This is a story about unintended consequences...

The UK's notorious tabloid rag, The Sun interviewed a grieving father & husband and quoted him as saying "I should never have let the bastard near my family" with reference to a homeless man who had been taken in by his wife. The British press variously reported that the woman - later murdered by the homeless man she'd tried to help - had given "her husband's dinner" to her killer, who also killed her son and badly injured her husband.

Quite unbeknownst to me, this news story had received widespread coverage at exactly the same time as I was taken in by a Good Samaritan - what risk, one wonders, to her children & husband if this is any kind of precedent?

Scanning the column inches for similarities between myself and the perpetrator of the double murder, the newspapers reported mental illness and drug abuse. My Good Samaritan collected me from a secure psychiatric institution on the day when the crescendo of media coverage reached its peak. During the car ride to the family home I explained that I had seen illegal drugs used by my parents on a daily basis, and we agreed that to do that in front of children is not normal, right or proper.

Perhaps my gracious hosts have been hoodwinked. Perhaps I have fabricated a story about my sweet innocence and a set of unfortunate circumstances that have come about through no fault of my own. Given the extraordinary amount that I have written, it seems like a rather elaborate ruse, to write extensively about my chequered past, even when it has clearly caused me more harm than good. Is it not true that I've left my readers in no uncertain doubt about my every misdemeanour?

Further digging through the archives of the internet, I found a newspaper which reported that the aforementioned homeless murderer had been diagnosed with borderline personality disorder (BPD). BPD was casually tossed into the mix by one psychiatrist that I met, as a possible additional diagnosis for my own mental health problems. The only official diagnoses I've received are clinical depression and bipolar disorder, but adjustment disorder also featured in some of my recent paperwork, although this did not appear on my hospital discharge summary.

I'm mindful that further comparison is not at all useful, and I find myself to be extremely stressed about what the kind family who has taken me in, might think about the fact that this matter has been on my mind. When I read the grieving husband's words "I wish my wife had never set eyes on him" I do worry that I never asked my own Good Samaritan "what does your husband think?" but then wouldn't the atmosphere now be a little strange if the reply had been "he's got some reservations"?

I would say that I have never searched my soul for any kind of malice, as extensively as I have done knowing that I would be residing under the same roof as a happy family with several kids. If I had the slightest suspicion that my behaviour could be erratic, then I would not find it conscionable to expose a family to any danger that I might pose.

That said, I'm aware that bonding with the family is taking place. I'm still deeply troubled by almost unbearable levels of anxiety, and suicidal thoughts intrude whenever I consider what the future holds. I'm hopeful that my state of mind will improve when my medication changes are done. I am however mindful that in the worst-case scenario, I do pose a risk to my own life, and although I would put some time & distance between myself and the family, it would be incorrect to say that it would have no effect on them if I were to end my life prematurely.

The question of whether to accept help is as difficult as that of whether to offer assistance to those who are in need. I'm incredibly lucky to not only receive aid, but also to be able to openly discuss the obstacles and difficulties involved.

You may be surprised to learn that these 700 or so words are some of the most carefully chosen I have written, out of over 700,000. I have been shown a great deal of love, care, respect and trust, and this is why the anger, bitterness, rejection and hurt of the past, that usually flows out from me onto these pages, has been replaced with a daunting sense of responsibility towards those who I am now close with.

I'm going to publish now, because it's been agonisingly difficult to write this.

Tags: #homeless #mentalhealth #addiction #depression #suicide #family

This is a story about neurotoxicity...

What's happened to the left hand side of my face? My eyelid has drooped; my face is no longer symmetrical. Why do I have a facial tic? Why is my speech slow and slurred? Aren't these all symptoms of cognitive impairment; brain damage?

I decided to read back through some of my blog - I read from February through to June, when I was very unwell. I was surprised that a lot of it was gibberish - I thought that I had written with lucidity, but I had mis-remembered things.

As is so often the case with me, I dice with death and I dodge bullets. I'm still very sick, but I'm getting better. I'm going to make a full recovery. My speech is normal; my face doesn't tic and my eyelid no longer droops. The brain is a remarkable thing, but I do need to stop abusing my body.

A month ago I was livid; I was unbelievably angry. I was fighting for my income, my home and my liberty - I was fighting for my legal rights - and I was spitting venom; I was furious at being abused; mistreated; taken advantage of.

I re-read the lengthy blog post I wrote a month ago, which started OK, but then I got plunged into repetitive thoughts - you can tell that my brain was stuck on a loop and I repeated myself several times. It's surprising that I could express myself fairly well, given the circumstances. I imagine that it took me a long time to compose what I wrote, and I clearly struggled to remember what I'd written at the start, as I reached the end.

It's tempting to edit and airbrush history, but it's much more interesting to maintain a public record of exactly what I was thinking and feeling at a certain point in time. Inadvertently I also capture other details about my state of mind in the way in which I express myself.

I've now been writing for long enough to capture two periods of total abstinence from all mind-altering substances, including alcohol, caffeine and nicotine. I'm a lifelong non-smoker. I stopped drinking caffeinated beverages in 2013. During this particular period of abstinence, I've not drunk any alcohol for 35 consecutive days.

What's the net result of all this?

Nah, I'm only kidding... that was me when I was twenty years old. However, I'm sure there's been a marked improvement now that all the crap is out of my system.

A few friends spoke to me soon after I arrived on the psych ward. Although I sounded like my old self and I was in good spirits, my recovery was only just beginning - friends who see me and speak to me on a regular basis report that I'm much improved from how I was a month ago.

My hair, my skin, my nails, my teeth, my breath, my sweat and most importantly, my brain - all of these things are completely different, now that I'm not glugging gallons of booze and popping loads of pills.

I cringe with shame a little bit, to think that I made myself very exposed and vulnerable at a time when I was very unwell - the public got a little bit of a behind-the-scenes peek at me when I was extremely poorly. You can go digging in the archives, if it pleases you, or you can take my word for it: there's no surprises and there should be no pleasure in gawping at somebody when they're sick.

If we've not spoken for a while, I highly recommend that you get in contact and we actually speak on the phone - my email is nick@manicgrant.com. You might be very surprised to learn that your friend is in possession of most of his marbles, and not the raving lunatic that you might have guessed I would be, after such a traumatic couple of years.

Here's another one for the photo album, taken only seconds ago. My left eye is not yet 100% and I'm still suffering a lot of brain fog and other recovery-related problems - it'll be a month or two before I'm fighting fit. My face still tics when I'm stressed, but it's less pronounced.

I'm struggling with horrible anxiety, depression and confusion; memory problems. None of this is a surprise to me - it's to be expected, given what I've been through and I'm still going through.

I've got no idea what I'm really writing about, or what my purpose is now. Is this still the world's longest suicide note, or am I now campaigning to end the stigmatisation and discrimination that our less fortunate members of society must face: the mentally ill, alcoholics, drug addicts and homeless people... the dregs that nobody wants to touch with a bargepole. I know that I want to be the voice of the voiceless, although I know how clichéd that sounds.

I'm swimming through a fog of confusion, but I know I'm slowly getting better.

Tags: #mentalhealth #recovery

This is a story about pill popping...

If you're unfortunate enough to find yourself on a psych ward, you might be surprised to discover that you don't have a choice about whether you take your medication or not - you can be treated against your will. That's worth repeating one last time: you can't refuse your treatment.

At the moment, I'm effectively unmedicated. I'm taking pregabalin for neuropathic pain, but I'm reducing my dose by 50mg every 4 days, so I will stop taking it altogether in just 12 days time. I'm taking zopiclone for insomnia, but I will halve the dose in 7 days time and stop taking it altogether in 21 days time. Meanwhile, I've been taking a tiny dose of lamotrogine - just 25mg - which is too little for it to have any effect.

But, presumably I was on some heavy medications while I was in hospital?

No. No I was not.

Since the 9th of September 2017, I've stopped drinking altogether - I'm teetotal - and I've stopped abusing benzodiazepines (Xanax and Valium). I've also not taken anything other than pregabalin and zopiclone. It was less than 3 weeks ago that I started taking a tiny dose of lamotrogine, which is not capable of controlling any mood disorder that might be troubling me.

I must admit that I rather toyed with the poor psychiatrists who saw me. I casually dropped olanzapine and sodium valproate into conversation, and their faces lit up like a Christmas tree. My fellow patients were acutely unwell, and injections of Depakote - colloquially known as "depo" - were dished out to anybody who exhibited troublesome behaviour. It's a sad sight to see somebody who's just had their injection, shuffling along the corridor like a zombie.

Although strictly speaking this is not supposed to happen, I dictated the medication I wanted. My notes from my psychiatrist in London had not travelled up to the North of England with me, and my new doctor (General Pracititioner) knew nothing about me. The clinical team had to take my word as gospel.

I'm now wondering whether to be compliant with the medication that I decided I wanted, or not.

tags: #mentalhealth #bipolar #medication

This is a story about slipping through the safety net...

Exactly one month ago was World Suicide Prevention Day and exactly one month ago I was in a critical condition, on life support in intensive care. I was given a 50/50 chance of living or dying, following an overdose the night before. It seems sickeningly ironic that if the emergency services had reached me just a little bit later, I wouldn't be writing this. If I didn't live in the United Kingdom, where we have the best healthcare system in the world, I would probably not be writing this.

It was 9 years ago that I first sought help for my mental health. "Have you heard of fluoxetine?" asked my doctor, within 30 seconds of me explaining my symptoms: suicidal thoughts, low mood, low energy and an inability to get out of bed and go to work like normal. I was disappointed to be offered patent-expired generic medication, without a moment's hesitation. I walked away empty handed.

Clinical depression was where I started my mental health journey. Having the label "clinical" made a huge difference. To add that word - clinical - onto how I was feeling, was necessary to defend myself from anybody who might say "just snap out of it" or "pull yourself together". In my case, having a label was desirable - it wasn't an excuse; it was a diagnosis.

Every time I've gone to my doctor, I've been hoping to receive some counselling, but instead I got referred into psychiatric services as an outpatient in 2010. I was referred for Cognitive-Behavioural Therapy (CBT) treatment, but by the time I was assessed, my mood disorder had been diagnosed as type II bipolar disorder. The assessment concluded that my mood disorder was too severe to be treated with CBT. I was left with no psychological treatment. "What am I supposed to do?" I asked. "Go back to your doctor" came the reply. It was a devastating disappointment.

By 2011 I was so unwell that I was assessed under the Mental Health Act, to see if I needed to be detained in hospital - what is colloquially referred to as a "section". I begged to be hospitalised as I was suicidal. I repeatedly said the classic cliché that so many people will say when they are desperate for help: "I'm going to kill myself". Community Mental Health Teams (CMHTs), crisis teams and home treatment teams must hear those words so often.

With a shortage of psychiatric beds, there's a huge reluctance to "section" anybody. At the time of my first section assessment, my girlfriend and my dad were present, so the assessment concluded that I could be kept safe at home. In fact, I sawed a hole in the back of my shed, climbed over a neighbour's fence and ran away. The police were called to look for me because I was a danger to myself.

Soon after that, I was seen by a private psychiatrist, referred and admitted for 4 weeks of inpatient treatment at a private hospital. The cost was over £12,000.

There was some debate with my medical insurance company as to whether my bipolar disorder was acute or chronic. The insurance company said it was a chronic condition, and therefore not covered by the policy. The consultant whose care I was under, managed to argue - over the course of a couple of nail-biting weeks - that my presentation was acute.

Having to resort to the private sector; having disputes with an insurance company - none of this was conducive to getting better. In fact, having to find my own psychiatrist, get approval from the insurance company to even speak to the doctor and then having the stress of thinking that I might need to spend £12,000 of my dwindling savings, was an awful ordeal when I was clearly very unwell.

At the end of 2012 I got married and 8 months later I separated from my wife. She didn't care about the incredible stress that divorce and selling our house would put me under. I moved to London to live with supportive friends while my life was ripped to pieces. I lost my job.

By 2014, I completely slipped through the safety net. I took an overdose and lay dying of multiple organ failure on the floor. I managed to phone a friend who got me to hospital. After a week, the hospital discharged me to a hotel. I had two weeks to organise my own accommodation because no bed on a psychiatric ward could be found for me. My muscles were horribly damaged by the overdose and I was in agony. With a bundle of documents to prove that I was a priority case for emergency housing, I visited the local council housing department. The officer I saw promptly disappeared on holiday, abandoning my case. I became homeless.

After living in cheap backpackers' hostel, I reached my two week limit, which is a rule that most hostels have. I then started living in a bush in Kensington Palace Gardens. When it became apparent that living in a bush was not a long-term solution, I stumbled into nearby Paddington - St Mary's Hospital - and presented myself at Accident & Emergency. 12 hours later, I was given two weeks respite in a "crisis house". I tracked down the housing officer who I'd spoken to before. At the end of two weeks, I received a one-line email: I wasn't eligible for any help from the local council. Why? What now?

I was homeless on Hampstead Heath. It was very beautiful, but it was still summer. What was I supposed to do when the weather turned bad?

How had this situation come to be? I'd been a highly functional, productive and fine upstanding member of society: I'd had a successful career, paid taxes all my working life, bought a house, gotten married and done all the things we're supposed to do. What the heck was I doing homeless and abandoned by the state when I was obviously a vulnerable adult? My doctor had written a letter saying I was a vulnerable adult, and my psychiatrist had done the same. These letters had been presented to the local council housing officer, but yet it had made no difference. What have you got to do to get help in this country?

Eventually, I came to be living in the North of England, in an apartment which was a perk of a job I'd taken out of desperation. The apartment was miserable, dark and dingy, and I was terribly lonely. On the 9th of September 2017, I took a massive overdose, which I had researched on the internet to make sure it was likely to be fatal. I regained consciousness after having been in a coma, in hospital, on the 11th of September 2017 - I had completely missed World Suicide Prevention Day. A machine was breathing for me and I was put back to sleep. I didn't leave the intensive care and high dependency wards until the 12th of September 2017.

On the 13th of September 2017, I found myself discharged from hospital and left to flounder all on my own. I didn't want to go back to the apartment where I'd tried to kill myself. I've not been back there. I'll never go back there.

I was sectioned - a section 136 - after being taken to hospital by police. I had to make a massive public nuisance of myself in order to get help. The hospital upgraded me to a section 2, which meant I was going to be kept on a psychiatric ward for up to 28 days. Why now? I'd had two near-fatal overdoses, which had hospitalised me in a critically ill condition, but yet I hadn't been considered enough of a risk to myself to receive inpatient psychiatric treatment. Why did it take so long to finally get the treatment I'd been begging to get for 6 years?

The psychiatric ward discharged me from my section after 12 days, and another week later I was discharged from hospital - a good samaritan has taken me into their home. Again I wonder why no temporary housing was forthcoming, given the fact I am so vulnerable - I lost my job and my apartment due to mental health discrimination. I'm being victimised again & again.

I'm in a safe place now, but my food & accommodation comes from a charitable family who have taken pity on me, after reading my story on my blog - we clearly don't have a system that works for the whole of society. We can't all turn to Twitter every time we're having a mental health crisis.

My Twitter followers brought the emergency services to my door, saving my life. Through my blogging and social media presence, a stranger read about my desperate plight, and kindly offered to take me into the family home.

Today, I feel OK, but why have I been subjected to such a horrific ordeal? I very nearly succeeded in ending my own life, because no help was forthcoming when I really needed it - we're locking the stable door after the horse has bolted.

Using myself as a case study, the safeguards we have in place to prevent suicides are woefully inadequate. My first-hand experience of NHS mental health services, is that they're desperately underfunded and overstretched.

There will be so many tragic preventable deaths if we allow the current situation to persist.

Tags: #suicide #mentalhealth #bipolar #depression #nhs #hospital

This is a story about modesty...

It took 12 days to be "discharged" from my section - that is to say, to be allowed to leave the secure psychiatric ward whenever I wanted. However, it took 21 days before I was actually discharged from hospital: no vulnerable adult can leave hospital without a discharge plan, although I could have discharged myself against the advice of the healthcare professionals who were taking care of me, because I was a free man.

I'd been assessed to see whether I needed to be detained under the Mental Health Act at least 5 times. 6th time lucky.

When you find out for the first time in your adult life, that you're about to be detained against your will, I would've thought that everybody would have a similar reaction: "oh my god, I'm now trapped somewhere I might not want to be, and I don't have any say in the matter" which is distressing.

It's not so much that I didn't want to be in hospital; it's that I couldn't leave even if I wanted to. Although I wanted to be in hospital - because I knew I was very sick and in a dreadful situation - there was still a moment where I thought "oh shit what have I done?".

To calmly accept your plight is not something that would be anybody's natural reaction. Under such stress and shock, it's hard to recognise immediately that any attempt to fight against the system will lead to further difficulties. I was least surprised out of anybody that I got sectioned, having been the one who actually phoned the police to come and get me. Of course, escape is not hard if you're determined enough. I was conflicted - I was safe, but the price I paid was my detention: I lost my liberty.

Running away from a psych ward will result in the police being called to look for you. Britain's most dangerous psychiatric patients are kept in facilities which are far more secure than anything I experienced. I could have escaped easily and the police wouldn't have tried very hard to find me - I was a danger to myself but not others.

Our natural reaction to detention is to panic and start yelling for anyone who can possibly get you out - a solicitor, a social worker, a family member - and to start demanding your rights. There's a process that's got to chew you up before it can spit you out, and once you've just started the rollercoaster ride there's no getting off until the end - scream if you want to go faster.

Despite my messed up state, I knew that I had the right to appeal my 'section' with a tribunal supposed to happen within 7 days. I knew that my dad had the right to request my release, with a decision having to be made within 72 hours. I didn't have much hope that my dad would be helpful, so I requested an appeal.

It's so damn hard to get any treatment for mental health problems, beyond some cheap patent-expired generic medications or a computer-based Cognitive-Behavioural Therapy (CBT) thing. Inpatient hospital treatment, paid for by the NHS, is only given to very unwell people or exceptionally stubborn & determined people. However, when you have been admitted to hospital once as an inpatient under a section, you might struggle to ever escape the revolving doors.

Many of my fellow patients had the same story - they were released from hospital, stopped taking their medication, went mad and were brought back into hospital, where they were forced to start taking medication again... eventually being released and starting the whole process again.

Note, when I say "forced to start taking medication" I literally mean that they were held down by a whole gang of hospital staff members and forcibly injected against their will.

It would be stupid to argue that psychiatric medication is entirely unhelpful. However, one should be mindful that a perfectly sane person who had been taking powerful antipsychotic medication, would experience extremely powerful withdrawal symptoms if they stopped. Antipsychotic withdrawal symptoms are indistinguishable from the spontaneous psychosis that occurs in a person with a mental illness - how can one distinguish between a madman and somebody who's experiencing the perturbations of a brain that's readjusting to medication-free homeostasis?

As we move towards a world where the majority of us suffer near-debilitating levels of anxiety and depression, and psychiatric medications are dished out like candy from general doctors who have no specialist training in the treatment of mental health problems, are we diagnosing disease when we should be looking at what a person's life circumstances are like?

Ironically, I was diagnosed with adjustment disorder, which is to say that I simply couldn't cope with stressful life events - a clinical label for an intolerable clusterfuck of dreadful stuff which could happen to anybody. There isn't a pill for adjustment disorder, yet, although a bottle or two of wine each night is often chosen as self-medication.

The stress of living with 20+ mentally ill men in a locked psych ward is something that most people would not adjust to particularly easily. The 4 walls of my home were replaced with a curtain, which was opened every 15 minutes by a nurse or a support worker to observe what I was doing.

I think psych wards are necessary and I'd rather have the apparatus that treats mental health problems, than not have it at all. This is not an essay that criticises mental health treatment or the hardworking professionals who care for people with mental health problems. I write merely to reflect on my journey through the mental health system, which finally ejected me yesterday. I'm coming to terms with the fact that I was discharged from hospital, and today is the first time in weeks where I have woken up somewhere I can leave without having to ask permission.

Yes, I think that sums up yet another Earth-shattering overnight change to my life: I've gone from a flimsy curtain and a locked door, to 4 solid walls and I'm free.

Tags: #hospital #nhs #mentalhealth

This is a story about how nothing really mattress...

This is the last double bed I slept in, 27 days ago. That's my brand new bedding with brand new pillows and a brand new duvet. I moved to Manchester with nothing more than my laptop and a bag of clothes. New life - clean slate. This is the apartment where I tried to kill myself. It was a miserable place and I'm glad I never slept there again.

I woke up on Saturday 9th September, and I was miserable. I wrote a blog post in this bed, about how miserable I was and how close I was to committing suicide. It was prescient.

The next bed I lay upon was owned by a guy who I had become friends with through my girlfriend. My girlfriend at the time was of no fixed abode - sofa surfing with a guy who she met on a dating website. I'd travelled to this friend's apartment to see my girlfriend. We lay kissing and cuddling on our friend's bed. Then, we broke up.

Coming home to my miserable apartment, I didn't get into bed - I took a massive overdose and lay on the bathroom floor in the dark, waiting to die. The next bed I laid upon was in the Accident & Emergency department of the nearest hospital.

I'm presuming - because I was unconscious - that I stayed on the same hospital bed, as I was transferred from A&E resus to the Intensive Treatment Unit (ITU) and then to a High Dependency ward. I was on life support. I was having seizures. I don't remember any of this.

I vaguely remember having to scramble across onto a different bed, to move me out of the High Dependency ward and onto a general ward. I remember this because there was a bag of my piss sloshing around that had to be moved too, and there was a tube coming out of my penis, which I had to be careful not to entangle with anything. The tube that was going up my dick yanked my male member around - it wasn't a comfortable experience.

From hospital I was thrown in a police cell. There was a 'bed' made of concrete painted with light blue paint - the same glossy paint that adorned the floor and walls of the cell. To slightly soften the hard concrete, there was a thin blue foam mat, which was wipe-clean. I did not sleep.

Driven home by the two police who had interviewed me - at 2am in the morning - I finally got back home at 3:30am. My sleep medication was nowhere to be found and I'd had a traumatic day - sleep was impossible. I lay awake on my bed, waiting until the earliest possible moment I could go to the office and try to find a work colleague - I was in a desperate situation and I needed help from somebody friendly and sympathetic to my plight: alone in a strange city with no friends or family; no smartphone, laptop, debit card, credit cards, cash or driving license.

After a second dreadful day I was pretty fucked up, as one might expect of somebody abandoned in such shitty circumstances. As sleep deprivation reached the 40+ hour mark, I ended up back at the same hospital's Accident & Emergency department that I had been in 5 days earlier.

Another day, another hospital bed. This one I came round face down on, with my wrists handcuffed behind my back, after having received an intramuscular injection of 4mg of lorazepam. It was approximately 3am in the morning - now 6 days after my original hospital admission.

Sectioned first under a 136 (up to 72 hours) and then upgraded to a section 2 (up to 28 days) I was then taken to a secure psychiatric facility with airlock-type doors, to stop anybody escaping. I was given a private room that was quite nicely appointed, with a writing desk and an ensuite wet-room.

Having blearily come round in the early hours of the Tuesday morning, it was now Thursday night. I finally had a single bed in a comparatively peaceful environment in which to collapse and sleep, mercifully with the assistance of some zopiclone to calm my jangled nerves and soothe me into my slumbers.

Gone were the bleeps and hisses of the machines that were keeping people alive, on the Psychiatric Intensive Care Unit (PICU), replaced with the sound of alarms, slamming doors, shouting and running in corridors, as my fellow patients were restrained by staff. I found it somewhat comforting, to know that my crisis was no longer at its peak.

After 8 days on the PICU, I was transferred to an acute psych ward. It was terrifying.

With me in hospital I had two Apple iPhones, two Apple Macbooks, a Nintendo Switch and £1,150 in £50 notes. It's not really recommended to have that amount of valuables on your person, in amongst some very poor and deprived people. The wealth disparity was vulgar.

My guardian angel facilitated the return of my surplus iPhone and Macbook - Apple were excellent and refunded me with no quibbles.

I begun life on the new ward in a private bedroom, but I didn't have an ensuite shower and the TV blasted right next door for 19 hours a day, at full volume. At first, I was too tired to care and I could sleep through the dawn chorus of utter bullshit television a million decibels, but then it started to keep me awake, leaving me less than 5 hours of shut-eye per night.

Then, the dreaded dormitory. Dorms are a mixed bag - very dependent on the luck of the draw, in terms of your fellow occupants. Security is a massive concern, as nothing more than a privacy curtain separated my personal possessions from anybody who'd care to have a look through my bags. Snoring can be a pain in the arse, with one person able to keep everybody else awake listening to their noisy slumbers. Thankfully, my dorm buddies weren't too bad.

This morning I woke up to "second; minute; hour; power; shower" repeated over and over, as a poetic dorm buddy wrote a new rap. That was 5:15am. It was still dark. He was pretty loud. He's sleeping now - snoring.

Today, I'm bustin' out of the psych ward. Watch out, general public of the United Kingdom - I'm going to be moving among you again as a free man.

This is my current bed. I'm lying on it as I type this. I don't know what the bed or the room I'm sleeping in tonight looks like - I've never set foot in the house I'm going to travel to this afternoon. It's a leap in the dark, as is my wont.

Some of my few remaining worldly possessions are here with me in Manchester and some are in London. I'm surprised that I haven't lost more of my valuables. I can't quite bring myself to do the maths, to figure how much money I've lost on this crazy jaunt to the North of England. What does it matter? I'm alive and about to be accepted into the fold of a kind family who are taking me in - the IT consultant who lost his mind in a city where he didn't have any friends or family. It's unlikely that I'd have ended up homeless, but I wasn't relishing the prospect of being chucked off the psych ward and into a dreadful bed & breakfast, in some shitty suburb.

The very definition of "my" home and "my" bed has been smashed to smithereens. Tonight will be the tenth bed I've lain upon in less than 28 days, including several hospital beds and the concrete slab that passes for a bed in a police cell.

Distress flares were fired off and a good samaritan is coming to rescue me from a fairly dire situation.

Tonight, I sleep in a normal house for the first time in what feels like a very long time.

Tags: #hospital #mentalhealth #nhs

This is a story about being inspected...

Today the psych ward is being inspected by the Care Quality Commission (CQC) and the staff are so nervous that some of them feel physically sick. I try to reassure one nurse that they're doing their best, despite staff shortages and rampant drug use - the synthetic cannabinoid called Spice is ubiquitous throughout prisons and psych wards.

There's always somebody peering over your shoulder, sneeringly judging you. Is it any wonder that paranoia takes hold in a mind, destroying it? The United Kingdom has an exceptional ability to track the movement of its citizens, using simple conventional CCTV - no spy satellites even needed.

In the free West, we deride the Stasi and the KGB. We talk about China's vast number of people employed to snoop on their own citizens, but we don't acknowledge the work of GCHQ and the NSA. Have we forgotten Edward Snowden's revelations so quickly? The Government read your fucking emails and the police - the regular ordinary police - have a backdoor into Facebook to read all your private messages.

Nothing to hide, nothing to fear. If you believe that, why do you feel stressed if a police car is following you when you're driving, and a sense of relief when the police overtake you and disappear over the horizon? You have insurance; you've had your car's roadworthiness tested; you've paid your road tax... nothing to worry about, right?

It was only a short time ago that I was deeply indoctrinated by my schooling, that had shaped me into a meek conformist - I was fearful of defying any of society's rules and regulations. A family friend wanted to go fishing with me, and I said we needed to obtain a permit. "Our prisons are full of people who got caught fishing without a license" this friend laughed. "What are you in here for? Murder. What are you in here for? Fishing without a license" he continued jovially.

The city centre is crammed with 50,000 protestors preparing to march. I walk past a police cordon and I can hear a police officer yelling at me that I can't go the way I'm going, but I know that he'll be busy dealing with my obedient friend who will have stopped per the instructions. I keep walking, pretending to be unable to hear the entreaties to return. The policeman lets my friend go and we walk to the head of the march.

I'm sure that anarchy would be a disaster for sick and vulnerable people. I have no desire to see civilised society crumble. We can't all do whatever the fuck we want, whenever the fuck we want. Perhaps if everybody acted like I did, it would be the end of the world as we know it.

"Don't walk" says the sign in the United States. I jaywalk with gay abandon. Even in Manchester people look at me like I'm mad and suicidal, for the way I cross the road. However, it's done with such confident aplomb that nobody challenges me. I notice that people who are surrounded by plenty of steel and glass and plastic, such that they would suffer no injury at all if they killed me to death with their motor vehicle, do not give a single fuck about whether I live or die. In London, a motorist will slow down or even brake, to avoid killing a pedestrian, but these provincial plebs treat human lives with no such sanctity.

To live in a crowded city is to be humbled by humanity. To be detained against your will on an underfunded psych ward is to humbled, also. In the city, you are forced to confront your pathetic meaningless existence, as an ant crawling in its nest would be, if it had the faculties to perceive itself and its surroundings. But an ant's nest is akin to a row of gleaming skyscrapers, insofar as being a testament to what can be achieved by a society working together. On the psych ward, you are forced to confront your powerlessness over forces greater than yourself - society will exclude its troublemakers.

Perhaps you think I would endorse heroin being sold in supermarkets and that babies' pacifiers should be replaced with crack pipes?

As six police officers pinned me to the ground and my bum was injected with lorazepam, in the Accident & Emergency department of a hospital, I noticed a cleaner and a security guard nearby - some of the lowest paid people in society are often completely unacknowledged for the role they play in maintaining the division between the peasants and the aristocracy. My face was inches from the floor, but the policeman's trousered knee on my head was clean and so was the linoleum. Circles of red and green blinked at me - the police bodycams, videotaping the whole gruesome specatcle. I'd fallen from grace, but I hadn't slipped anywhere near the bottom - it's a long way down.

A friend whose judgement I trust and respect, tells me that I should drop the bad boy image of "the guy who got fucked up in Manchester". She knows that people are watching and I'm misrepresenting myself. She knows that people are lazy and won't look any deeper than the superficial image that I present.

Is my life - and the way I document it - by accident or by design? Do you imagine that when I'm writing, I don't think at all about how things are going to be perceived? The joke's on you if you don't read what I write with the prerequisite pinch of salt.

If you just dip in at random - like a care quality inspector - then you will get a random impression. On a good day you'll get a good impression. On a bad day you'll get a bad impression.

Do you think the graph above shows that things are improving? No. No it does not. Things are getting worse. Much, much worse. The data above shows conclusively that during the period under examination, there was a fourfold increase in the very metric that was supposed to be cut by 80%.

Do you remember blue tablet man? Well, anyway, he assaulted a nurse for giving him a yellow tablet (5mg of diazepam) instead of a blue tablet (10mg of diazepam).

A drugs dog sweeps the ward. The patients believe the dog can sniff out cigarette lighters. I ask the handler if the dog can sniff Spice and he confirms that it can. There's Spice everywhere on the ward, despite its deleterious effect on the mental health of susceptible individuals - prodromal schizophrenia can turn into fully-blown psychosis under the influence of the powerful synthetic cannabis, making it all the more concerning that it's so widespread on an acute psychiatric ward.

The patients here are the lucky ones and they know it. Everybody agrees it's better to be here with a warm dry bed and three hot meals a day. Everybody agrees it's better to be here, where the chances of being beaten up and/or robbed are minimal. With winter on its way, months of unimaginable suffering lie ahead of Manchester's homeless population, which has increased 1,100% in just 7 years - and a huge number of them smoke Spice.

Abandon hope all ye who entered the world from the mid-1990s onwards. What are the prospects for the youth of today, and the glut of graduates who were promised that indebting themselves and spending three or four years at university would be a good move?

Does it not seem like an obvious reaction to a decline in living standards, to retreat into drugged-up oblivion?

We're sifted and sorted and dissected by tests. We're examined, inspected and measured in every conceivable way. We never have any respite from the world's desire to label us, grade us and monitor us. The pressure to meet the expectations placed upon us is relentless. Some of us will crumble and have nervous breakdowns or be paralysed by anxiety disorders. Some of us will rebel and kick back at the suffocating environment that's desperate to eject and marginalise anybody who doesn't neatly fit in a box. Lots of subcultures have sprung into existence, with members exchanging knowing looks - these people are so much happier now that they have rejected the stereotype they were supposed to embody.

It saddens me that the hard-working staff on the ward are anxious and on best behaviour, when the other 364 days a year I know that they try their very hardest. This is just one of many psych wards, where the macro problems are greater than anything that can be influenced in the microcosms.

If you're going to randomly dip in, be careful to not make a lazy judgement based on a small sample size.

Tags: #nhs #hospital #mentalhealth #addiction #politics

This is a story about being counter-productive...

95% of my fellow patients smoke cigarettes. There's nothing to do on the psych ward, so I can see why they would. Cigarettes are a way to pass the time; to deal with boredom; to relieve some of the stress of being locked up with a load of mentally ill people; to self-medicate for all manner of problems.

Nicotine is fiendishly addictive and a psych ward is not the right environment to kick the habit. As a non-smoker I'm well aware that I'm not involved in the activity that dominates the lives of my fellow patients - obtaining tobacco, rolling cigarettes and harassing the staff to be let outside to smoke.

There is a small outdoor area which can be accessed via some steps, enclosed in a cage so that nobody can jump and injure themselves, or attempt to escape. Every hour, the door to the steps is opened for 15 minutes, and the smokers all cluster around the top of the steps, getting their nicotine fix. Nobody goes down the steps into the outdoor area - they remain in the cage.

I challenge the staff - why don't they leave the door open the whole time? Nobody could escape from the outdoor area, because it's surrounded by high fences. The outdoor area is well covered by CCTV, and it's no harder to keep an eye on people than any other part of the ward.

The standard response from the staff is that it's "promoting health" to deny nicotine addicts access to the only place they're allowed to smoke. I call bullshit on this, because there's no data to support the hypothesis. "Look around - everybody smokes... nobody is smoking less because of this rule" I say. The staff argue that the NHS can't be seen to be "promoting" smoking. This is a completely ridiculous idea. The nurses and support workers hand out the cigarettes and cigarette lighters - the NHS is intimately involved in the whole process of smoking, far more than if the patients were given the choice as to how they dealt with their addiction.

I'm in a dorm with 3 other men. It's a lot quieter than the single room right next to the TV - the TV blasted out for 19 hours in every 24 at full volume. The noise was unbearable. My fellow patients in my dorm report that they're lulled off to sleep by the rhythmic tapping of my keyboard, as I pound out these words. I was concerned that I was being a noisy nuisance, but they reassure me that it's quite the opposite - it's a kind of white noise that's relaxing, like hearing raindrops falling on the roof or hitting the windows, driven by the wind.

A guy is coming out of my dorm, but he doesn't sleep in my dorm - he has his own room. What's he doing down at this end of the ward? Then, my nostrils are assaulted by the smell of smoke. I push the door to the bathroom open and it stinks - there isn't even a decent extractor fan to get rid of the smell. I write a note and secretly pass it to a nurse, pretending to pass her my laptop to be charged in the office. I scurry away down the corridor but she yells after me "tell XXXXX about the smoking in the toilet" waving the note, right in front of the guy I'm dobbing in. I cringe - does she not know that snitches get stitches?

Another nurse comes to our dorm and she starts accusing one of my dorm mates of smoking in the toilet. I leap to his defence. "Who was it?" she asks, and then bellows out his name when I whisper the answer. The fact that many of my fellow patients have a criminal past and have been in prison, does not seem to concern the staff members. Perhaps there aren't fights in here. Perhaps they never see any violence. Perhaps my fears are unfounded. Am I being paranoid?

The fire escape is padlocked shut, there are no fire extinguishers or sprinklers, the break-glass buttons are enclosed in plastic boxes that prevent the fire alarms from being set off - a fire in here would be catastrophic. Yet, I am certain that there are at least 2 cigarette lighters that are being used in my dorm. The patients smoke openly when the staff are doing their handover between shifts, when there's absolutely nobody around.

I make subtle enquiries with my fellow patients - how do they feel about the restrictions on smoking? Everybody agrees that the restriction on access to the outdoor area is more about control than it is about "promoting health" - they feel that the staff have created a system that allows them to exercise dominion over their inmates. "Smoke time!" demands one of the more aggressive patients, banging on the window of the office. "Calm down! Stop shouting!" yells back a staff member. This is an artificial and avoidable situation - why does it exist, when it's creating conflict between staff and patients, and making people stressed and unhappy?

When I was confined to the ward I would have made use of the outdoor area to walk around, get some fresh air and get some natural light. However, I couldn't get past the gaggle of smokers clustered around the top of the steps. To leave the door open all the time wouldn't create this ridiculous situation, where all the patients are fixated on this controlling aspect of their lives.

It's saddening, to see 19 men all hanging around waiting to be given a lighter and be let out, like they're animals; pets.

In defiance of the pointless draconian controlling bullshit, a handful of patients have smuggled cigarette lighters and tobacco into the ward - it's not hard when some patients are allowed unaccompanied leave from the ward. "Have you got any bottles or lighters on you?" a nurse asks me when I get back from an outing - I'm not breathalyzed or searched, even though I'm carrying a bulging bag.

I suppose the privilege of being allowed to leave the ward could be revoked, as a punishment for misbehaviour. The chance of being discharged early and allowed home is also under threat, for any patient who's troublesome. Most patients are here for a 6-month stay. It's up to 6 months, but it's more often longer, not shorter. The reaction to not being allowed to go home is rarely handled well - can you imagine that people who are unwell are able to remain calm and represent themselves clearly and articulately, when their liberty is at stake?

In terms of mental health, nothing could be more stressful, adversarial and paranoia-inducing, than having doctors and nurses discuss you behind your back, having been peeked at through the curtains every 15 minutes - patients are literally spied on and judged. Life, liberty and free-will are all interfered with in an institutional environment that's a cross between a prison and a school. Notices on the wall tell us they promote "independence and well-being" while also telling patients the very strict times that they need to be at the dispensary hatch to get their medications. At 8:54am I'm harassed by a nurse to go for my 9am meds... I'm well aware what the time is and also well aware that to be early is to be turned away empty handed. At 11:54am I'm harassed to go and stand in line for some food which is not even being served until 12 noon at the earliest, and is often delayed.

I'm aware that I'm lucky to have a sought-after psych bed - many people who are having a mental health crisis will have no access to inpatient care. To bite the hand that feeds me seems churlish, but I do feel sorry for my fellow patients who can't articulate their frustrations effectively.

The only patient I know to have attempted to file a complaint is the guy who's relentlessly trying to get 8mg more Subutex out of the doctors... unwilling to go along with the treatment that will wean him off his opiate addiction and quite determined to sabotage his recovery, perhaps.

Nobody's stopping smoking because of the "health promoting" rules around access to the outdoor area, but I'm certainly missing out on exercise and fresh air because of it.

It all looks rather counter-productive to me.

Tags: #addiction #hospital #mentalhealth #nhs

This is a story about being overwhelmed...

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

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

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

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

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

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

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

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

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

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

I'm dependent on charity.

Park bench.

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

"I want to go home"

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

"I want to go home"

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

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

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

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

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

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

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

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

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

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

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

Tags: #mentalhealth #homeless #suicide #bipolar

This is a story about customer service...

Amongst a small group of my friends, we have all found that a medication called pregabalin - marketed as Lyrica in the UK - has been useful to us, but also has adverse side effects and is difficult to stop taking. Pregabalin is quite good at combatting anxiety and improving sleep, which are obviously the desirable effects: most of us have stress in our lives, and struggle to get enough high-quality sleep. Personally, pregabalin is an effective treatment for the phantom limb pain I feel, due to damaged nerves - I can't feel my left foot. Pregabalin is far better than the opiate painkillers, which left me sweating and nauseous at times. However, stopping taking pregabalin leaves me feeling anxious and gives me insomnia - what goes up must come down.

Soon pregabalin - "the new Valium" - will be scheduled as a class C controlled substance, which makes it much harder to obtain a prescription, and possession without a prescription could be punished with a criminal conviction.

Here on the psych ward, a man screams for a "blue tablet". Perhaps more blatantly obvious as an addiction, another man attempts to wheedle more Subutex (buprenorphine) out of the staff - he's been droning on about having his dose restored from 8mg to 16mg, because he is being weaned off the synthetic opiate he is addicted to. I can hear this guy, who is obviously no stranger to our prison system, chopping and snorting drugs his room. The man who screams for a "blue tablet" is actually asking for a 10mg diazepam pill - blue in colour - which is Valium. Our screaming friend decides he wants to leave hospital, and the staff tell him he can't leave because he's going to take heroin. "It's my body! I do what I want!" he screams. Then, he starts getting abusive.

Early on in my hospital detention under section 2 of the Mental Health Act, I ask a nurse if she can nip to the shop to get me a 4-pack of beer. We lock eyes for what seems like an eternity. I maintain a completely straight face. Then, we both snigger and she regains her composure. She jokes that we should have a big piss-up on the ward. With a different nurse, I tell her with a straight face that they have forgotten my methadone and she immediately unlocks the cabinet containing the opiates that are so coveted by some patients here... I hastily tell her that I was joking, but she still continues to search my medication chart. Do I look like a junkie? I certainly don't have track marks on my arms or other identifying features of an injecting drugs user, such as abscess scars.

A doctor comes to take my blood. She doesn't shut my bedroom door. Three men, who I know were heroin users, peer into my room and I feel bad that I didn't ask the doctor to close the door or get up and close it myself - surely the sight of a needle going into a vein is going to be a terrible trigger. There's good evidence that addicts' brain reward pathways are activated when they see drugs and drug paraphernalia for just 33 milliseconds, which is less than the 40 milliseconds that a single frame of cinema film is shown for.

Having been detoxed from my physical dependency on benzodiazepines and alcohol, I find that I crave nothing more than a few drinks in the evening - some wine or some beer - to take the edge off the stress and anxiety of my situation and help me relax during what is a fairly dreadful clusterfuck of issues with employment, housing, accommodation and my health. However, I don't want to sabotage my treatment and recovery.

I'm incredibly grateful to the NHS, for accidentally detoxing me while they were treating my deadly deliberate overdose - my suicide attempt. Being physically dependent on a medication is to be shackled to it - to stop taking it would cause seizures and potentially death. There wasn't a 'buzz' that I was chasing with booze & benzos. I was using mind-altering substances to soothe my jangled nerves: self medication.

Am I glorifying drug taking, or making light of serious matters? Don't be so ridiculous.

An epidemic of illicit opiate use sweeps across the United States, with the number of overdose deaths and addicted babies born, skyrocketing in the past few years. An epidemic of mental health issues has pushed the services that are there to support those who become unwell, to breaking point. Only a wilfully ignorant person would turn a blind eye to what's happening all around us.

Carfentanil - a synthetic opioid - is so powerful that an aerosol of it could be sprayed in a packed metropolitan area and cause hundreds of people to die from respiratory arrest. This drug is being sold as an adulterant in bags of heroin, in the United States today. In the UK, carfentanil's less potent - but still deadly - chemical cousin, fentanyl, is quite common now in batches of street heroin. If you're worried about terrorism and weapons of mass destruction, these things have already arrived on the shores of the US and UK, in the form of incredibly deadly chemicals that are available for sale to anybody with the money.

My fellow patients are unrelenting. There's been a 2-day nonstop assault on the staff, as the patients attempt to get a tiny amount more synthetic opiate out of the doctor. There's not much else to do on the ward, and whatever medications the doctor has decided to write on their chart will remain fixed for a whole week. I guess they've got nothing to lose apart from their 30 minutes of escorted leave from the ward. One patient has done a runner, sensing that the doctor's decision has not gone the way he would prefer.

"You've not done anything wrong. You can come back and you won't be in any trouble" a stressed looking nurse is saying down the telephone, to the patient who has gone AWOL. Meanwhile, a patient takes breaks between harassing the staff for 8mg more Subutex, in order to chop and snort lines of white powder in his room - presumably he has a plentiful supply of his own drugs, which he wishes to supplement with a legal prescription.

I try to calmly await my section tribunal, despite the chaos outside my bedroom door.

It should be noted, that the quality of care does not vary with one's behaviour - the staff are supremely professional - but good manners are declared as the number one thing that every staff member wants, on a notice board that tells the patients a little more about the team of people who look after us.

Good manners cost nothing.

Tags: #hospital #mentalhealth #drugs #addiction