patient] it's about everybody else"

I'd had my suspicions for a while - gathering plenty of evidence - that those who profess to do no harm might actually have been corrupted into serving other purposes; into betraying their profession and failing in their duty of care. This was the final confirmation that my worst fears were realised, and there are powerful actors within the healthcare system who place other things above the health of their patients.

By co-opting doctors into the capitalist profit-driven sector of the economy, and by co-opting them into the welfare system, we are asking doctors to choose between their luxury cars, the private school fees for their children, and other trimmings associated with their high social status, versus increased taxes to pay for the welfare state. By placing the most vulnerable people in society in front of the doctors, when seeking incapacity benefit, the government is pitting one group against another.

If the study of economics has taught us anything, it's that people respond to financial incentives. While a GP might argue that they're saving valuable taxpayer money, which might be spent on the NHS, by denying incapacity benefit to a vulnerable member of society, one must also admit that the GP acts in rational self-interest. Less money spent supporting society's most vulnerable means a lower tax burden and more money in the pockets of the profiteers, which include GPs who are partners in their practice.

The first principle of do no harm forbids a doctor from weeding out malingerers based on their best guess. To cut off somebody's incapacity benefit is definitely harmful, and there is no diagnostic test which could decide with a high degree of accuracy who is the malingerer and who is genuinely unable to work. If the doctor in question truly cares about their patients, they would have no option but to choose the option which gives most benefit and inflicts least harm.

We see so many suicides because patients are fobbed off with inferior treatment options, because it's a cheaper alternative to give somebody pills than to give them psychological therapy. While I understand that being cost-conscious might be seen as being pragmatic, it again violates the principle of do no harm. To fob a desperate and vulnerable person off with ineffective medication, when better treatment options are available, is tantamount to negligence. If a doctor has a consultation with a man under the age of 45, they must surely be well aware that suicide is the thing that is most likely to cause their death, and they should therefore treat it as a serious threat to their life. To call people's bluff and knowingly prescribe ineffective treatment is obviously the reason why suicide rates are so scandalously high.

I imagine that some doctors - although egotistical and in love with themselves - have a tiny piece of them that wants to make a difference and save lives. I think that exhaustion and the pressures that are felt by ordinary people are imposing themselves on doctors now, who are struggling to send their children to the best private schools (boo hoo) and are feeling compassion fatigued because of burnout. If we can relieve the pressure on GPs, they may become more willing and able to work in support of their patients' needs, as opposed to "everybody else" (read: being the government's job police).

I strongly believe that we have an urgent need to change primary care, so that it becomes not-for-profit, and patient healthcare can become the primary objective. Perhaps profits are not the primary motivator, but money has a corrupting influence which can be clearly seen when you speak to a GP who is/was a partner of a practice. Co-opting healthcare professionals into the job of coercing vulnerable people into bullshit McJobs, where they are exploited by the capitalists, has absolutely nothing to do with healthcare and is most certainly harmful.

I've witnessed first-hand how this care for "everybody else" - instead of patients - has become shorthand for the compassionless, sympathy-lacking, bullying, hectoring and suicide-inducing grotesquely twisted vision of so-called medicine, inflicted on society's most vulnerable people.

If you want to be the job police, and you think that suicides are an acceptable price to pay, so you can feel superior and send your kids to private school, perhaps medicine is not for you.

Tags: #nhs

This is a story about being functional...

In every supermarket, corner shop, convenience store, licensed café, restaurant and in vast numbers of bars, pubs, clubs and other establishments where people gather to spend money and socialise, there is always alcohol on sale. Alcohol is ubiquitous. It's always possible to get cheap booze quickly, wherever you are - you're never further than a short walk and a couple of quid away from intoxication.

The weather in the UK is pretty miserable. We get hardly any snow, and there's only a couple of mountains that have a ski lift - it's quicker and easier for me to fly to France, Austria, Switzerland or Italy, than it is for me to drive all the way to Scotland, where the mountains aren't very high and the snow's really poor. The pleasant months of weather in the UK are May through to September, and the rest of the time it's grey and overcast; drizzly and thoroughly miserable. Our summers are often plagued by rain, although the weather is at least pleasantly warm by British standards, but don't forget your brolly even in August. It's enough to drive anybody to drink.

Our little island is quite overcrowded. The industrial revolution led us to abandon our rural lifestyle and move to the cities, seeking our fortune. Our cramped towns and cities have rows and rows of terraced worker cottages, which are too small to comfortably accomodate a family. As our social fabric disintegrated in the 1960s and 1970s, we built brutalist concrete monstrosities, very similar to Soviet-era blocks, which could house vast numbers of people who serve no useful economic purpose in the age of robotics, technology, automation, IT and the boom of the service industries. The vast majority of Britons are struggling to just-about-manage on god-awful estates, some of which were built by councils as social housing, and others were built by a handful of massive property developers. Estates comprise huge numbers of cheap and nasty houses built on the outskirts of dismal towns, which were already struggling to provide the necessary infrastructure to educate, transport, entertain and look after the health of local residents. We have not scaled well.

Overcrowding has reached such problematic levels, that cities such as London, Bristol and Manchester have no-go areas, where drugs, guns, knives and prostitution are the backbone of their black-market economies. In those areas predominantly populated by people who are considered economically redundant, there is little hope of escaping poverty, except by selling drugs or selling your body. Gangs compete for their turf, and violence is rife.

Meanwhile, we have seen the rise and rise of the bullshit job. While the economically redundant are given a pitiful state handout and left to rot on their council estates, the 'cream of the crop' will be able to study at university and obtain the necessary academic credentials to get a job that's completely unrelated to their field of study, which will mostly involve pointless boring meetings, Excel spreadsheets and a ridiculous volume of emails about absolutely nothing. The service industries produce nothing - no real value to the economy, no productive output - but they account for 85% or more of the so-called economy. Paper gets shuffled around in increasingly elaborate ways of obfuscating the fact that nothing of any importance is being done. Our smartest people are very busy doing nothing... and the smarter ones quickly figure this out and become quite disillusioned with the whole sham.

All of these things contributes to a toxic environment which makes people depressed, demotivated, stressed, anxious, but horribly trapped by their mortgages, car loan repayments. Despite stress and exhaustion, there persists a futile and flawed belief that if we only work hard enough, we'll be able to elevate ourselves from our dismal situation and build a better life for us and our family. When the workers eventually realise that life in the UK is a massive con, and we're going to be stuck in our dead-end job that we hate until the day we die - and our children are going to struggle just as much, if not more - then we need vast quantities of antidepressants, anxiety pills, tranquillisers, sedatives - and alcohol - in order to allow us to ignore the horrible situation and carry on functioning. Our nation is packed full of functional addicts.

Alcohol is used because of its ubiquity. It's self-medication that's available on every street corner. The proportion of the average family budget that gets spent on alcohol, versus food, is quite staggering - alcohol is the glue between the pooh... the only thing that's allowing people to carry on being functional in such a toxic environment; under such a hostile conditions.

Alcohol is the cause of so much obesity, as well as the other health-damage that accompanies its chronic consumption. If we really cared about people's health, we wouldn't bully and hector them to give up their crutches, but we would instead improve the quality of people's lives. If we make the world a less depressing and stressful place, we'll see alcohol consumption levels naturally drop.

I hate that I have to drink, just to get through the working week. I hate that I'm using a really fattening and health-damaging drug to salve my stress, and to help me to cope, but it's freely and readily available without having to see a condescending, patronising and unhelpful doctor, who has no sympathy and compassion for the day-to-day struggles of the proletariat. Doctors enjoy a position of high social status and an income that is many times greater than the average wage - they have no idea what life's like in the real world, for ordinary people - and while my overall experience with doctors has been a mostly positive one, the elites completely fail to grasp the awfulness of life for ordinary people, and fail to sympathise with the plight of the just-about-managing struggling masses.

Our doctors are trained in acute medicine - disease and injury - and are not succeeding at treating the chronic conditions that arise from the current economic climate, which is so toxic to mental health. Instead of lecturing, hectoring and bullying people because they use alcohol, cigarettes, coffee and drugs to be able to cope, our medical community needs to recognise that people are driven to use substances because of their intolerable living conditions. The mental health epidemic and scandalous suicide rates are all the proof we need that the model of medicine which dished out bucketloads of antibiotics is not succeeding in saving lives, when it dishes out bucketloads of antidepressants - clearly it's not working and suicide and mental health problems are the number one public health issue we're facing.

Having access to a fast-acting drug which can help when the stress levels become unbearable - when life becomes unliveable - is vitally important for a society that wishes to treat its people with some degree of sympathy and compassion for their plight... people need something to ease their suffering.

I think alcohol is a terrible drug, and I pity those who have become addicted to it, but it's plain to see the reasons why people drink too much, and it's not that they've got 'addictive personalities' or they lack willpower - it's that their lives are fucking shit and they've got to find a way to cope.

I wish I could quit alcohol, but how would I cope without it?

Tags: #alcohol #addiction

This is a story about getting fat...

In December I started a lovely little self-contained project. I flew to Warsaw to gather the requirements from the client and then I flew back to London. I was living in AirBnBs and travelling home to Wales every weekend. I was living out of a suitcase, but it was OK because I was busy getting on with my project.

Then I finished the project.

The project was only supposed to take 6 weeks, but I finished it in 3. I spent another 3 weeks polishing the finished result and adding every bell and whistle I possibly could to create a completely spectacular Rolls-Royce solution, but then the project was well and truly finished and there was nothing left to do.

The team I was working with were based in Warsaw, and I was based in London. I had nobody to even chat to in the office, to while away the hours. I was bored out of my mind. The client was quite happy for me to sit around doing nothing, and he even wanted to extend my contract for a further 6 months beyond the original 3 months, but I was losing my mind with the boredom.

To cope with the boredom, I started to drink. I was drinking heavily. At one point I was drinking 2 bottles of wine a night, every night.

At the start of last September I had a benzo habit that had gotten out of control. I was taking several Valium and Xanax every day, and then a couple of zopiclone and zolpidem at night, plus a whole load of pregabalin. All those medications are GABA agonists, which is to say that they're hypnotic-sedative/tranquilliser type drugs that all act in the same way... very similarly to alcohol. I was physically addicted to those medications and if I stopped taking them then I would have a seizure that might kill me.

By the time I started that project back in December, I had managed to quit the Valium, Xanax and zolpidem. However, I had stopped but then started taking the pregabalin again because I was so stressed out by the travelling and the new job, and the fact I was homeless and rapidly running out of money. The pregabalin soothed my jangled nerves during the day, and the zopiclone helped me to sleep at night. With the combination of those two medications, I was able to limp through that 3-month contract in London.

I drank a lot when I was in London because I was bored and I was withdrawing from the benzos, and I hated the job because I was so isolated and lonely, and I hated the travel and the AirBnBs. I was suicidal A LOT of the time.

Along with the drinking, I got into bad eating habits. I would have fried chicken from KFC and burgers from McDonalds. I would have greasy curries and fatty kebabs. I lived on fast food and vast quantities of wine. I really let myself go, because I hated my life so much and it was so unbearable.

In January I decided that I needed an incentive to quit the London life and base myself in Wales full-time, so I started dating. I met a lovely girl who enjoys eating out, getting takeaways and drinking wine. We've had a great time, eating, drinking and being merry.

Now I'm feeling fat.

My girlfriend and I have stuffed our faces with fine food and wine for the last 3 months, and I'm feeling fat and unfit. I've had a brilliant time, but I've really let myself go. I've stuffed my face without a single ounce of restraint.

There's a canteen at my new workplace, and I stuff my face with chips, burgers, pizza, burritos, pies and numerous other incredibly unhealthy foods, every single lunchtime. Gone are the days of my relatively healthy lunches that I used to have in London. My lunches in Wales are nothing but carbs, carbs and more carbs.

All the money I've earned has so far been spent on living expenses. I'm running out of money, although I should get a much needed cash injection early next week, which can't come soon enough, because it's been really expensive getting myself back on my feet - renting an apartment and buying a car so I can get to work. It's been really stressful, having the threat of bankruptcy hanging over me for so long. It's been so stressful being so short of cash.

Because of the unbearable stress, and the dreadful withdrawal that I've been through from stopping all those highly addictive tranquillisers and sleeping pills, I've been compensating with comfort eating and alcohol. I've been drinking bucketloads and eating far too much. I've put on weight, and I'm depressed about that - it affects my self-esteem.

Hopefully, money will come flooding in next week, and I'm booking a holiday for mid-June, which can't come soon enough, because it's been a ridiculous 21-month slog without a holiday to get to this point, and I still have a month and a half more to go before I finally get a nice break.

I'm using alcohol and food as a crutch, because I'm not taking any medication and I'm not taking any time off work. I'm stressed and exhausted, and the thing that's suffering is my health; my weight; my appearance. It depresses me that I've let myself go, but I've been dealing with more than I can handle. Frankly, it's a miracle that I've made it this far.

So, as if I haven't worked hard enough, I'll need to cut down my drinking, exercise more and eat less. That sucks. At least there's a holiday and summertime on the not-too-distant horizon.

Tags: #medication #weight #eating #food #health #mentalhealth #addiction

This is a story about relentless monotony...

I fell asleep at my desk today. I haven't had any time off since November. I spent November writing a novel, so I guess I haven't had any time off since October. I was in hospital in October and I moved house, so I guess I haven't had any time off since September. I was in hospital in September and I tried to commit suicide and I lost my job and I was evicted, so I guess I haven't had any time off since July. I moved house and started a new job in July, so I guess I haven't had any time off since June. I was selling loads of my stuff, trying not to go bankrupt, while also trying to get a job in June, so I guess I haven't had any time off since May. I was quitting supercrack, having an episode of medication-induced mania from California rocket fuel and breaking up with my girlfriend in May, so I guess I haven't had any time off since April. I was a drug addict in April. This is what I was doing back in April.

Here I am looking at the dark web a little over a year ago. I'm probably not buying anything that would be illegal because I already had enough supercrack to last me 2 years. The fact I'm wearing clothes and sitting in my lounge, taking recognisably normal-ish photographs suggests that a little over a year ago, things were going OK.

Oh no I spoke to soon. This night-vision photograph indicates that I was going bat-shit insane while high on supercrack. I took this photograph only a couple of days after the one before, where I was sat in the lounge browsing the dark web. This photograph was taken about a year ago.

What the hell is THAT? Well, it's pretty obvious that I've barricaded myself in my bedroom. This photograph was taken one year and one day ago. This photograph perfectly illustrates my subconscious fears of privacy invasion - that people are going to burst in on me, shame me and violently attack me. I don't come across as very paranoid in day-to-day life, but I'm very traumatised, and this is my reaction that that trauma: I barricade myself in to protect myself from my parents and ex-wife. It's bat-shit insane, of course, but this is my underlying psychology.

Looks like I was eating some food. I'd probably barricaded myself in my bedroom for days. I'd probably not slept for days. My life was a horrific mess a year ago. I had a virtually unlimited supply of supercrack and my addiction was raging out of control. Clearly I was paranoid because of drugs and sleep deprivation, but what was the seed of that paranoia? I wonder if it could have anything to do with having the rug pulled out from under my feet - being muscled out of my own home; being horrifically injured in my own home; being punched in the face or suffering a horrific injury to my leg, at the hands of my ex-wife and parents. I wonder if it could have anything to do with them. I was trapped in a corner for so very long, with no means of escaping my tormentors, who were demonstrably vile, violent and abusive. Fuck them. That kind of trauma has a lasting effect.

My paranoia reached such ridiculous levels that I barricaded the door to my ensuite bathroom using my laundry bins and some clothes storage boxes. Clearly I just wanted to be left alone. Clearly I didn't feel safe. Yes, it's paranoia that's come about because of drug abuse and sleep deprivation, but there's got to be a seed too. Nobody gets this paranoid unless they have their ex-wife kicking doors in and screaming abuse at the top of her lungs. Nobody gets this paranoid unless they have their parents humiliating them and bursting in on them, and dragging them out of their own home. There's a seed for paranoia. There's always a seed.

Something to help me sleep (zopiclone) and something to help me cope and function (dexamfetamine). You can't end a horrific addiction instantly. There's no cold turkey when you're in as deep as I was. I was too dependent. To attempt to suddenly quit overnight would have caused me unbearable withdrawal symptoms and would have required me to be hospitalised. This is what I prescribed myself - two medications for harm reduction. Two medications that I used to wean myself off the dangerous and highly addictive supercrack.

I flushed that big bag of supercrack a year ago. There was enough to last me a couple of years, easily. I can't remember when exactly I flushed it, because my life was chaotic, but the evidence suggests that it was at this point I decided to get clean, using substitute prescribing.

Things didn't go smoothly, but it's very difficult to deal with a major addiction as well as mental health problems and all the practical problems that came about because my life had disintegrated. I needed to get money, get a job, get an apartment I could afford. I needed to move house, move city. I needed to get a new girlfriend and a new group of friends. I had a false start in Manchester, but I tried again in Wales... I'm trying again in Wales.

Maybe you think my life is easy and everything is sorted out, because I earned bit of money, which I spent renting an apartment and buying a car so that I can get to my new job. Maybe you think my life is easy because I get up and go to work every day, and I'm doing a good job and my bosses are impressed with me. Maybe you think my life is easy because I've 'bounced back' from losing two apartments, running out of money three times and being hospitalised twice. Maybe you think my life is easy, because I've made it look so easy, quitting supercrack, Valium, Xanax, tramadol, codeine, dihydrocodiene, pregabalin, zopiclone and zolpidem, which are all highly addictive. Maybe you think my life is easy, because I've gone 7 months unmedicated and I haven't had a single mental health episode that's caused me to commit suicide or do something else drastic to fuck up my life. Maybe you think my life is easy because my finances are improving and I've got a girlfriend. Maybe you think none of what I went through in the last year was very hard. Maybe you think none of what I've been through in the last year has caused any lasting damage.

I'm in my 5th consecutive month of full-time work without a holiday. I'm working my bollocks off. All I do is work work work, because I'm running as fast as I can to get myself into a position where my housing is secure - nobody can evict me - and I'm financially secure. I constantly have to ignore my physical and mental health, because I so desperately need to get myself into a position where I can collapse in a heap and have a minor nervous breakdown.

Yes, I can do stuff like this - I can save myself; I can come back to life; I can return from the brink of destitution and make it look very easy.

It's not easy.

Tags: #homeless #addiction #drugs #bipolar #mentalhealth #suicide

This is a story about justice...

If you're a self-righteous twat and you're a privileged and entitled member of the guardian class, then you snobbily and sneeringly believe that you're in the right on every matter. Surrounded by sycophants and a society that worships you because of your social status; your kindly-call-me-God job title, you expect people to drop to their knees and kiss your arse.

Most ordinary people have the support of their families. Most ordinary people are well established in their careers and at their place of work, with their colleagues. Most people have a group of friends who they see and communicate with regularly. Most ordinary people are well established in the real world.

When you get tarred with the 'mad' brush, people who don't even know you can start being dreadfully patronising. "Have you taken your medication?" and "do you think you should up the dose?" and "are you having an episode?" people will ask, instead of talking to you like a normal human being.

Example:

Me: "Ugh! This cup of tea tastes disgusting! You've put two spoonfuls of salt in it instead of sugar"

Patronising twat: "<aside> awww bless, he's having an episode. Better get him to the doctor and get his medication increased"

You can't argue with a twat like that. If you tell the twat to taste the tea, which obviously contains two spoonfuls of salt, then they'll be evasive and blame the victim. It's a horrible way to treat people.

Thus, social media is needed to arbitrate in instances where a vulnerable person is being mistreated. By calmly presenting the facts on social media, a jury of my peers can decide, instead of some smug arrogant guardian-class twat, who thinks they're right about everything, even in the face of overwhelming evidence to the contrary.

Social media is the best place to go when you're alone and isolated, because you can crowdsource support. Instead of getting wound up by those who hold themselves to be immune from criticism, and incapable of making a mistake, engaging the power of social media can hold a twat to account.

I'm really pleased that there's an immutable permanent record of everything I've had to put in front of a jury of my peers. I'm glad to have the record of what the crowd thought. I'm glad that everything is stored for posterity. I'm really grateful to have this antidote to the patronising smug twat who thinks they know best.

I've made mistakes in the past, putting stuff in emails and on Facebook restricted to my close friends. I've made mistakes when I've been extremely unwell. However, on balance, using social media and public scrutiny as a means of holding a twat to account has been a staggering successful strategy for returning myself to health, wealth and prosperity.

Very few people could have survived the destitution and stress that I've been through, with only a few people fighting my corner. I'm lucky enough to have some very loyal friends who I love dearly, but they're spread all over the country and the world. I've almost exclusively turned to social media when I've needed support the most, and social media has delivered.

I've been feeling pretty lonely and isolated and low over the last few weeks, but I've had a great response on Twitter, which has really boosted my spirits. I'm glad to have connected with so many lovely people via social media. I really depend on my social media friends, when I'm having a bad time.

So, in the case of the Twat vs. Social Media, very clearly the online crowd are the winners.

Tags: #socialmedia

This is a story about borderline personality disorder (BPD)...

If you've ever wondered about being detained against your will in a mental hospital - on a locked psych ward - then this is how it all begins... a 'section'. Being 'sectioned' means you're being legally detained under a section of the Mental Health Act (1983). The police can section you for 24 hours under section 136 of the Mental Health Act. After an initial assessment you might be sectioned for 28 days, under section 2. If you're assessed again you might be sectioned for 6 months, which is section 3. As you can see above I was sectioned under section 2.

I've been diagnosed and treated by 13 different psychiatrists. I've spent 10 weeks under lock & key on psych wards and a total of 18 weeks as an inpatient, receiving treatment for my mental health problems.

All the psychiatrists agree: I have bipolar disorder.

One unqualified doctor has been so bold as to ignore the fact that they completely failed their psychiatric long case, and ignore the fact they're utterly incompetent when it comes to making a sound mental health diagnosis. This unqualified doctor apparently read a book about borderline personality disorder and then tried to diagnose me, despite their obvious shortcomings and prior failures in the area of mental health. That pissed me off. That idiot doctor ignored all the years of evidence and the unanimous opinion of 13 specialist highly experienced and fully qualified psychiatric doctors, because their ego is over-inflated, and frankly, they're a bit of an idiot arsehole.

So. I have bipolar disorder. That's beyond question - it's been confirmed and reconfirmed. I've had a second opinion. I've had a third, fourth, fifth, sixth, seventh, eighth, ninth, tenth, eleventh, twelfth and thirteenth opinion.

I did not ask for a fourteenth opinion.

In fact, I made it expressly clear that I DID NOT WANT another opinion... especially one from an unqualified doctor who skim-read the first few pages of a book. Especially an opinion from somebody who I think lacks empathy and compassion for vulnerable people. People with mental health problems aren't safe around that unqualified doctor, who doesn't seem to have taken on board the fact that they failed their psychiatric long-case and are therefore unqualified to be practicing psychiatric medicine.

Furthermore, when we are thinking about a borderline personality disorder diagnosis we have to consider co-morbidity.

If a person is under a great deal of stress due to housing, job, finances, relationship and other external influences, it is not possible to diagnose borderline personality disorder, because of the co-morbid adjustment disorder. Adjustment disorder is just a fancy way of saying "your life is hell right now". Naturally, it's not possible to unpick mental health problems from the stress and anxiety that anybody would be feeling when their life's in tatters.

Just as a little reminder... I'd been through a breakup with my girlfriend, had to leave my apartment in London, move to Manchester, start a new job, I broke up with another girlfriend, tried to kill myself, lost my job, lost my apartment in Manchester, moved to Wales to live with strangers, ran out of money, got another job, went to Warsaw, went back to London and ran out of money again. That is more than enough stress to give anybody adjustment disorder, making any new diagnosis impossible. There is too much co-morbidity.

Also, when alcohol and drug abuse are co-morbid, diagnosis is impossible. This does present a bit of a paradox, because alcohol and drug abuse are quite often present in cases of borderline personality disorder, but they are also very often present in bipolar disorder too. There's a specific diagnosis for that co-morbidity: dual-diagnosis.

I know a lot about dual diagnosis because I spent 4 weeks in hospital seeing the country's leading specialist almost every day, and I continued to speak to that specialist regularly for a long time after I was discharged from hospital. While substance abuse was a problem in my life, my diagnosis was quite clear: dual-diagnosis (bipolar disorder & substance abuse disorder).

Finally, we must consider loss of status.

There are excellent data showing that loss of social status causes emotional instability. If you think about it, it's pretty obvious. Imagine that you lost your wife, your kids, your job, your house, your car, all your money, the respect of your friends & family... do you think your self-esteem would be intact? Do you think you'd be fine with that and you'd be carrying on with your life like normal? Of course you'd be emotionally unstable - it's a normal human reaction to that devastating loss of social status. You can't just say "it's just stuff" because it's not - it's intrinsic to your identity and your sense of wellbeing.

It's not possible to diagnose borderline personality disorder - also known as emotionally unstable personality disorder (EUPD) - when there are concrete and undeniable external factors that would contribute to a person's loss of self-esteem, social status and consequently make them emotionally unstable. It's simply not an appropriate diagnosis for somebody whose whole life has collapsed and is in ruins.

The arrogance of Dr Death to attempt to give an unwanted and unqualified fourteenth opinion, ignoring the unanimous verdict of thirteen highly qualified and experienced specialist doctors, is highly offensive and antagonising. This opinion was aggressively thrust upon me when I made my wishes crystal clear: "do not diagnose me, Dr Death, because your opinion is worthless unqualified irritating tosh that will only upset and anger me". The fact that Dr Death proceeded to do what the f**k they wanted anyway only serves to further prove how arrogant and lacking in any compassion they are... this is a person who's not even my doctor.

So, please don't play pretend-psychiatrist and give me your amateur diagnosis... I've spent 10 years in and out of the mental health system, and I've done extensive research of my own. Shove your crackpot theories about me up your ass.

I dearly wanted to get to the point where I've been symptom-free and medication-free for long enough to declare I'm 'cured' but for now I reluctantly accept the opinion of 13 very experienced and qualified specialist psychiatrists, who are experts in their field and highly respected. I accept their opinion - that I have bipolar disorder - and I reject f**king idiots who skim-read a few pages of a book and hardly know me. F**k off Dr Death.

I was disappointed to learn that I probably have type 1 bipolar disorder, not the milder type 2 that I thought I had, but I've had 6 months without medication and without an episode, so I seem to be managing the illness very well, especially considering the fact that I've moved 4 times, been in hospital twice, attempted suicide once, had 3 jobs, been through 3 countries, bought a car, narrowly escaped bankruptcy three times and finally managed to rent a new apartment and have a healthy happy relationship with a lovely girl. I mean... sheesh... that level of stress would send anybody insane, wouldn't it?

So...

I have bipolar disorder. That's it.

Tags: #bipolar

This is a story about self-medicating for anxiety with wine...

I keep my empty wine bottles behind the kitchen dustbin. The collection of bottles waiting to be recycled has grown very quickly, given that I've been polishing off at least a bottle of wine every day for months. Wine has been my unhealthy coping mechanism. Wine has helped me to get through 4 solid months of work, living out of a suitcase, dating, courting, buying a car, renting an apartment, moving home, two different jobs, three different countries, 12 AirBnBs and countless other anxiety-creating things.

It should be noted that during the last 4 months, I also quit a neuropathic painkiller called pregabalin, and a sleeping pill called zopiclone. The net result of quitting those medications was a vicious rise in my anxiety levels, as a result of the rebound from stopping taking them: withdrawal syndrome. It's hard enough to get off pregabalin and zopiclone under normal circumstances, let alone when you have huge upheaval and stress in your life.

A little over 6 months ago, I quit diazepam and alprazolam, which are both anxiety medications. They're better known as Valium and Xanax. They're highly addictive, and stopping them can cause a discontinuation (withdrawal) syndrome that can last for months and create unbearable anxiety levels.

So, the circumstances have created a hell of a lot of anxiety... a ridiculous amount of anxiety.

Alcohol has helped me to wean off the addictive medications and become medication-free. Alcohol has helped me to cope during incredibly stressful times. Alcohol has been my anxiety medication, during a time when my stress and anxiety levels would be unbearable for even the toughest person.

The ubiquity of alcohol is about the only good thing that can be said of it. Alcohol's effects are short-lived. Alcohol is a poor sleep aid. Alcohol is very unhealthy. However, it's not desirable to take benzodiazepines, Z-drugs and painkillers on a long-term basis, because they all quickly build tolerance and require a bigger and bigger dose to be effective. Valium also has a very long half-life, so you are affected by it 24 hours a day once it reaches a steady concentration in your bloodstream. At least with alcohol, you sober up pretty fast when you stop drinking.

The body's ability to eliminate alcohol is very impressive. Tonight is my third night without a drink and I've suffered no ill effects from abruptly stopping my daily boozing. It would be expected that I might get the shakes or something, given my chronic self-administration of large quantities of alcohol over a long period, but that's simply not the case - I just stopped and I'm fine.

My sleep was a little disturbed last night. My body and brain are re-adjusting to life without copious amounts of wine being tipped down my throat. I'm not feeling the benefits, and if anything I'm feeling a little worse than I was when I was drinking every day. That's to be expected: my body's repairing itself. The booze has been very hard on my body.

I've gained weight and I just feel unhealthy from a winter of misery, where I drank vast quantities of wine. I really need a mini-detox. I thought about having a sober April, but I don't see the point. Drinking in moderation is what I'm aiming to do, so I'll have a little break and then I'll try to drink less.

Having a break from drinking is important, because I need to get into better drinking habits now that the shitstorm of stress has passed. There was no way that I was going to be able to do anything healthy while I was still heavily dependent on alcohol as a crutch, during a really horrible period of my life, but now things are improving and my life is a lot more manageable.

Perhaps I'm one of the lucky ones who can take it or leave it. Perhaps I'm just normal - I'll use whatever's available and my behaviour is dictated by my environment. During stressful times of course I'm going to hit the bottle. During happier times, of course I'm able to make healthier lifestyle choices. Seems obvious, doesn't it?

So, alcohol's not great, but it's not all bad either. It helped me get to where I've got to today.

Tags: #alcohol #anxiety

This is a story about a sick man...

I didn't drink last night or tonight. I've stopped taking sleeping pills. I've stopped taking anxiety medication. I've stopped taking tranquillisers. I've stopped taking sedatives. I don't take antidepressants. I feel very unwell.

I woke up and I thought about getting some rope and going to find a tree to hang myself from. I've not really thought about hanging much, but it's been on my mind. I think about a last minute change of heart, where I might try to take the weight off the noose, but it would be futile - I would try and I would fail. I think about the uncomfortable final couple of minutes, where I'd be panicking as the hypercapnic alarm response would make me thrash around, trying to get air into my lungs. Hanging would be a brutal way to die, because I imagine that I'd be conscious for quite a lot of it, then I'd lose control of my bowels and some poor sod would find me strung up with soiled underwear. Somebody would have to cut down my lifeless body. Anyway, that seemed like one of the options this morning.

This should be a happy period of my life. I'm not homeless, I have friends, a girlfriend, money and a car. I'm not a drug addict. I'm highly employable. I have my physical health, mostly. I've got a local job which is very well paid.

What's going on? Why am I so depressed?

I'm trapped. I can't go backwards. I can't stay still. I can't go forwards. I need to keep moving forwards, but I've run out of rope; I'm at my wits end.

I should have taken some time off in-between the last job and the new one, but that's not the way things worked out. Make hay while the sun shines, they say. Don't look a gift horse in the mouth, they say. Somebody opened a briefcase of money, tempting me with it, and it seemed like a good idea at the time. It is a good idea. It's a really good idea to have a really well paid job that's a short distance away from where you live. The problem is, I've got nothing left to give.

I can't fail. I can't falter. I have to succeed. I can't go back. I can't stand still.

I'm so desperate to feel better, but I know that the answer doesn't lie in pills. I know that to take antidepressants would send me manic. I know that pills aren't the answer. I'd love to feel a bit better though. My bank balance would love me to feel a bit better. It'd be nice if I didn't keep writing things that worry and upset my friends and girlfriend. Such is life. These are the cards I've been dealt.

What's important to me? It seems like it's all about work and money, but that's a good place to start. Without work and money there can be no future. Without a future there's nothing to hope for - I might as well just give up. This is the strange situation, where work is making me unwell, but without work I'll get unwell because I'll get into financial difficulties and I'll have nothing to look forward to except bankruptcy.

Just a little bit longer... if I can just work for a little bit longer...

How much money did I lose in January and February to ill health? Was it £10,000? What does it matter? I worked as hard as I could.

I've managed to buy a car. I've managed to get a local job. I've got a girlfriend. I've got some money in the bank. These are major milestones; major achievements. Things are looking up in my life.

I need to impress some new people; prove myself. I've got a new routine to get into. I've got a load of new stuff to learn, and not the fun kind of learning - this is stuff I'm expected to know already. I've got to give a good first impression - I can't turn up to work hours late every day; I can't let on that I'm not very well.

I'm sick but I can't afford to be. I'm sick but there's too much at stake. I'm sick but I don't want to lose the amazing opportunity that's fallen in my lap. I'm sick but my life looks perfect in a lot of ways - why am I sick?

I don't want to accept that I'm sick but the anxiety and depression are unbearable. It's enough to drive me to drink, drugs and/or suicide. I want to run away from the source of stress. I want to hide under the duvet for a couple of months. I need to recover but I can't - there's too much work to do. I need time off but I can't afford to lose everything.

I'm the epitome of functional. I'm getting up and doing the things I need to do, even though it's destroying me. Somehow I keep putting one foot in front of the other. Somehow the things that need to happen keep happening. I'm keeping the plates spinning even though I'm sick. At times, I'm quite happy and contented. At times I'm a picture of good health and carefree joy.

I've worked hard - even if you don't think I have - to give myself some easier times. I've put up with horrible situations because I knew they'd pay off in the end. There has to be some reward, otherwise it wouldn't have been worth the stress and aggravation at all. It would be a lie to say that my life is purely miserable. Misery kind of stalks me though - I know it lurks just around the corner at all times.

"Cheer up... it might never happen!" somebody might say, but I really wish it would happen, because I can't stand the constant anxiety. I can't stand the fact that it is happening, and I know exactly how long it's going to keep on happening for because it's not very difficult to work out such things. I know exactly what to expect. I know exactly the way things are going to go. I know exactly what has to be done. I know exactly how awful it's going to be.

My mood would be a lot better if I could abandon all responsibilities and follow my mood. I know that time passes incredibly slowly when I'm having to kill time and suffer horrible periods with nothing to do at work. I know that it's incredibly toxic to my mental health to be solving the same problems I've done a million times before, but with a load of constraints that artificially limit me from being able to work and occupy myself - to keep myself busy. I know that isolation - working alone - is really unbearable. The last place on earth I should be right now is twiddling my thumbs, bored but chained to a desk with nothing to do and nobody to talk to.

I'm going through a difficult transitionary period. I should have taken some time off. I'm emotionally exhausted. I'm trying to switch mindset, from the isolation of the last job to the possibilities of a new opportunity. I know that I need to give it a few days, or a couple of weeks, to get settled.

Everything's so stressful and unsettled. I've got a new commute to get used to. Somehow, I've got even less of a home than I did when I was living in AirBnBs. I can't get changed. I can't have a shower. I can't take a shit. I can't make myself something to eat. How did I end up like this, with a stressful job and no place to call my own... no bedroom; no privacy. It sounds ungrateful, but it's just a description of my current situation, at times. It could be worse, perhaps - I could be homeless; destitute. I could be additionally isolated and lonely, living alone. It could be worse... it could be worse... it could be worse. There is gratitude, but there is also a heap of stress and anxiety that's beyond what I can cope with. I am grateful, but I'm also struggling.

What do I want? Do I want everything to be perfect right now? Do I want easy solutions, like swallowing pills? Do I think somebody should gift me everything I need, all wrapped up with a bow? Do I expect somebody to just give me the keys to a place of my own and wave a magic wand to move all my stuff? What about friends? Should I just snap my fingers whenever I need them, and snap them again when I don't want them around?

I don't know about any of this stuff. All I know is that I woke up and I thought about finding some rope and a tree to hang myself. I thought about walking out of the perfect opportunity that's fallen in my lap. I thought about letting everything go to hell in a handcart, because I've reached the end of my tether. I don't know why I think this stuff. Maybe I'm a bad person. Maybe I'm an ungrateful little shit. Maybe I should just fuck off and die.

I don't know what I'm going to do. I'm going to have another alcohol and sleeping-pill free night and hope that these awful feelings subside. I'm going to hope for a better day tomorrow. I'm going to grab my black holdall and take the show on the road.

I'm sick, but do I have to be? I think I know where the problems are. I think I know the solutions. I know that nothing's going to be perfect. I know that life is full of compromises. All I can think to do is to keep trying to set things up so that the very least number of things are causing me distress. I keep reducing the number of things that are unpleasant and broken, in the hope that at some point things start becoming a bit easier, because at the moment there are too many times when life's unbearable.

Maybe I need to quit drinking. Maybe I need a drink. I don't know. Too much change and too much that's unsettling. I've lived out of a suitcase for far too long.

Yes, underlying mental health problems are the obvious thing to point to, but what's the solution? Of course the little bit of me that's got some survival instinct left thinks that being medicated up to the eyeballs, living in a council house, supported living or institution is preferable to death. Is being alive without dignity or hope preferable to this life that's a fate worse than death? Isn't it all the same anyway? If the rewards aren't there and the suffering is unbearable, why bother?

I managed half a day in my new local job, and I felt sick, sick, sick.

Maybe tomorrow will be better. If it's not, I don't know if I can carry on.

Tags: #suicide #career

This is a story about a functional nervous breakdown...

I'm sleeping 12 to 14 hours a day, yet I don't feel refreshed. I'm commuting and I'm working, but I'm spending less than half as much time in the office as I'm supposed to, and when I'm there I'm not productive. I reach the weekend and all I want to do is collapse in a heap. I get stressed out about seemingly trivial things - buying a train ticket, booking a hotel, buying some birthday presents, social engagements, the pressure to be a good friend, the need to stay in contact with people. I feel like I'm going to burst into tears when I'm in the shower, or just before I walk into the office. I'm a complete wreck, but to an outside observer I'm a picture of good health and a productive member of society. My colleagues seem to have been duped - they compliment me on the work I've done and they want me to stay longer; they want to give me another project to do.

I had prepared myself psychologically for 6 weeks work in London, but it's been 3 months. I had prepared myself psychologically to get to the end of the contract, but not a single day longer. I'm barely managing to cover up the fact I'm very sick - I arrive in the office at 1pm most days, and leave just after 5pm. I don't turn up for whole days. I sit at my desk endlessly skipping through music, trying to find a song that will lift my mood, but I can't. Life's pretty torturous, even if there doesn't seem any reason why it should be.

Everything feels like it's going to require the expenditure of more effort and energy than I could possibly muster. I get exhausted at the thought of speaking to agents, or challenging myself to do something "new and interesting". What sounds like fun to you, is something that makes me feel even more anxious and depressed. I just want to curl up in a ball.

Those who are happy and healthy say things like "you're only one gym workout away from a good mood" or they suggest things I could do with my spare time. It doesn't look like much of a life, working and sleeping... oh I do quite a lot of moaning and complaining too, but surely I must want to learn to weave baskets or dance salsa, mustn't I? The truth is that I'm 99% shut down - I'm in survival mode, clinging on by my fingernails as I attempt to earn as much money as I can, as quickly as I can, so that I can afford to have a nervous breakdown.

"Nervous breakdown" sounds really shocking and alarming, but I'm actually quietly having a breakdown. I've had persistent paralysing depression for more months than I care to remember, but I'm somehow forcing myself to keep going. "You can't be depressed if you're getting up and going to work" you might say, but you seem to have forgotten that I'm bunking off loads of days, and going in to work 4 hours late on the few days when I do make it. I'm working the very bare minimum I need to, in order not to lose my contract. If I just collapse in a heap and refuse to leave my pit of despair, I lose everything. If there was any way in the world I could just draw the curtains and convalesce, then I'd do it, but I'm trapped by circumstances beyond my control.

I have a week and a half left to go, and then I've finished my contract in London. I have to do 4 more 3.5 hour train journeys. I have to stay in two more AirBnbs. I have to suffer two more Mondays (although I'm planning on bunking off at least one of them). It might not sound like very long - just 3 months - to have been travelling all over the place and doing a job that's been mostly isolating and lonely, and has left me twiddling my thumbs a lot of the time, but the time has really dragged... the time continues to drag.

When you're not feeling good, it really takes an emotional toll. It's really not nice to spend weeks and months, hating your life; hating your circumstances. Yes, I'm very well paid and there's no such thing as a perfect job, but the money really has not been great compensation for the psychological suffering it's caused. I'm perfectly capable of making a mercenary decision to earn a lot of money doing things I don't like doing very much, but it's damaging to my mental health. I really am at my wits end with the London contract.

Who knows what'll happen next. Maybe I'll have been made too unwell by the present contract to even think about the next one, until I've had some rest and recuperation time. You might think that I should be very well rested, because I've been having 3-day weekends and only working half days, but those things are a symptom of just how exhausted I am. It's very hard to explain how I'm emotionally exhausted, even though I seem to be physically rested. It's hard to explain just how draining things have been this year. Seasonal affective disorder, depression and a bit of residual rebound anxiety from medication withdrawal, have conspired to create a viciously awful low mood and sense of despair, which has been hugely exacerbated by being bored at work, with no colleagues to talk to or project to keep me busy.

Finding a new client locally is going to be stressful. I need to meet a whole load of new work colleagues and impress them. It's going to be exhausting. It's going to be destabilising. At the moment, I just want the current contract to be over, so I can curl up in a ball and not leave the house. I want to draw the curtains and turn off my phone. I want to collapse in a heap and yell "ENOUGH!"

It sounds to me like it's some kind of breakdown, but I don't understand why I'm still apparently quite functional. I don't understand why I'm not stripping naked and running through the streets, before smearing jam all over myself in the supermarket and talking in tongues, or whatever other image "nervous breakdown" conjures up in your mind. Perhaps you think of me uncontrollably sobbing, or going mute. Instead, I'm just kind of hollow and empty - I've got nothing left to give; the petrol tank has run dry.

The challenge, of course, is what I do next. Do I collapse and become so dysfunctional that there was no point in exerting myself? Do I lose all the gains that I've managed to achieve, because it was so costly to my mental health to push myself so hard? Have I stored up some kind of almighty breakdown, by limping along for so long?

I've been offered a contract extension. There's no way on earth I can do it, of course. Don't you understand? The money might be incredible, but I don't get paid if I'm not in the office, and I'm already almost at breaking point. Money's not going to get me out of bed. Almost no amount of money is worth the emotional damage that's being done; the emotional exhaustion of the situation.

Of course, there's an argument that I should have just taken medication to prop myself up artificially - to allow myself to be doped up and carry on with a job and a situation that's intolerable. There's an argument to say that it's me that's faulty, for not enjoying living out of a suitcase, working a project that I finished ages ago and just having to look busy, in an office all on my own with nobody to talk to. There's an argument that says it's me being a silly billy, and I should just pop pills and shut the f**k up and get on with life. That's life, right? Life absolutely sucks and it makes us want to kill ourselves. Life destroys every single ounce of happiness and wellbeing, and the only way to put it back is with powerful psychoactive medications.

On the flip side, I've been glad that I've kept my mouth shut and limped along to the end of contracts before, without making too much of a fuss. I'm going to get a good reference and I've earned quite a lot of money. This is the strategy: short-term pain for medium-term gain. I've left jobs on good terms before, and then found it's immensely improved my mood to free... free to do what I want; free from the oppression of a horrible job. I very much expect that my mood will improve massively when this contract is over.

There it is: I need to keep venting and complaining and whinging, because I've got another week and a half of hell to get through. It sucks, and I bet you wouldn't put up with it if you were in my situation.

Tags: #career

This is a story about being bloody minded...

I've been subjected to the most bizarre accusation: That I can "get better" anytime I want; that I enjoy being depressed or somehow need to have a mental illness because it's part of my identity; that I want to be unwell. Part of the accusation hinges on my Twitter following - I'm accused of being two-faced: Writing blog posts and tweets which don't somehow manage to convey that sometimes I'm not suicidal.

I'm a bit confused to be honest. I don't think I could be any more authentic. I don't think it would be possible for me to be any more candid and open. My blog isn't supposed to be a diary, accurately recording the day's events. My blog is therapy for me - I write about the things that are upsetting me the most; the things that are causing the most pain and anguish.

Perhaps I'm being given credit where no credit is due. Perhaps I'm perceived as intelligent enough to be able to rationalise away my problems and force my moods to bend to my will. Perhaps the decisions I've taken out of desperation have been mistaken for choices. Perhaps my determination to stick with a plan which will boost my finances and continue to give me a lucrative career, is seen as deliberate self-sabotage: I'm purposefully making myself sick, in the eyes of my accuser.

I can see the positives and the negatives of different "choices" without assistance from somebody else to help me 'see'. I'm not so cognitively impaired that I need somebody to point out the bleedin' obvious to me. For everything that I moan about because it's making me ill, there are many benefits which make my choices worthwhile. My work, travel and living arrangements are not conducive to good mental health, but neither is poverty and hinderances that would make me less employable. The playing field is not level. I do not get to make unbiased choices - I've got to do what I've got to do, even if it's unpleasant.

I'm accused of being the problem. It's not the job, it's me. It's not the commute, it's me. It's not the lonely AirBnBs, it's me. Apparently, everything's all my own fault and I can choose to be healthy and happy any time I want, according to my accuser. Personally, I think that life's a lot easier when you've got money behind you and you've got a stable home life. Personally, I think that we are healthier and happier when we get the pieces of the puzzle in place: friends, family, a home, an income, financial security and something we're passionate about. Let's leave aside the blame game of how I ended up in the present situation. We can even assume that everything's all my fault if you want to, but that doesn't change the fact of the matter: I am where I am and I need to get back on my feet. Blame doesn't change my needs. Blame doesn't change my situation or my mood. To accuse me of fucking up my life AND deliberately keeping it fucked up is dumb. One of the big reasons why I'm suicidal is because I've tried so hard to fix the things that are broken, but it's been a miserable exhausting experience and my life's still pretty messed up. I really am trying very hard to get things sorted out. It's a lot easier said than done, I'm afraid. Sorry about that.

I think there's a lot of ego involved. People want to be helpful, but then they start thinking like they've understood me and I can be 'cured' with simple solutions. When the simple solutions to an oversimplification of my problems don't work, then the 'helpful' people get annoyed with me... like I'm deliberately messing up their useless suggestions. I seem to have really frustrated my accuser, that I'm so determined to be a real living person, with a real life, instead of some simple little thing that can easily be fixed. "Oh I'm so silly! How brilliant of you to point out the completely obvious solution to an easy-to-solve problem that I don't have! Thank you!" I'm expected to say all the time, on top of dealing with real life.

There aren't any quick fixes. Things take time and effort to get better, and it's exhausting. Things have to be done in the right sequence. Sometimes, it costs a lot of money to make changes. Sometimes we have to wait for the things we want and need, because we can't get them immediately. I can't - for example - switch jobs until I have a financial cushion to give me some runway to make the change. Every change I make brings with it a whole new set of problems, so I need to deal with things in a step-by-step way. There's a plan, even if somebody thinks that I can just teleport straight to the end goal. Sadly, life doesn't work like that - we have to suffer in the short and medium term, to achieve our long term objectives. You have to pay to play.

I'm not short of ideas for what to do when I have surplus time and money. I'm not short of ideas of what I'd do if I could do anything, because money's no object, but it's bullshit to suggest I'm able to just abandon my current source of income and go off and do something else. I can't be a student again. I can't be a poet or a dog walker or a sculptor or a circus clown. Life doesn't work like that. Even if I took a shitty McJob, I would still need to afford to travel to work every day for a month or so until I get paid. How do you think capitalist society even works? I'm making smart economic choices which are painful at the moment, but will give me the financial means to pursue something more rewarding and better for my health. I'm giving myself the working capital to be able to pick and choose my next options.

I might have spent some of today playing like a big kid and enjoying myself, but that doesn't mean that my mood can't be plunged dangerously low when reality bites: Monday morning will come around, along with the realisation that almost nothing in my life is quite where I want and need it to be. There's so much unpleasant hard work ahead, and so little reward in the short term, that it's quite understandable that I'd get worn down and decide to reject life altogether. What looks like a few short months of hard work to you, is somewhat of an insurmountable obstacle for me, because of the journey I've been on. I've fought my way back from nothing, and I'm still fighting, but yet it feels like I'm getting nowhere. Where's the reward for my effort? Why is life still so miserable, most of the time?

In the company of my friends, or going on a date with a girl - for example - life can briefly seem wonderful, but the bulk of my existence feels like packing and unpacking bags, moving from place to place, sitting at a desk and hating every second... unsettled and unpleasant. The dread of the rat race - the treadmill - is enough to cast a dark shadow over other times. When I should be enjoying the last few hours of my weekend, I'm already depressed about another week shackled to the job I do out of economic necessity. I make a fuss, but it's not over nothing and it's not me. I'd pick up dog shit if it paid as well as my current job... at least it would feel like I was making a real tangible difference to my local community, if I was doing something like that.

There are a whole raft of issues at play, including my desire to be free from medications. It might seem obvious that my depression could be 'cured' with pills, but it wouldn't be a cure - my depression is a reaction to my toxic circumstances. I don't want to become medication dependent, when I've worked so hard to wean myself off so many different pills. I'm quite close to being 100% substance free.

I want to plan a holiday. I want to buy a car. I want to dream, but dreams require money. The dreaming part is the easy bit. Life's a lot more complicated than it seems for a casual observer. It's easy to come up with a million "you should do..." ideas, but they're infeasible if you don't have the time, money, company, energy, motivation and a million other things that are the product of getting some building blocks in place: a home, a girlfriend, some friends, a tolerable job, some money in the bank, disposable income etc. etc.

There are myriad broken things in my life, and no quick fixes. If I haven't fixed something yet, it's not because I want it to be broken. I'm not choosing to be depressed. I don't want to be sick. I'm perfectly capable of imagining a life that would be healthier and happier, but it takes time, money and energy to make it happen.

Moaning on my blog is what I do for therapy. Moaning on my blog is what I do, because it's cheap and it helps me to limp along while I'm getting the cash together to be able to do whatever I want to do next. Moaning on my blog is not my identity - it's my outlet because there isn't any other healthy way to cope. I'm trapped by circumstances and there's no escape, except through the path I've "chosen". I do not choose to be depressed, miserable and suicidal.

I don't know why I'm accused of being the architect of my own depression, when I'm working so hard to fix my life. The accusations don't even make any sense - they just seem to be an egotistical version of "have you tried being more simple so that I can solve the problems that you don't have?" and "have you tried being me instead of you, because I think I'm great?".

I've exhaustively documented the challenges that I'm facing. It upsets me that somebody would want to oversimplify things, just because of their own ego and a desire that I should blame myself and generally feel like I'm lazy and stupid, despite the fact that I HAVE TO LIVE 24 HOURS A DAY WITH SUICIDAL DEPRESSION and I'm the one who does all the actual hard work fixing my life. Pointing out the blatantly obvious is not a hard thing to do. Leaping to incorrect conclusions is not a hard thing to do.

There is a prerequisite condition for having an opinion on "what's wrong with me" which is to have read what I've written. If you want to know what's wrong with me, I've exhaustively documented everything I'm going through right here. If you want to tell me what I should and shouldn't do with my life, it needs to take into account the reality of my day-to-day existence, which I have accurately explained the most challenging parts of on this blog. If you want to give me "you should..." type instructions, then they need to be grounded in reality or else I'm just going to ignore them. Please don't get upset when I ignore your unhelpful suggestions. Please don't accuse me of wanting to be miserable and depressed.

I've written more than I intended to. I'm wondering why I'm writing. What's the point? But, that's what this blog is. It's not an attempt to manipulate sympathy out of my audience. This is a living document that records my distress in unflinching detail. This is where I pour out all the stuff that's really upsetting me. Here's where I work things out that are going round and round in my head. This is therapy for me.

One other accusation that I've faced is that my blog is making me sick - my blog is causing me to get stuck, ruminating on things that I'd otherwise let go. I think that's bullshit. My blog is where I've been able to finally let go of things that have been upsetting me. It's taken a long time, and I've repeated myself A LOT but that doesn't mean it's not working. If you take a lazy glance, you might think that I always write about the same stuff and that I'm therefore stuck in a rut, but if you look at the full story, you must surely see that I've been through some pretty traumatic stuff and this blog has helped me to cope. Writing is my healthy coping mechanism. People don't often pull through the things I've been through, and go back to being healthy happy productive members of society. I give credit to this blog for allowing me to deal with things that would otherwise have caused me to lose my mind.

I could probably edit this down, or just delete it and rewrite it, but I'm going to publish it because I want the public scrutiny. I want to document what I'm going through. I want to capture a piece of my consciousness, without censorship.

Yes, I'm lashing out, but I don't deserve to be accused of not helping myself, when I'm working so hard.

Tags: #writing #suicide #depression #mentalhealth #bipolar #friends #family