O Captain! My Captain!

When I woke up on Tuesday morning and read of Robin Williams' death, I cried. 

My earliest memories are of finishing nursery at lunch time and coming home to watch Mork and Mindy on TV. I thought they lived on a Boulder in Colorado, and was worried they might fall off. I remember running around the house saying shazbot and nanu nanu and my mum having no clue what I was on about. I remember being really excited when my cousin gave me some rainbow braces because then I could be just like Mork!

Whenever a celebrity dies, there is a lot of media attention. Column inches are devoted to their obituaries, to speculation about the cause of death, to interviews with people who barely knew them. When Princess Diana died, it seemed like half the world was in mourning and talking about how she had somehow touched their lives; London was practically paved with flowers.

When it's a young star and drugs are implicated, everyone talks about what a waste it is, how they were such a bright shining talent whose greatest achievement was yet to come; they were taken too soon, blah blah. If they have died in an accident, we tend to get more of the same. If they die of a "real" disease then there is a lot of talk about new treatments, possible cures, how other people are living/coping with the disease.

Robin Williams seems to have divided opinions somewhat, though. I've seen some people saying we shouldn't be reporting his death as suicide but rather that he died from depression. Other people have said it was his decision to die.

I have to say, I'm not sure I know which side of that argument I agree with. Even having suffered somewhat badly with depression myself, and having been so horribly close to suicide more than once, I still find it hard to understand. I still want to tell people to just pick themselves up and get on with it. More than once I have wanted to give someone with depression a big old slap and say "nobody's going to get through this on your behalf, so get the fuck up!"

On the other hand though, I understand. I know that depression is like an evil, stinking bog monster that sits on your shoulder and offers proof and reasoning as to why the whole world would be better off if you were dead. Although many see suicide as the selfish option, I think the majority of people who kill themselves do so because they genuinely believe their friends and family would be better off without them. At the depths of my depression, people used to say to me "but wouldn't your family be devastated if you killed yourself?" and my response - the response of the bog monster - was always yes, they would - but they would grieve and then get over it, rather than spend the next 40 years having to try and hold me up as I drag myself through this life. I felt myself unable to cope with life, and a burden on those who tried to help me do so. I spent huge amounts of time having impassioned conversations with people, explaining that people with mental illness should have just as much right as anyone with a physical disease, to go to a clinic in Switzerland and end it all. I genuinely believed that someone who has suffered for years with mental illness should have the right to assisted suicide. 

The man who wrote the blog post about it having been Williams' decision to die has received a lot of negative comments, and even more trolling, for his opinion. But realistically, I think he's probably right. I think I agree with him. The thing with depression is that it's not just a chemical imbalance, and you're very lucky if your depression is "cured" just by some pills to iron that bit out. My personal experience was that the pills just made me able to cope with things like having a shower, getting dressed, putting on a front. They made it easier to pretend I was ok; they didn't make me actually ok. And the CBT I was offered on the NHS was no massive help either; I remember telling my GP, great, I can write a plan for doing the washing up, but I still want to fling the dishes on the floor and roll around in the sharp edges - they'll just be clean when I do. The actual being ok didn't start until I began to argue with that bloody stinking bog monster. And I don't think that was the pills; I think that was me.

There came a point in my depression where I thought to myself, if you're going to kill yourself, get on and do it. And if you're not, then get on and live your life. I felt like I had been living in limbo for months, waiting to see whether I had the nerve to kill myself, weighing up the pros and cons of staying alive. If I stay alive, I'll see that new movie that's due out next week. If I die I won't have to go to that big gathering of people I'm supposed to like at the weekend. I had these conversations in my head constantly, for months. 

Robin Williams' death petrifies me. He was rich and famous; he probably didn't have money worries or worries about being lonely or unpopular or that he wasn't loved; the whole world loved him. But I know that all of that counts for nothing at 3am, when that horrible, stinking bog monster is whispering in your ear.

To see that someone with seemingly no possible worries could still succumb to that stinking bog monster makes my position seem that much more precarious. My mental health is still very much a daily effort. I don't have internal conversations about suicide any longer - because I can't afford to ever let it get to that point again. I have S now, and am very conscious that I am the only parent she has. Therefore I am hyper aware of the first signs I might be heading in the wrong direction, and I try to do something about that.

I remember when I was an angsty teenager, reading a quote by someone (I think it was Ian Curtis' wife): how bad must one's life be, that death seems like the preferable option? To me, hearing of anyone's suicide is horrible. I have felt that pain; I know what it's like to feel that you are genuinely alone, that the world really would be better off without you. 

I think the thing with depression is that it chips and chips and chips away not just at your ability to stand, but at your desire to stand. and it's that desire to stand back up that you need, in order to survive. I have no idea where I found the strength to stand up, and I know there is no guarantee I will find it again next time. I cry for Robin Williams because he made it to 63 before he gave up. There but for the grace of God, go I.

Depression: Should No Treatment Mean No Benefit?

In the news today, there is a worrying story. The government are apparently toying with the idea of telling those people receiving ESA (Employment Support Allowance) for mental health conditions that if they refuse to accept "treatment," their benefit will be stopped.

In theory, this sounds good, right? If you're not prepared to make an effort to go to therapy sessions in order to improve your mental health, why should society help you. Right? Why should we help someone who won't help themselves?

But what if the "treatment" people are being offered is woefully inadequate? What if the only treatment they are being offered is yet another antidepressant, after the three they've tried previously have only made matters worse, and this one has a list of side effects as long as your arm? What then?

Regular readers of this blog will know I had a massive breakdown in 2010. I was lucky enough to be signed off work with full pay for a month, and then took voluntary redundancy with garden leave for my notice period - so my recovery was not fraught with money worries.

But what if it had been? What if I hadn't worked for that particular company, whose sickness policy was very generous for someone who had been there for five years? What if I hadn't had the choice of taking voluntary redundancy? I think I would have had to leave my job; there was no way I could have continued as I was. That would have left me on benefits.

I took the drugs the doctor gave me. I took the Prozac, even when it made me even worse. Even when I stopped eating or sleeping or thinking sensible thoughts. Then I switched and took the Sertraline they gave me, even when I saw no point in it. Even when I was taking as many other pills as I could find in order to get me through the long, dark nights - I still took the bloody Sertraline like a good girl. I did as I was told. But I have refused to take any medication since I fell pregnant with S, and I'm not sure I would be so compliant, were I to get sick again. The Prozac very nearly killed me, and I don't believe the Sertraline did as much for me as taking fish oil capsules has.

I was sent to various "talking therapy" options, including a woefully ill-equipped lady who tried to get me to fill in work sheets for doing the washing up, and group therapy which was largely taken over by a particularly large personality with myriad problems. I went to group therapy for a few weeks, but stopped going when someone from the group saw me in town, and asked me loudly (and in front of mutual friends) whether I felt the group therapy at the mental home was helping me. At one point I was assessed for one-to-one therapy and told I would be put on the waiting list for it, but that it was a long list, the wait indefinite.

I was first referred to the Community Mental Health Team (CMHT) in the Summer of 2010. When the therapy I needed finally became available, it was February 2011, and I was about to start a new job. I turned down the therapy, because I didn't want my first conversation at my new job to be about needing Thursday mornings off to go to therapy for the breakdown from which I am still recovering."

Toward the end of 2011, when I was pregnant with S, I was sent back to CMHT for counselling because the GP was worried about me coming off my medication. The system had changed slightly; now you had to call a number to book an appointment with someone who would be in your surgery one afternoon per week. The idea was that you had your appointment, got some homework, and then booked another appointment for two weeks' time. What actually happened was that you called the number to book an appointment, and got an engaged tone. Eventually after numerous tries, it would ring, at which point you would get a voicemail message saying the person manning the phone was on lunch and you could leave a message. Eventually, after several phone calls, you would be given an appointment in three week's time. After your appointment you would leave and attempt to book another appointment, which might not be for another four weeks because the department was so woefully over-subscribed and under-staffed.

This is the state of mental health care in this country. This is what happens when you don't have the money for private therapy. 

I simply cannot see how the government can even entertain the idea of imposing benefit sanctions on people claiming ESA for mental health issues, if there is no framework in place to cope with them. 

I was very lucky in that my GP had me come back to see her weekly while I was in the throes of my breakdown. She talked to me and made me feel like she actually cared how I was doing. Every Friday, I would go to my appointment with her, get a new sick note and a new prescription, take the sick note to my boss at work, and then go home. Some weeks, those were the only things I was sure to do. It was this routine, and the brief time I was attending group therapy three mornings a week, that gave me some form of routine in my life and allowed me to begin to pull myself out of my pit of despair. By the time my turn came to have the therapy for which I had been so desperate a switch had already flicked in my head and I had realised I had to do this on my own, or not at all; either get better, or get on and kill myself.

If you put a depressed person in the situation where they have to go to these ridiculous sessions or face losing their benefit, you may well find that you leave them nowhere to turn, except the one place all of this is apparently trying to avoid. 

When you are depressed, everything is pointless. There is no merit to doing anything, except perhaps killing yourself. At the very nadir of my depression, I could reel off numerous reasons, not only why I should kill myself, but why I believed people with depression should be able to opt for assisted suicide at a clinic in Zurich. 

If you stop a depressed person's benefit because they can't muster the strength or wherewithall to drag themselves to an ultimately pointless therapy session, what else is left for them? They may as well be dead, a thought that has probably been tormenting them for months or weeks any way.

Mental Illness vs Mental Wellness

Have you ever heard the saying the holistic therapists always wheel out, health is not merely the absence of illness?

The same goes for mental health. 

It's all very well not having depression, not being on medication, not being of concern to your GP.

It's quite another to be mentally "well."

There is a vast chasm in between the two. A vast chasm filled with sticky, black treacle. It's hard to trudge through it and scale the cliff to the other side. Getting off the medication is just the start. And often, just when you think you're starting to reach solid ground on the other side, the treacle drags you back again.

I've written about my breakdown before. I make no secret of the mental health issues I've experienced. People have expressed surprise at my openness, but since the breakdown itself was fairly public (until I went properly cuckoo and deleted my Facebook, that is), I see no point in hiding it. Also for me, writing about how I felt formed part of my recovery.

One thing few people talk about, or possibly even give thought to though, is what happens once you're considered "recovered." Once you're off the medication, and you stop going to the counsellors, and people stop hiding the knives when you visit... it's not over. There's still a lot of fighting to be done.

A major part of my breakdown was the overwhelming feeling of loneliness. I was plagued by the belief that I was fundamentally unlovable; I believed I was just plain bad inside, and that I would be alone forever. I wanted to die, rather than face 60 more years of feeling this alone and disgusting.

If I'm honest, those feelings are still there. They've not disappeared. I've just grown better at coping with them. Or ignoring them. Pushing them to the back of my brain, and telling myself they're wrong. Sometimes it works; sometimes it doesn't. There have been times in the 2 years since I fell pregnant, that S has been literally the only thing keeping me alive. If she weren't here, neither would I be.

This blog is more successful than I ever expected it to be when I started it.

I have a blog on my local newspaper's website.

I've been invited to speak on radio shows on the issues I write about, and have written guest posts for several websites.

People tell me I am good at writing. People whose opinions I trust and respect; people I know would tell me if they thought something was shit.

I still don't think I'm good enough. I still don't understand where these readers come from each month.

I'm not depressed all the time, but I have waves. And the waves are still pretty bad. Before, when I was properly ill, the depression was more of a sustained period of absolute, soul crushing, abject misery. 

This is more a couple of days or a week here and there. I am still horribly lonely. I still feel dejected and fed up and not good enough for the friends who make so much effort with me. 

I'm nowhere near bad enough to go back to the medication, but I know I need to do something pro-active myself, to make sure I don't slip any further. Make sure those waves don't get any longer than a few days. 

What I'm wondering is, will I ever reach the other side? Will I ever feel good enough? Will this bloody black dog ever die?

Who Would Have Thought...

When I was in the middle of having my breakdown, I went to the beach several times. I think I thought the sun, sea and sand would make me feel happy and at peace, but it never really did.

Every time I went, I would look up at the balloon that goes up from the Gardens, and think, "you could just get in that, wait for it to go up, and jump..."

One time I went as far as joining the queue, but I didn't have enough cash on me.

The next time I was there, I was with a friend. I told her about my plan with the balloon. She looked at it and said, "you can't jump off that; there's a cage all the way round to keep people in!"

Fast forward three years. 

Today I went to the beach with S and two of my sisters. It was S's first trip to the beach, and I kind of expected her to not really enjoy it. Imagine my surprise when I took her down to the sea for a paddle, and she just kept on walking. I lifted her over the waves as they came, but I missed a few and they got her full in the face! No tears though - she just giggled and kept on kicking her legs and jibbering away to herself. 

In the end, I walked up to Primark to buy a cheap bikini so that I could take S into the sea properly. I left her with my sisters (with a list of instructions as long as both their arms), and set off up to the shops. That involved walking through the gardens for the first time since that time three years ago.

As I walked past the balloon, I looked up and thought, imagine if I'd done it.

My life now is far from easy. I'm constantly behind on my studying, the housework, blog posts, emails, Twitter. S is not sleeping brilliantly, I'm constantly knackered, am too tired and short of time to buy and prepare proper food for myself. But I'm the happiest, most contented I've ever been in my life. Instead of going to the beach in a vague attempt to pull myself out of the pit of despair, I was there to enjoy the sea and the sand with my beautiful daughter, who enjoyed the whole experience a lot more than any of us expected.

As I passed the balloon, I texted my friend saying, "hey, remember that time you told me I couldn't jump out of the balloon..." Her response? 

Who would have thought you'd be where you are now?

Certainly not me.

Recovery

This is one of a series of posts about a breakdown I had in 2010.

The first post is here.

Did you know, in Darlington, they have a train made from bricks?

By August, things have started to improve without my really noticing.

After a while, I realise there is nothing saying I have to stay at home all the time. I visit friends in Oxfordshire, Cardiff, Darlington. I see people I have not seen for years. I do the tourist thing. I get drunk. I spend hours upon hours on trains, reading books, listening to my iPod and looking out of the window. I miss Group Therapy and the one-to-one counselling, but my opinion is that visiting friends is better for my recovery any way.

I continue to work weekends at the local pub, waiting tables in the restaurant and garden. It's too hot and horribly busy on the shifts I work, but I enjoy it. The people there aren't really aware of what's been going on in my life, so they don't treat me any differently to any other weekend waitress. Once I am made properly redundant in October, I decide I will take on more shifts at the pub, and spend the rest of my time writing a book. I realise this is the first time I have thought about the future in months.

I begin to enjoy having enough spare time to be able to just go off on the spur of the moment. On the August Bank Holiday weekend, a friend comes to visit. We spend the evening drinking with my sister and another friend, then head into town and meet more people. The next day, with stinking hangovers, we agree that I will go and stay at my friend's place for a few days. I pack a bag, and we leave that evening. I spend about a week in Oxfordshire, splitting my time between two friends' houses, depending on when each of them is working.

This week marks some sort of change in me. I actually have fun; both when we are out drinking, and in the days that follow, just hanging about and not doing very much.

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More Psychiatric "Services"

This is the latest in a series of posts about a breakdown I had in 2010.

The first post is here.

Me, at the top of Snowdon -
better therapy than anything Psychiatric Services had to offer!

Although I am glad to have been allowed to take gardening leave from work, I am well enough to recognise that sitting about navel-gazing is not the best thing for me right now. At first I continue to go to Group Therapy, and to sit in cafes reading books.

A different lady from Psychiatric Services calls and asks me to go in for another interview. When I get there, she looks at my notes and realises I have already had a preliminary interview, which is what she had been planning to do with me. She tells me I have ended up with her through a series of errors. My GP originally referred me to Primary Care, and when that wasn't working she referred me to CMHT (Community Mental Health Team). CMHT then referred me back to Primary Care (no explanation as to why), and Primary Care referred me to this lady. She is Intermediate Care. If I ever get to see a proper therapist, that'll be Secondary Care. I resist the urge to point out that, since they are dealing with people who have a reduced ability to function, perhaps they should make these things a little more simple.

She tells me there is a 4-month waiting list for any one-to-one assistance, but I can continue to see Primary Care (the counsellor who seemed scared of me and was no help). There is a group called Working Through Depression that starts next month, and they've put me on the list for it. She thinks the course runs for 8 weeks. Meanwhile, I can join some Open Groups. I tell her I am already doing those, and they are not helping.

I wonder what a person has to do in order to get proper psychiatric care around here.

Having visited a friend in the locked ward recently, it seems even getting sectioned doesn't guarantee any sort of assistance to get back on one's feet.

The story continues here

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Up and Down

This is the latest in a series of posts about a breakdown I had in 2010.
The first post is here.

I give the Sertraline a few weeks, and then I go back to the doctor, indignant that it’s not working. I’m still miserable, I’m still not eating, I’m still not sleeping, and I still want to die. The Sertraline has failed, and I am distraught. The doctor tells me not to panic; it can take a month or two to begin to really kick in. (A month? Or two? I can’t wait that long, I won’t survive!) And also, 50mg is still only a low dose. They can always increase it. Some really crazy people are on up to 200mg a day. This guy is not the doctor I usually see. He realises, after he’s made this comment, that it was perhaps not the best choice of words, and changes the subject. I go away under instruction to take my little white wonder pill in the mornings rather than the evenings, as this may improve my sleep. As I am currently averaging 3 hours a night, I am willing to take any and all advice where my precious sleep is concerned. I change my pill-popping routine.

After a week of the higher dose, I have a day where I am ridiculously manic. I get up early, bake and ice brownies, tidy the house, work a lunch time shift at the local pub, iron clothes, change bed sheets, work the evening shift at the local pub. Around 7pm, I crash and burn, and spend the evening at work drinking Coke and coffee, shaking. My eating is still an issue.

The sleeping is still a problem; I am still taking a lot of whichever pills are closest to hand before getting into bed each night. I know this is probably a Bad Idea, but I just really want to get a decent night's sleep.

One day a friend gives me some of the antipsychotics he's supposed to take but doesn't. I take one, and lose two days in blissful slumber. It is amazing. I am scared to ask him for more though, as I know I will end up just sleeping for months at a time.

The Sertraline doesn’t seem to have any side effects. Something seems to be sort-of working. I don’t suddenly wake up happy one day, but I do stop obsessing quite so much about killing myself. Instead, I am filled with apathy. I don’t not want to kill myself because of a new-found zest for life, but rather because I just can’t be bothered to make the effort. It’s as if I am standing outside of myself, watching. 

You know when you learn to meditate and they tell you to just sit and notice your thoughts like a passive observer, well I am doing that with my entire life, and I don’t even care. I’m not bothered that I’ve become the proverbial shadow of my former self, but I am slightly bothered about this lack of concern. Even in my addled state, I know that I should be bothered by the fact I’m on a slippery slope. I feel very much that I am walking down a road from whence there is no return, and have resigned myself to the fact that this is just fine; perhaps I will just keep going down this road, and never return. Perhaps I will just die. 

I am still unable to cope with social interaction, and have not answered my phone for weeks. I leave it on silent, in the spare room. I read some of the messages that come in, but rarely respond. I have deleted my Facebook account and feel bad that friends have texted asking if I’m ok, why have I deleted my account… and I just can’t bring myself to respond. I feel intensely guilty that I may have hurt people’s feelings or made them worry, but I still can’t get around to doing anything about that. During this period I will end up losing a lot of people I thought I could count as friends, because I simply cannot explain my actions to them. And I’m not entirely sure they’d want to understand any way. People steadily stop calling or texting over the weeks.

I begin to read every memoir of depression I can get my hands on. Even though most of what I read doesn't go in, I keep reading. I search Waterstones and then Amazon for books by people who have survived this, in the hope that by reading about them, I will somehow figure out how to help myself.

In one book I read, the author describes how, frustrated with the doctors and pills, she researched supplements. I take a note of everything she takes: fish oils, magnesium, 5-HTP. Then I take myself off to Boots, and buy a ridiculous amount of supplements. Surely the contents of one of these little pots will fix me, and I will be normal.

After the apathy comes the mania. It starts with a vague sense of purpose, and within a couple of days I am up at the crack of dawn, baking brownies, cleaning, tidying, moving furniture, doing laundry. Anything and everything, to an OCD-like level. I cannot sit still. I am suddenly super-productive, getting everything done. The house is spotless. This lasts a few days, and then I crash and burn. And suddenly this is worse than it was before. Because I thought it was over. I thought this was the magic cure-all pill that was going to save me from all my troubles. But it’s betrayed me, and here I am, back wallowing in my familiar despair. It’s like that line from that song: “If I hadn’t seen such riches I could live with being poor.” 

I want nothing other than to lie down and die. I feel lost and am convinced nobody of my family or friends wants to find me. While all this is going on I still have the tiniest modicum of self-preservation instinct. Alone in the house and scared of what I might do, I try my best to contact an acquaintance who lives on the other side of the park from me. He doesn’t work; I figure there is a good chance he will still be up at 2am, while I am having my crisis. He’s fast asleep and cannot come to save me. I drink more and go to bed feeling terribly alone. I have had 29 years of feeling that I am surplus to everyone’s requirements, and it does not matter what happens next; open the vodka, take some more pills. I take more than is strictly necessary (since none is necessary) and lose myself for a while. 

It is July now. This has been going on all year so far. I'm sick of it. The phrase "shit or get off the pot" keeps coming into my head. I am impatient with my own inability to get well; if I'm impatient, no wonder I'm losing friends left and right. 

You know that scene in The Beach, where the Scandinavian man has been bitten by a shark, and keeps howling in pain, and everyone just wants him to either miraculously recover, or get on and die? 

That's me right now.

The next part of the story is here

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Group Therapy

This is the latest in a series of posts about a breakdown I had in 2010.
The first post is here.

Mount Snowdon: a turning point

I have agreed to attend Group Therapy courses because if I turn them down, there is nothing else. No other help available. The GP thinks it will be good for me to have to get up and be somewhere three times a week. The lady from Psychiatric Services thinks Group Therapy will keep me going until she can get me into the "Working Through Depression" group. I would rather just stay in bed and wait to die. But I said I'd do it.

And so, the following Monday, I get myself up and wander into town. I stop in a cafe and buy myself the largest possible latte, with added syrup, and sip it on my way to group therapy. I try to look as inconspicuous as possible as I wander along a main road of almost stationary traffic, and turn into the grounds of the mental institution. In reality, they probably don't care one way or another. I'd like to think I don't look particularly crazy; it's entirely possible that even if I am noticed, people would just think I was a member of staff, or visiting someone. Or not even care.

I sign in at the reception desk, which is behind a glass screen as if the staff need to be kept away from us, lest they catch our madness. I am told to wait in the waiting area. There are some chairs and some magazines. I am early. I take a seat. More people turn up; the waiting area is tiny and packed with people who don't make eye contact with each other. Eventually a lady comes out from behind a locked door, and takes us through to another room. We all sit down, and don't make eye contact. I assume this is the first week the group has run, but actually most of these people have been coming for several weeks. I am the only new person; they just don't speak to each other. Except for one lady, who turns up late and talks enough for all of us put together. It basically becomes her own personal therapy session.

Group therapy consists of this: a group of socially awkward, horribly depressed and anxious people sitting in a small conservatory crammed with too many vinyl hospital chairs and some dusty plastic plants. The lady running the course goes off to get her folder, then comes back. We all get a handout about today's session, and then she sits and reads it to us. I sit there, incredulous. Do I have to sit through two hours of this? How is this going to help me with anything other than my insomnia? Ironically, this is the assertiveness group, and I am not assertive enough to stand up and tell them what a crock of shit this is. So I sit and sip my coffee while we read through the worksheet, pausing every couple of sentences for the loud lady to tell us all how this point is relevant to her life, her week, her dog. Sometimes the lady running the group tries to be assertive herself, and ask whether anyone else in the group has anything to add. Mostly, though, she lets the loud lady do the talking.

There is no Goal Setting group that week, so I am granted a few days' peace before the relaxation group on Friday. The loud lady is in the relaxation group too; as is my brother in law, who I barely know. We don't really get on. He usually tries to tell me what to do, and I usually bite my tongue so as not to start a family feud. Between the two of them, I don't feel very relaxed. The same lady comes in to lead the group again. She hands round sheets, and reads them to us. I am sensing a theme for group therapy. After an hour of discussing how the loud lady finds it hard to relax, we go into the gym and lay on camping mats with pillows under our knees. The lady puts on some relaxing music, and reads a text to us while we close our eyes and "relax." Afterwards, the lady tells each of us how well we did at relaxing, or whether we still seemed tense. And then I leave, as quickly as I possibly can.

The groups are the same the following week. I am not impressed. 

This week is my first time at Goal Setting group. The loud lady is there again. My heart sinks. The same lady is running the group, and seems powerless to stop the loud lady from taking over. We spend the first hour having a sheet read to us, like story time at school. Then we all get a "goal setting" sheet. Apparently in the second hour of this group, we review the goals we set last week, and set a goal for next week. This weekend, I am being taken by a friend to climb Mount Snowdon (more about that here). It's something I agreed to ages ago, and he is holding me to it as a way of ensuring I am ok and making me Get Out And Do Things. On my goal sheet, I put "to climb Mount Snowdon and get to the top." When we go around the room and read out our goals, I have my first ever inkling that actually, I'm not so bad; actually, I may be on the mend and not as hopeless as I thought. Everyone else's goal involves doing the washing up or writing a letter. Jaws drop when I read out my goal.

I attend Group Therapy for a few more weeks. Irritatingly, my GP is right - it's not the therapy, so much as having to get up and out of the house three times a week that helps. After therapy, I go back to the cafe, order another large latte, and curl up in an arm chair upstairs, alternately reading a book and watching the world go by outside. It's my own form of therapy. Sometimes I have two or three coffees, curled up in my armchair, reading endless memoirs of depression and madness.

After a few weeks, I start missing groups. I'm going away for the weekend, or the weather is nice and I want to go to the beach for the day. 

One day the loud lady is in a pub I am having a drink in with friends. She asks me, in front of everyone, whether I think Group Therapy is helping me. I do not return to Group Therapy after this. They call to check I am ok, and I say I don't appreciate being "outed" in front of people who may not have known I was attending Psychiatric Services.  She doesn't have an answer for that.

The next part of the story is here

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Psychiatric Services, and Other Jokes.

This is the latest in a series of posts about a breakdown I had in 2010.
The first post is here.

I have no idea how to live my life. I feel like the last couple of months I've been in some sort of weird stasis; whole days and weeks have merged into one. I couldn't tell you what I did last week with any certainty, much less how I spent the month I was signed off work. I don't know how to change this. I can't even think what to wear to work tomorrow. The simplest of decisions is beyond me; I skip meals for days at a time because I just can't decide on what I want.

I am aware that this has been going on for far too long now. Several of the people who were very sympathetic and nice when I first started showing signs of being a bit "off" have either mysteriously disappeared, or openly told me to just pull my socks up and sort my shit out. I don't know if they're right or not. I probably should sort my shit out but I can't even sort out doing the shopping. I can't remember anything I used to do, how I used to function. I can't decide anything, it's like I'm just stuck. And everything is black and sticky.

The lady from Psychiatric Services calls me. We discuss my situation. When I tell her I am taking 25mg of Sertraline, she suggests I increase it. I speak to the GP about it, and we discuss the potential side effects of doing this. I go away with my prescription for the stronger dose, and try to watch myself for signs of further mentalness.

A few days later, I have my preliminary meeting. It is in Fountain Way, the local mental facility on the outskirts of town. I sit in a room with too many chairs, a table and a box of tissues. The lady wanders off to get my file, then comes back. I tell her all the same things I have told everyone else: I am broken, it's not fixable, I want to die. She tells me I should think of my younger sisters, and how they would feel if I died. I do not find this helpful.

On the phone, the lady said it would take "45 minutes to an hour." It takes two hours. There is a lot of crying.

The lady is nice to me. She tells me she has to go back and discuss my case with the rest of her team, and then I'll get a letter. They'll send a copy of it to my GP as well. She tells me that with the increase in my medication I should see an improvement. I tell her I have been self harming a lot; she doesn't seem bothered. I leave, feeling drained, and cry on the way home.

I know that these people cannot help me. Even if they do decide they will refer me for "treatment," the lady has already told me they have a "fairly long" waiting list, so I won't get any help for a while. I feel like I've been tricked; I sat in this too-hot room for two hours, dragging up all sorts of crap from my past that I generally just deal with by not thinking about it. Now I am left with it all spinning around in my head, and no clue how to deal with it. I feel like I have gone right back to square one, feeling worse than I did when I was originally signed off work - except now I have to get up and wash and dress myself and speak to people every day.

For the last few weeks I have been "hanging on," waiting for my next appointment with the GP, or the counsellor, or for this assessment, thinking "ok, just hang on until this appointment, and then you'll be okay." And every time I get to the appointment, and I'm in the room, I have this thought, "well, you managed to hang on and make it to here - but nothing has changed, you're not magically fixed, things are not okay, and when you leave the room it'll all just be the same." Now I've spoken to Psychiatric Services, I'm back to sitting in limbo, waiting for the next thing to hope will offer salvation.

I go home, and sit and stare into space, thinking to myself, "what are you doing? You can't just sit here and stare into space." The lady from Psychiatric Services had suggested I go for a run. She has clearly never been in my position, sitting in the house, petrified of going out and bumping into anyone I might know.

A letter arrives from Psychiatric Services a while later. There are leaflets for "group therapy." I put them on the floor next to my bed, and forget about them. 

I tell the GP I think "group therapy" is not for me; it seems stupid and a waste of time. She tells me that perhaps it will do me good to have a reason to get up and out of the house every week, now that I'm not working. I can't find the words to form an argument against it, and I don't want to seem ungrateful for the only help being offered, so I say okay, and leave.

A few days later, the lady phones. She tells me she thinks I would benefit from going to the group therapy for depression, but that the group is currently full, so I am on a waiting list. In the meantime, what do I think about the leaflets she sent me? I quickly pick the leaflets up and blag my way through the conversation: "er yes, I was thinking I'd do the Assertiveness, the Goal Setting and the Relaxation..." She seems pleased with this.

To be continued.

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Voluntarily Redundant.

This is the latest in a series of posts about a breakdown I suffered in 2010.

The first part of the story can be found here

The pub garden where I spent my summer

As my time at work goes on, I realise I can't just carry on working only two hours a day for the rest of my life. I have to increase my hours, and start doing proper a proper day's work again. This thought terrifies me.

The whole company has been on notice for redundancy since January. It's July now. I could make all this effort to increase my hours back up to full time, and be made redundant any way.

I speak to my boss about it. He tells me that there are around ten people at my level, and only four jobs in the new structure at that level. 

I am tired. I am not enjoying my job any longer. I didn't want to come back, and I don't want to be here now.

I decide to ask if I can take voluntary redundancy. I speak to my boss again. He tells me that under the circumstances, the company may consider allowing me to take my notice period as gardening leave, something most other people have not been allowed. He tells me to leave it with him; he will speak to his boss.

So my boss speaks to his boss, and his boss speaks to HR. One Wednesday morning I am invited to a meeting with the nice lady from HR. She tells me that I can take voluntary redundancy, if I want. I can take my notice period as gardening leave, if I want. I can finish at the end of this week, if I want. I say yes please, and go back to my desk. 

I go and speak to the big boss, to thank him for getting the company to allow me gardening leave. He tells me that it's not a problem, and that I need to concentrate on getting myself well again; he can see that I was not ready to come back to work.

And that is how I came to spend the rest of the summer drunk and sunbathing in a pub garden, reading endless memoirs of depression.

The next part is here

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Turns Out I Wasn't Fixed...

This is one in a series of posts about a breakdown I had in 2010.

The story begins here.

This is what my life feels like... only without the light at the top.

When I return to work, I am still having suicidal thoughts on a daily basis.

One day, I have been plagued by yawns all day. You know that feeling, that if you just lay your head down and close your eyes for five seconds, you'll fall into a deep, delicious sleep? Except every time I try to go to sleep, I fail. That night, frustrated with feeling this offensively, mortally tired, I ransack my stash of pills, and take one of every type I can find. In the middle of my mad scramble for pills, it occurs to me that I could just keep going. I could just end it all now, just take every single pill I can lay my hands on and be done with it. Then that would be it. Then it wouldn't matter if I couldn't sleep. It wouldn't matter that everyone I love always leaves. It wouldn't matter that I'm alone. It wouldn't matter that none of my family gives a shit about me because they're too busy fighting amongst themselves. It wouldn't matter that I am utterly miserable in my own skin. The only reason I stop, and don't go through with it, is that I haven't written a note. I don't want to leave people without an explanation. I am too tired by this point to write anything coherent, so I just lay on my bed and fall asleep.

I am going to work every day, but I am still crying on the way home. I am still drinking vodka in the middle of the day, despite my promises to the GP that it would stop once I went back to work. I am still self harming. I am still turning up for work still dozy from the previous night's cocktail of sleeping pills and whatever else I can lay my hands on. I am not, by any stretch of the imagination, fixed.

As the days go on, I am taking more and more sleeping pills each night. Four, sometimes five. I don't always sleep any better, but I find that I am not so bothered by it; I spend large amounts of time in a weird state between asleep and awake. 

On one day in particular, tired of always being tired but not sleeping, I take five sleeping pills and go to bed. I still wake up at 3am, so I waste no time in taking another four pills and going back to sleep. When I wake at 9, only parts of me wake up. I don't trust myself to stand in the shower, so I tie my hair up and put on some clothes that seem clean. I catch the bus to work because I don't trust my wobbly legs. I buy a large coffee with an extra espresso shot, and wobble my way to work, where I pretty much collapse at my desk. I receive three emails telling me I look rough. My boss asks me why my speech is slurred. And I bump the door frame every single time I get up to go to the toilets.

The big boss comes over to speak to me. He tells me not to worry at all about work; nobody is cross with me and I am not taking the piss. I need to just take my time and things will get better. This is a gruff, middle-aged man from whom you are normally lucky to get a "morning" barked at you as he lopes past in the morning. I almost cry.

When my two hours are up, I walk home. It takes me nearly an hour to walk a journey that usually takes half that. When I finally get home, I lay on the sofa and fall asleep. When I wake up, I sit and stare at the wall.

I am vaguely aware that I appear to be going down hill. I am vaguely aware that the number of burns and cuts on my arms really can't be passed off as clumsy accidents any more. I am vaguely aware that I am taking the piss now. A friend emails me and basically tells me I need to pull my socks up now, and go back to work properly.

I know I am being irresponsible. I know I need to turn myself around and start behaving myself.

But on the other hand, what have I got? A doubled dose of medication, an inability to sleep without chemical intervention, a handful of people who say they are there for me, but are generally busy whenever I actually pluck up the courage to ask them to spend time with me. No chance of any sort of therapy or whatever else sort of help for at least a couple of months.

By this point, it's not that I want to die, so much as that I really can't be bothered to live like this any more. And I don't know how to change that. Everything seems so irreparably futile. 

This is going nowhere; there is no happy ending here.

The next part of the story is here

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Returning to Work

This is one of a series of posts about a breakdown I had in 2010. 
The story starts here.

Me, just as I was starting to get ill

Early July.

I can't imagine how I will go back to work when my sick note runs out. I feel like everything is just so much effort. Even just walking through town: all those people, the noise, having to pass people and make decisions and cross roads and smile and act like I don't want to just jump under a truck. How do normal people deal with this? How did I cope with my life up to a couple of months ago, when it started falling apart? Have I just dropped something I had before?

I feel increasingly like something inside of my head has simply snapped, and no amount of drugs or ridiculous cognitive behavioural therapy are going to stick it back together again. It's just broken, and this is just how it is now.

I feel like whatever happens next, I'm still going to be the girl who had a month off work because she couldn't cope with putting one foot in front of the other - a failure, someone you need to tread carefully around in case she goes mental again and starts talking to the pot plants in the office.

I talk to my doctor about going back to work. I know it will have to happen eventually. She says I should have a "phased return" and writes this on my final sick note. 

At first I am pleased I at least have a week to psyche myself up for going back into the office. But then, I am not. I feel like I am going back to my job, my desk, my computer, as if I am fixed and back to normal - and I am most certainly neither of those things. Once I am back, everyone will think I got sick, and now I'm better and everything is fine.

When I hand that last sick note to my boss, he says we will arrange for me to just come in for a couple of hours each day, no pressure. He says he will tell the people I work with not to make any sort of fuss or treat me any differently when I go back. Once we have discussed this, I go home and have a panic attack that lasts for 3 days. I do not want to go back to work, but I know that I will have to, sooner or later.

All too quickly, that Friday morning rolls around, and I have to go into the office. I have to see my doctor beforehand, and end up turning up around 9:30, coffee in hand, just as everyone has settled down for the morning and will notice someone wandering past them. Just my luck that my desk is at almost the farthest point from the door. I feel everyone's eyes boring into me as I pass them, and will the ground to just swallow me up. I finally make it to my desk, sit down, and wonder what the hell I'm supposed to do, now that I'm here, being stared at.

I have a meeting with my boss who, true to form, is legendary. He says to start with I should only work 2 hours a day; we will have a brief catch-up each day to see how I am getting on, and whether I want to increase my hours, or cut back if it's getting too much.

I sit at my desk, and don't know what to say to these people. I've not seen or spoken to any of them for a month, since the day I just came back to my desk, picked up my things and left. None of them have been explicitly told why I have been off, but they probably know it's linked to some sort of "mental trouble." I don't know how I should act; I feel like if I carry on as normal, having a laugh and a joke with them, they'll think me a fraud. Should I sit here crying? Should I just not speak to any of them? What should I do? In the end, my friend Sarah, who sits behind me, comes and chats to me. I could not tell you what she said, but I was eternally grateful for it.

I do not feel ready to be back at work, but I know that if I waited until I felt ready, I would never get there.

I go home after two hours, relieved I went back on a Friday, and have the weekend to recover.

On Monday mornings our department has a get-together. This has always been around the bank of desks I sit on. The big boss has always come and stood next to my desk for the meeting. I have forgotten all of this until the big boss - the one who was so unexpectedly nice to me before - comes and crouches next to my desk. He asks how I am, tells me it's good to have me back. Smiles. Then he stands up, and the entire department are behind me, waiting for this morning's chat. I know they're staring at the boss, but I'm right next to him, and feel like they're all sneaking looks at me, wondering why I was away for so long, how come I'm still not turning up at 9am, how come I had such a short day on Friday. I am sure they must all hate me. None of them makes eye contact with me. None of them speaks. 

When everyone returns to their desks, one boy emails me to say it is good to see me.

To be continued

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A Week Between Two Drugs

This is one of a series of posts about a breakdown I suffered in 2010.

The story begins here.

Wishing I'd Stayed in Spain

I go back to the GP. It's neither of the two I've seen before; it's an older lady who's been there a long time. She tells me Prozac is not the drug for me. I leave with a prescription for Zoloft, and instructions to stop taking the Prozac, and leave a week before starting the Zoloft.

I haven't been on the Prozac for very long, and since it's made me go a bit bonkers as it is, there doesn't seem much point in coming off it slowly. The GP doesn't tell me to, either. So I just stop taking it, and wait a week, as per instructions. 

That week is, without shadow of a doubt, the worst in my life. When I look back, it is like a montage scene from a very bizarre movie. I go proper, unrelentingly, bat-shit crazy. There is no let-up. I cry, I wail, I scream, I throw things, I burn myself: deep, painful burns that will scar over int he weeks to come, the scars still clearly visible years later. I cut myself; I bang my head against door frames. I drink all day and night and feel like death. I don't get dressed or leave the house or speak to anyone for four days straight. Somewhere in the back of my head, I am aware that this is all caused by the withdrawal from the Prozac, but right now, I can't listen to that voice because I am convinced that everything is doomed and black and broken, and we will all die horrible, painful deaths. 

I can't even say what's wrong, what's different now than it was yesterday, last week, last month. I've just plain had enough and am done with it all. 

I feel so very alone... I can't even put it into words. I have five brothers and sisters, but few of them bother with me. People I thought were my friends have disappeared. People for whom I went to a great deal of trouble for their birthday, people I've made a lot of effort for throughout the year, people I've listen to complain and moan and let off steam about their problems... not a word. People I thought would come out for a mad night out on my birthday because they were such great friends of mine didn't even get me a card. I feel like I put in a lot of effort with people; if I like a person I will go out of my way to do things for them. Perhaps it's because I'm so desperate for someone to care about me. But I do all these thoughtful things to make people smile whenever I can... and it doesn't work. People can still see whatever poison I have inside of me, and they run away. 

The thing with side effects from this sort of drug is... Well, the likelihood is you were already a bit suicidal when you started taking them. So you don't really know if it's a side effect, or really you. Ditto that for every single thing you think or feel. When a drug is designed specifically to change the way your brain functions, how do you know which parts are you, and which are the drug? I am particularly worried about this, as living alone, there is nobody to say to me, "you've been staring at that wall for half an hour now..." I worry that I will convince myself to jump off a pier or something, but it'll just be a side effect of the drugs. And there's nothing more irritating (I should imagine) than jumping off a pier and realising just as the water breaks your legs, that actually it's probably just a side effect. 

I should probably have stuck with the original plan and not come home from Spain. Now I'm stuck here with no clue what to do to get me from now to bed time, much less through tomorrow or next week. 

I just want to go to sleep until this has passed. Or indefinitely. Because I really can't cope with how things are at the moment. You know when you learn to meditate and they tell you to just sort of sit and notice your thoughts like a passive observer. I'm doing that with my whole life. And I don't even care. 

I feel like with every decision I make at the moment, I'm moving myself that much farther away from "normal." Sending Facebook messages to people I don't know very well, calling people I barely know, texting people I know I shouldn't. I just don't want to be left on my own. I send Facebook messages to two people I vaguely know from the pub, because I know they are friends with a bloke who lives over the road from me (who I also barely know). I wanted his number so that I could call and go over and hang out with him. I don't want to sit in the house on my own; I don't trust myself. But it probably says a lot about me that I am. That even after I've exhausted every avenue, I'm still here, on my own. That there's actually nobody who thinks enough of me to be here.

The shiny new pills are called Sertraline, the generic name for Zoloft. In 2007, this was the most-prescribed antidepressant in the US. I can't remember if this is the drug that was in the papers because it made loads of people want to kill themselves. 

I begin to look forward to the day I can begin to take the new pills. I see them as some panacea wonder-drug in the distance, lit up by a glow of heavenly radiance, and here to cure all my ills. That first night, I take one before I go to bed. A little white 25mg pill that will fix me.

I wake at 3am and sulk. It hasn't fixed me. I'm still screwed.

Months later, when I am recovering, I meet my older sister for coffee. It is the first time I have seen her in months; I am not sure whether she knows what I've been going through or not. When I tell her the GP put me on Prozac she pulls a face, before telling me, "People in our family can't handle Prozac, we all react very badly to it. You shouldn't have taken the Prozac." Quite what use this information will do me months after the fact, I do not know. But this, unfortunately, is the nature of my family. We discuss everything months, often years, after the fact.

The next part of the story is here.

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On Sleep and Skinniness

This is one of a series of posts about a breakdown I had in 2010
The story begins here.

Me, mid-breakdown.
Skinnier, but not happier.

I am so tired that I yawn constantly. Yawns so big that I feel like I can't open my mouth wide enough to allow them to escape. I find myself unable to get through sentences without stopping to yawn at least once. Seeing as how I'm off work, and no longer need to stick to any sort of schedule, I will often lay down on the sofa for a crafty nap, what with being so tired and all. But as soon as I'm horizontal, I'm wide awake. I'm still yawning wide enough to make my dentist proud, but my eyes won't close. My mind won't switch off.

I've had depression before. I've gone through (fairly long) stages of self-harming before. I've dealt with all sorts of personal issues and mental upheavals and untold stresses. Until this point, my way of dealing with things getting too much was just to sleep more. When I was depressed or stressed or upset or felt like I didn't know who I was any longer, I would just sleep more. Sleep has always been my way of coping with problems. Perhaps not strictly the best or most effective way of dealing with one's problems, but it always worked wonders for me. I would often sleep 9 or 10 hours a night. To be in this position now, and to be unable to sleep it off, is destroying me. The insomnia is the worst part of what has been happening with me lately. I feel very strongly that, if only I could sleep properly, the rest of it wouldn't seem to bad. I can think of nothing more appealing than taking to my bed and staying there for a long, long time. Nothing bad can happen if I am under my duvet.

Nobody should be this intimately familiar with 3am. By now I know all the sounds of this estate as it wakes up in the mornings. Each morning I lie in my bed and listen to the succession of odd noises. I think to myself that perhaps I'll get up, go out and find out where a particular noise comes from. But I never do. That's apathy for you.

I feel like I've reached the end. I've admitted defeat and there is no going back. There's nothing left to fight with, and I don't think I want to any way. I may start to respond to the drugs and get over it this time, but it'll always be lurking in the wings, waiting for my back to be turned. It will always come back. Like in Harry Potter, where Voldemort is defeated at the end of each book, but we all know he'll be back by Chapter Five of the next one, and worse than ever. I'm not Harry Potter; I can't keep fighting this over and over again. I'm tired and I just want to sleep now. I'm awake at 3 every morning, and before I'm even conscious of my thoughts, I'm thinking about how to die. I talk about suicide constantly. People pull concerned faces and ask me to promise I won't do anything "stupid." As if my word means anything. As if I think killing myself is a stupid idea. Idiots.

Since I first started getting ill, I have lost over a stone without trying. My clothes hang around my waist. I love the feeling of being skinny. I don't want to tell the doctor I'm not eating, in case she does something to make me fat again. At the back of my head there is a little voice saying, come on, you've got enough to be going on with, without developing an eating disorder too. But I can't help it. I like being skinny.

I read The Devil Within by Stephanie Merritt, and feel a certain resonance with this passage:

Thin, I would still be me, and what I loathed and wanted to punish was not this rebellious body that so defiantly refused to look like a picture n a magazine, but the me that was inside it, the essence of who I believed myself to be - someone who would always be standing on the outside looking in. But I didn't know how to express this hatred except by inflicting damage on what was visible. Something had descended on me, and I could not explain it; it had entered through my ears and nostrils like vapour and wrapped itself around my brain; it clouded my vision and made me retreat into myself, fearful of company and the sound of my own voice.

A friend's mother dies, and I wear a tight black dress to the funeral. It's been in my wardrobe for years, but I've never been able to get away with wearing it. This time I put it on and it's too big. I like to think I look stylish, but I probably don't. I've not reached the stage yet where I could actually be referred to as "skinny" or "gaunt;" I think people only notice my weight loss because of the way my trousers hang off my hips. But it makes me feel better. The only positive thing in my life at the moment is a pair of shorts that I can pull down without unbuttoning the fly. I realise that for my entire life, I have loathed my body; my existence has been a series of events where I've needed to suck my stomach in. I feel fat and unattractive. I have always thought, if only I was skinny, if only I didn't have this pot belly, my life would be so much better. And then one day I am buying a bra to cheer myself up, and I catch sight of myself in the changing room mirror. I realise that these days I don't need to suck my belly in; it is fairly small, now that I'm not eating. It no longer protrudes over the top of my shorts.

But I still hate myself. My life still sucks, and I still want to die; I just wear a smaller size of clothing while I'm feeling wretched. I am the most miserable, apathetic and devoid of hope I have ever been. Having less of a belly and skinnier thighs makes absolutely no difference to this feeling at all. I feel like a fool for ever thinking it would. But if being skinny won't solve my problems and make me happy, what the hell will? I'm running out of other things to try here.

Perhaps there really is nothing.

The next part of this story is here.

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Too Much to Drink

This is one of a series of posts about a breakdown I had in 2010.

The story begins here.

The sorry contents of my fridge.

I start buying a bottle of vodka whenever I go to the local shop. A loaf of bread (to appear normal), some cans of Coke, and a bottle of vodka. I start with the smaller one, and then I just give in and buy the larger one; it's not like I need my money for buying food, after all. I make one cheese sandwich with the bread, which I hardly touch, and then the loaf sits on the side in the kitchen, going stale and then mouldy. Every morning I get up and drink a can of Coke. When my stomach starts to rumble, I might have another. More often than not though, I forget. Sometimes I eat Mini Baby Bel cheeses, because they're small enough to get into my stomach before it realises what I'm up to. I go weeks at a time without going further into the kitchen than the fridge. Not that there is much point in going to the fridge any way; these days its contents amount to cans of Coke, bottles of beer, a mouldy block of cheese, and the brownies I bake in order to fill my afternoons, then ice and give away because I can't actually eat them.

The evenings are when it gets really bad.If I'm sober, the evenings are hell. I can't settle, I can't concentrate. I go through book after book, my eyes following the lines across the page, all the way to the bottom. I turn the page and begin again, knowing that I have no idea what happened on the previous page. I have a stack of books next to the sofa which I appear to have read recently, but I have absolutely no recollection of what they were about or what happened in them. 

I go to the kitchen and turn on the hob. It heats up quickly, and I lay my wrist across it. That hurts. I must still be alive. I do it again, to make sure. And again. And then the other wrist. Sometimes I cut myself with the knives in the kitchen; they're no longer being used for food, after all. One day I'm so agitated I hold the point of a knife against my forearm and push. It pops through the first layer of skin and I panic and remove it. Chicken. If you don't want to live, why are you scared to cause a significant injury? Why these stupid little half-arsed attempts at burning and cutting? You can't even do that properly!

I keep going back to the doctor, and she keeps signing me off. She tells me I have clinical depression. She is clearly worried about me, and I feel really bad about that. I don't want to worry her; she's kind and seems very genuine. I think she has kids as well; she can do without worrying about me. 

By this point though, I am scared of going back to work. I associate work with panic attacks and worried looks and crying in the toilets. So I have to go back to the doctor to get a sick note to keep me out of the office. The doctor tells me I need to try not to burn myself too much. She asks if any of my cuts or burns need medical attention; I tell her no, they're only small superficial ones because I'm not that brave. She asks me about my drinking; I tell her I never used to drink at all (I used to go months without touching a drop) but now I'm drinking more. She asks, how much is more? I tell her a couple of beers here and there. Actually, most nights. And a little vodka. And sometimes during the day. Actually most days during the day. And sometimes in the mornings. And sometimes without any Coke.

She suggests I see an alcohol counsellor. I say no, I don't have a problem. She says I do. I tell her I intend to kill myself so it doesn't matter if I damage my liver. She asks me if I think about that a lot and I say yes. She asks if I have a plan. I do have a plan, and it's foolproof. I've been going over and over it in my head for weeks now. I can't tell anyone what it is though, in case they do something to try and stop me. I'm supersititous about this; if i tell anyone my plan then when it's time to use it I might fail because I've not managed to keep my big mouth shut. Someone might stop me. (Even now, three years later, I have never told a single person what the plan is.) I lie and tell her I intend to jump off Bournemouth pier. She tells me that is impractical; I would probably just break my legs. As if her saying that will somehow stop me from planing! I sneer at her in my head. She's fallen for my lie and won't press me for the truth. My secret plan is safe. I don't tell her the full extent of my obsessive planning; I don't want her to get me locked up somewhere I wouldn't be able to carry it out if I needed to.

She asks how I am getting on with the counselling sessions. I tell her they are pointless and I don't want to do them any more. The lady who does them is nice and everything, but she seems to be scared of me, and not able to help me in any way other than ensuring I do the washing up, or keep on top of the laundry. These seem like minor issues on the grand scale of things. Great, I'll have nice clean dishes, but I'll still want to smash them all on the floor and then roll about in the pieces. 

The doctor tells me she will refer me back to Psychiatric Services to see if I can have some "more in-depth" counselling. It turns out the poor lady from counselling has already done this any way though; at least she knows she's ineffectual when faced with the behemoth that is my depression these days. I feel bad for her; I hope having to deal with me hasn't made her think she can't help normal people with problems. I am just a lost cause; it's not her fault.

The doctor continues to mention the drinking every time I see her. The way I look at it, I'm using the booze to get me through a rough patch in the same way as I'm using the pills from the doctor, and who's to say one is any better a way of coping than the other? The drinking helps me to maintain the pretence of being a normal person, a non-mental.  I can have a laugh and a joke and talk rubbish with my friends, and am not totally preoccupied with the sort of thoughts people really don't want to hear about.

One day in particular, I look up and realise I have downed the better part of a bottle of Baileys before lunch time. I spend the rest of the day in a daze. It doesn't matter; it's not like I had to be anywhere any way. People tell me I shouldn't drink so much but it's not a real problem; I'm not getting obliterated every night and waking up in a pool of vomit in a strange man's bed or anything. There have only been a couple of times I've gone to the pub and not remembered getting home. I probably start drinking a little earlier than is really socially acceptable on a week day, but I don't drink particularly quickly or a lot, just enough to make things a little fuzzy around the edges and easier to deal with until bed time.

The doctor tells me the fact I fall asleep and then wake up seven or eight times during the night is probably down to the booze. I figure she's just scaremongering, and carry on. She tells me same thing the next week, and asks me again to see an alcohol counsellor. I tell her I'll cut down. 

That day is my first sober one in over 3 weeks. It is pure hell. It turns out the doctor is wrong; without the alcohol I don't even fall asleep in the first place. I tell the concerned masses (two people) that I will only carry on like this until I go back to work. Once I go back to work I will stop drinking. 

I laugh inside my head when they believe me; I have no intention of going back to work. I'll be dead before this week's sick note runs out.

At this point I feel it's important to stress again - this is not recent writing. I had a breakdown in 2010 and have been writing these pieces since then, about that time. I am not suicidal now; you do not need to worry. Promise.

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