RED BARON'S WORDS

Had I been the sort of person to be able to accept things as they are the first 2 parts of the story might reasonably have been where matters stopped. Indeed when I visited the Dr in 2017 it was not because I was feeling especially bad or in need of assistance, the commentary I gave to the Dr at that point was that given the relative stability of my life I was aware that whilst things in the world around me were fine things inside my head were not exactly how I wanted them to be and that this might be a good time to look at what the options were, principally because to do so when in a state of flux would be folly.

I had been on medication which was ok, and I use that term very specifically, they raised me up above rock bottom, at least that is certainly how it felt, whilst never quite elevating me to feeling what I might presume was ‘fine’, it was better than being consistently crap that much was certainly true. I had fluctuations that seemed cyclical, where my perception of things would suddenly change for no discernible reason and I would have a period of a couple of days when I really was not at all ‘on it’ before returning to my baseline state. In wider life I was comparatively comfortable where I was living, I liked the area, it felt like home and reminded me of where I was born. I had a stable job that didn’t pay well but was enough to just about get by on the whole, the key advantage of it was I felt I was worth something there and that I was valued. I was also able to cycle to work, which I was doing every day, so the fitness angle was certainly a major help. I was in a relationship which, whilst neither conventional nor easy was nevertheless rewarding and with someone I loved, all things considered therefore it was as good a basis to look at what changes to the internal me might be enacted as any.

I could not have known the nature of the year that was about to unfold and therefore had no method of determining what the impact of it would have been. None of the elements of stability were ones I presumed temporary. To an extent I was taking a chance on things but I was also, I felt, leaving myself in the hands of the medical profession at a point when perhaps there might be some ways of accessing further help and defining the nature of me and how to live long-term with that. There is a phrase ‘if it ain’t broke, don’t fix it’ and this might well be levelled at me at this point but I wasn’t feeling unbroken as such, I just didn’t feel the breaking process was worsening and therefore it might be a time to look at fixing. I felt there was more to things, that I was running at about 50% capacity and that if I were able to harness the rest of things that I might then be a better parent, partner, colleague etc. It is easy to look back with hindsight to determine things but I know that give the factors I had at the time and the way I was feeling I felt ready to try to push ahead and be just a better version of the me I felt I was. Never being happy or satisfied with myself is in part I suspect to do with the nature of my mental health but a small amount of such introspection is not a bad thing as I believe it does give you a little drive to be better. Conversely too much self-analysis if it involves constant critique robs you of any drive entirely and this has been my lot on and off for much of my life and the last couple of years in particular.

On the advice of my Dr I went for the first time in my life into the Secondary Care sector. Here I was given information about the Lithium trial, a common enough drug used to treat types of cyclical depression but the high-end one so to speak. I thought it worth a go as I had heard someone of late eulogising about it and how it had been a game changer – when what you are looking for is a game changer of your own such words are seductive. The nature of clinical trials is that you are first assigned a test group during which you are given either a placebo or the live drug, you are not aware of which until after the trial period. Having come off my normal medication without major incident I felt no real tangible difference, though some others said I seemed to be more myself, whatever that meant. I did feel though that I was not really engaging properly in ways I should have been, matters that needed attending to that might be important but not imminent were consistently pushed back and this felt like a problem. Which in itself is interesting as I have been a perennial procrastinator much of my life so for me to notice it suggests it may have worsened. The first part of the year the weather was pleasant and things were ok so there wasn’t a great deal to really test either hypothesis. That was to change.

Had a single sphere alone changed it would perhaps have been difficult to tell whether or not things were in hand, by which I mean one out of the home, work, love, family side of things but flux in all areas made for a great deal more upheaval both physically and emotionally with little chance of the respite of one area going well to retreat to. It is easier to focus on an area when the others are stable, not necessarily easy as it depends on the nature of change but watching one plate spinning and attending to it is less of a challenge than watching and attending to multiples. Looking back the changes within that space of time were significant and would have represented enough to keep one occupied on their own, altogether they were more than a significant hurdle and I don’t feel I managed any of them well. I was forced to move house, I changed jobs on the basis of a promise of something full-time that turned out not to come to fruition and my relationship came to an end in a way I hadn’t wanted but left me speculating over whether or not I would have allowed it to happen had my head been in the right place.

Some of the turmoil that ensued was not entirely my fault, on the house front I was let down by several people who had said they would do things which they then reneged on, I was left with a great deal to do to find someone to move anywhere at all but I did manage it, just. The person turned out to be a disaster for a variety of reasons and made the place utterly uncomfortable to live in whilst I was tied into a 1 year lease.

On the work front the finances of my workplace were in fluctuation but there should not have been much reason to change things around however my boss hadn’t been in the best of health and had decided to undertake a restructure without consultation and in a way which left me feeling far less valued than I had been and looking at the fact that it was one thing to be earning the money I was on at 30 but to be doing it at 45 was becoming a problem and without prospect of change. I found another job, it was long-term sickness cover, I was assured that the likelihood was that it would be made full-time. It wasn’t. I took it in the knowledge that it was a risk and weighing the career benefits of the job against where I was but I traded security at a time I felt I was ok and it bit me in the backside at a time I definitely was not.

On the relationship front I stopped fighting, I certainly never stopped caring, far from it, but the circumstances were somewhat enigmatic and at times difficult and I imagine my partner may, quite understandably have confused my detachment as being something to do with her whereas it was the first signs of a process that resulted in detachment from everything from which I am yet to really recover. The nature of the breakup though left many questions unanswered and didn’t feel right. We split and I fell into the arms of another quite by chance without planning or forethought, but feelings do not just dissipate and the memory is at times like the tail of a comet from the heart, it is long until the light subsides if indeed it ever does.

How much of all this was because of, in spite of or conjunction with the fact that it transpired I had been on the placebo to begin with followed by having been put on the live medication without any discernible effect during the transition or thereafter is impossible to determine, what I can state with certainty was that the lithium did nothing at all for me. I didn’t notice an effect going on it, neither did I notice an effect coming off it which I did after about 18 months. The timings were awful, the consequences far-reaching and whilst having rebuilt certain things out of logistical necessity such as having found another job and somewhere to live it has been a long time since I have felt either stability or joy within it.

The single biggest betrayal for me was that of the medical establishment which having been happy to take me on whilst I fit a potentially lucrative research profile was quick to shoo me out of the door when it was clear I was not the easy option they were looking for. When you are at your wit’s end having explained especially dark thoughts to a medical professional you do not expect to be dismissed and told that there isn’t really anything they can do because you won’t take the medication they put you on despite it being clear it doesn’t work. It remains an open wound that I went for help and was denied it, a scenario I am sadly not alone in experiencing and one where the profession takes advantage of the fact that individuals are at a point of sufficient vulnerability that the prospect of them having the energy and lucidity to complain is as low as their mood. Such things if occurring in the physical world would be seen as scandalous but those struggling with their mental health are the silently oppressed.

Song Of The Day ~ Orla Gartland – Heavy

Realistically whilst it was evident from an early age that all was not always well my run-ins with the medical establishment didn’t really begin until I sought help in 2006. It is difficult to put myself back in the mindset in which I was then but it was sufficiently serious that I agreed to trial antidepressant medication. I was assured that this was not something to be anxious about etc. in this instance they did at least put me at my ease on that score. What they failed to instruct me on was what to do if something went wrong, which it did, on the first set of meds they put me on, a very common SSRI called citalopram. No one could have foreseen such effects, I recognise this, I do not blame anyone, shit of this nature happens all the time to people struggling everywhere, you take the chance that the meds might help and if they do, happy days, if they don’t then you can console yourself that you are in the minority. Of course that consolation is a little hollow at the point you are standing in the queue at a supermarket with a full trolley of shopping and the whole place starts to close in on you such that your only thought is to get the f*** out as quickly as possible.

That was the beginning of the process of sampling all the medical profession were prepared to offer me, the only thing that had any realistically positive effect were the diazepam which were helpful for relaxing before sleep but they were reluctant to give me any repeat prescription for those, assuming perhaps that I might have friends for whom I could become a black market supplier. Other than that I had experiences that ranged from the utterly nondescript to the physically disassociating from my body and wondering if I were to jump under a bus whether I would feel the sensation or be immunised from it as an out of body onlooker! Thankfully I had foreseen the somewhat more turbulent nature of that medication and had taken myself off to a friends some days before for ‘observation.’ I was able then to order a lockdown of the premises on the instruction that I was not to be allowed out until I could describe why throwing oneself under the bus was a bad idea.

It’s fair to say that my medication experience was one I felt I had put behind me until 4 years later when a combination of 2 medical professionals taking the time to do no more really than what they were there for but doing so properly and for reasons of care, which made a huge difference. (The arbitrary nature of how this happens still makes me wince as it shows how random genuine support can be and this is just so wrong). I had changed Dr when I had moved house, I was muddling along in some form or another, just about getting by sometimes, occasionally enjoying things too but often still struggling. I moved to a nicer house to clear the head and the heart a bit and thought to try to make a slightly better fist of things elsewhere. I saw a GP at the new practice and started to explain things to him. He stopped me after around 25 minutes and said that officially we only had 10 minutes for an appointment and he was really sorry but given that there were other people waiting to see him he would have to cut me off there. He asked if I was free the following day, which I was, so he proposed booking me in for the last session of the day when we could take the time we needed without fear of eating into someone else’s. This gesture alone gave me what was and remains a fairly rare feeling of someone caring, I think the following day we talked for about another 45 minutes and he resolved several referrals for me and some other bits of go to and advice. Whilst this on its own would not have been enough to solve matters it started a process of renewed trust and meant I went into those referrals with my mind a little more open than I might otherwise have done.

One of the referrals was the next step in the coincidence list. I attended a clinic designed for psychological assessments and saw a clinician who seemed both friendly and knowledgeable. We spoke at considerable length and he made copious notes. He then proceeded to tell me that much of what I had thought previously about the normal state of things was not, it wasn’t patronising it was insightful, it showed that he had listened to what I had said carefully but had knowledge I did not. He explained things in a way that made a lot more sense about why I had not been understanding how most people lived up to now and provided a better structure for me to assess my own situation. I found it interesting and useful, he told me why in some detail the medications I had been on would not work for me and that there was a very different sort which might, were I minded to try it. I trusted him enough that I decided to give it a go and if it were an issue could come back. He explained how the dose would need looking at and over time and how I was to come back for a review in some weeks to look at the dose. He had explained he was a locum, so I’m pretty sure I had no expectation of seeing him personally again, I did look him up though and found that he was a somewhat highly-regarded Harley St clinician.

When I returned to the centre I was kept waiting nearly 45 minutes beyond my appointment time, with no apology offered when I was called in. The clinician asked me what medication I was on and when I replied said that this medication was usually used for epilepsy wasn’t it (which was indeed the main use for it) which puzzled me since I knew that the previous session had pages of accompanying notes that would have explained everything about the discussions that had been had and why. It became clear over the course of the session that this clinician had not read any of the notes and was expecting me to start again but was also much more of the ‘traditional’ mindset that I had previously encountered. So much so that I recall cutting the session short, ordering him to up the dose I was on to the that recommended for the second stage by the previous clinician and I would be on my way. The only useful thing he did was to do so without arguing and I left. I remained on that medication for 7 years. The diagnosis the first clinician supplied was as personal to me as it was comprehensive and remained the only diagnosis on file until 2017 and, ironically, is now being revisited due to suspicion that the updated diagnosis I received in 2017 may not be as accurate!

I leave that little diary part more as an indication of how arbitrary service provision is, how difficult it can be to get to see someone and then when you finally do how much of a lottery it is that you get someone who is even any good. For me it was the coincidental collation of a GP who cared enough to book a second session followed by a referral he made coinciding with the visit of a locum practitioner who took the time to listen to what I was saying. Those 2 individuals accomplished more in the 2 hours of their time that they gave me than all other professionals put together over more than 30 years, not because they were better clinically per se, though one might argue that fact on their behalf given the results they achieved, at least for me, but because they took the time, they bothered to do more than just tick the box.

It shouldn’t be the case that this is the exception to the rule, it angers me how random this makes healthcare provision, how people are subject to the most arbitrary of circumstances and competence of certain individuals to get the help they need. Would that I were a trailblazer, a campaigner passionate and motivated to further the cause but I’m neither diligent enough nor perhaps physically uncomfortable enough to be so. It is the path of least resistance to just keep going in some way ticking along, marking the days off and survival on that basis has in itself been at times challenging enough. All that’s missing is the date of release really, along with no sense that release brings anything, freedom or otherwise. It sounds nihilistic and sometimes it is though most of the time it lacks the buy-in even to be that, yet according to the medical profession, or at least certain parts of it the fact that I am still here, still holding down a job and relationship and family life means I am a success story and should take pleasure in the fact. I’m afraid their failure to understand the fact that taking pleasure from anything is simply not on the menu is as offensive as it is ironic.

Song Of The Day ~ Shame – One Rizla

For almost as long as I can remember I’ve tried to get the medical establishment to give enough of a toss for enough of a length of time to give me medical categorisation. This is for several reasons, firstly in a somewhat spectrum-like way I like the taxonomy of it, I like to know what I’m dealing with so that I can absorb salient information and figure it all out in my head. Specific diagnoses are therefore helpful in as much as they give more defined parameters as to the sorts of things that are and are not. Secondly there’s an identity sense afforded by the diagnosis of a condition, a community perhaps, solidarity with fellow sufferers but also possible coping strategies and mechanisms and a sharing of information.

When all is said and done though what I require most is comprehension and the ability to change. The way my head has been for as long as I can remember has been beyond my understanding, so many things that I seem to do that then infuriate myself for ages thereafter, now I’ll freely admit this is something most people can empathise with, some more than others, but I think generally these are things that muck around on the peripheries of people’s lives rather than come to underpin them or even engulf them – except in the cases of those who are in the vicious cycle of self-harm as I explained in my last post.

There have always been two hopes that come with the idea of an accurate diagnosis, the first is the naive one, one which is far more about the dream of suddenly being someone else, the better me, the me I thought I could, should and would be and that is that there is medication that flips a switch and ‘fixes’ who I am. I use that phraseology advisedly and specifically, I do not see mental ill-health as signifying someone is broken, unless of course they, like me, see themselves in that way. What I mean by it is that I can identify a core part in me that seems to know what is good and right and wants to follow it and another part that has the capacity to screw it up consistently. If it were hedonistically I might understand, down in the blaze of glory or notoriety and at least a bit of a laugh on the way out, but it is not like that, it is debilitatingly frustrating to me and cannot be easy for those around me either. Critically I think for the purposes of study and identification is that I do not enjoy it or the behaviour it brings, I am trapped in a room inside myself and I have lost where the door is. That there should be some Panacea Pill which should immediately have the capability to change precisely what it is I wish to change and not other facets and should be able to do so without side effects or effort on my part is frankly laughable. Nevertheless until all possibilities are exhausted there remains the hope. The more significant and realistic notion behind the issue of diagnoses is that having a diagnosis means the right direction can be taken on the next steps, medically, psychologically as well as physically, that to have a category in which to fall means that it should be a little clearer what lies beyond.

I had always assumed that since rarely rendered incapable of speech, merely action, that I would be quite an easy candidate to be categorised, at least in as much as verbal submission were able to achieve. Reality has proven to be quite the opposite in an experience which would be bad enough were it only to be me on whom it had befallen but now I am more in touch with others who share mental ill-health if not the same condition I find it to be all too common and this suggests to me that the system as it currently stands is not fit for purpose and had not been for a very long time.

Mental ill-health happens to a wide range of people, we know this, the severity and duration are individual as is the capacity of the person to cope with it during their lives. What is also clear is that for some people it is a constant struggle whilst others have breaks of undefined amounts of time between episodes. I had always been aware of a rather cyclical nature of my situation such that there would rarely be any specific change in circumstance that lead to a change in mood merely my perception of those same circumstances. Thus I characterised myself as cyclical because this seemed the most logical thing that marked me out from the experiences of others that I saw who had more specifically external stimuli related episodes. Of course we are all beset by pitfalls and we all struggle at certain times to deal with them, when I would be feeling low certainly I was hyper-sensitive to anything going wrong around me which would like a blanket flying in a hurricane attach itself to me and wrap around in a method that made me see the world or this specific as having been my fault in some way.

This I feel is the most dangerous part of any mental health, firstly because of the ease with which one can misunderstand this self-loathing and confuse it with self-absorption and self-obsession, it may share similarities but is the direct antithesis of arrogance; secondly it is the part that can so easily lead to thoughts that the world, principally those you care about, would be better off were you not there anymore. I have never thought I would ever act on those thoughts but by the same token I am no stranger to them either and sometimes the very inability to carry through what would be an irrevocable change one way or another leaves one feeling even more trapped and wretched and just as much the burden to those around.

It is possible that I may be a bundle of such incredible specifics such as to be the nemesis of the medical establishment, though somehow I doubt it, what is more evident is the lack of time taken or actual expert eye cast over my case and the ease with which certain professionals think that if you are not presenting as needing immediate hospitalisation that you must be ‘coping rather well’. This is all very much dependent on how one might define ‘coping’ and where I believe my understanding of it is at odds seemingly with some of the professionals I have met. True, we all have stress, we all have to deal with adversity and there are times when this can set us back along a path and render us less capable, however the assumption, if I am not mistaken, would be that this would be finite, would it not? The point at which a failure to deal with things is the norm seems not to be the one I associate with everyone else, perhaps I am wrong, perhaps they hide it the way I used to hide it, perhaps the human condition is indeed merely one defined ultimately by pain.

Let’s assume for now that it isn’t because if it were to be then I think all bets are off and we might just as well give up en masse but I sense by the fact that broadly speaking people describe life as being a positive experience that there is hope out there in some form. The question then is where to find it?

Song Of The Day ~ Lloyd Cole & The Commotions – From The Hip

It is both rather egotistical not to mention somewhat bourgeois to ask the question to a point, certainly to voice it in such a fashion however I think many if not all have the questioning within and what divides us sometimes is the nature of both the question and valid answers to it.

I have long since been aware that having a purpose matters to me, I’m sure I am not alone in that fact at all however the purpose we feel we have will differ just as the people we are and the filters through which we see things differs. I feel a need to be of use, principally to other people, to help those in need, to stand up for those who have no voice, it is important but it is also a path not without danger. Firstly who determines that I have any right to do so, that I have the skills, the desire, the understanding to be the best representative for the people I seek to help? There is an easy trap of presumption to fall into that just because someone isn’t doing well alone means that your help will make them do better and it is a trap I have fallen into more than once, for the right reasons I would say but I suspect that might not be much of a consolation to those who find themselves plunged even further into the pit by my hamfisted do-goodery. Added to this is the realistic possibility that the desire to do the right thing not only imposes my version of the world onto the world of another but also that if I am not careful I might look to gain my reward from the act of trying rather than from the act of succeeding in the assistance. On the flip side of that one cannot presume that just because one has not been ultimately successful in a specific endeavour means one has not helped at some point along the way either in whole or in part. it is a physical and moral minefield and not something that can be undertaken lightly.

I have for many years though gravitated towards jobs where someone comes to me for help, that is to say they are more often than not assigned to me as the supposed expert in the field in which they require help, this removes the aspect of whether or not they require help (whilst not entirely alleviating the issue of whether I am the one always best placed to give it). I have had successes and I have had failures, in my opinion I have succeeded at times where others might not and I have failed in circumstances where others might have fared better, such is the nature of the work I do. I would like to hope that at no point does anyone feel that I don’t give a shit even if they might struggle occasionally to see where the evidence of it is, the truth is that at times I struggle to focus on the amount of different strands required to keep all the plates spinning at the same speed. This is a lack of capability not a lack of will, which is a shame in a way because were you not to care enough it stands to reason that you wouldn’t lose any sleep over it. Sleep is a precious commodity.

I don’t require much to keep me going in my efforts to help but the one thing I need above all others is belief and when I look at the rest of my life I think I have something of a reliance on that in wider terms, when the faith goes so my own ability to care begins to decay. As a consequence I don’t think I am always as well placed to work through adversity unless I am able to quantify it in logical and linear terms and of course faith and belief are seldom logical or linear. That leads me to question why this reliance might be and whether there is more to it than simply reinforcement to bolster my own lack of self-esteem. I do not believe I am so self-absorbed as to be functioning purely propelled by self-validation. I don’t say that glibly, the self-esteem angle is clearly a predominant factor but there are areas in which I have more belief than others and therefore perhaps it isn’t as simple as it might seem at first. I should at this stage point out that I am not approaching this knowing the answers to any questions posed per se, I might have suspicions or ideas but this is a journey into some of the less dark depths of the mind in order to look at what does and doesn’t stack up, whether any descent into the emotional abyss comes from it I can’t really say. I don’t feel dressed for a journey into the deep and therefore can only look to wander around the slightly less cold areas and hope that inspiration occurs.

Something I genuinely don’t know is whether my need to create, in a recording sense, outweighs my need to assist or whether they are symbiotic. Since I have had less to write and less to say so I have been less good at assisting, the loss of emotional attachment has affected both equally profoundly. I know that the nature of anything I write is not because of the idea that anyone might read it but it is enhanced by the possibility of that fact and indeed has greater significance should it bring a positive reaction to that person and crucially not merely in a sense of self-aggrandising for me but in the sense that something I have done would have presented someone else with a positive aspect to their life that might not otherwise have existed. It is this very fact that has kept me of the belief that at my core I veer towards the good more than towards the bad. Juxtaposed with that though is that I am aware of many negative traits and my failure to deal with any of these not only impacts on me but also on anyone else that I might otherwise have been able to bring positivity of any sort to and that does sadden me.

Another thing that has come to light during periods of reflection is that I all too often look for the signposts to ‘the right way’ which presents a number of potential issues: Firstly it makes thinking out of the box a great deal more difficult, secondly leading on from that is a danger of easy dogmatism and intransigence; thirdly is the fact that I may fell prey too easily to ideology rather than imperial evidence if the line is followed without questioning; finally it means that where ‘the right way’ is not clear and there is ambiguity so I can lack the motivation until matters make more structural sense. I have examples of all of these things littering my life and indeed there is no easy or right answer. Some of these areas make me better at my job, the eye for detail and adherence is good for policy and the law both of which come into play, the innovators with grandiose ideals and ‘all the best intentions’ sometimes lack a sense of grounding and an ability to pinpoint what the pitfalls might be whereas I lack very often the grandiose ideals in the first place but seldom lack the ability to pick apart someone else’s. However this is where it is important to draw the distinction as to why I might do so. It would be a very different task seeking to denigrate someone’s ideas, hopes, dreams in order to put them down but it is quite another to want them to be aware of what the possible impediments might be to their achieving it so that to be forewarned is indeed to be forearmed. This again is an area in which I am confident in my reasons and my intentions however all too aware that constant problem-finding and naysaying can be regarded as being purely negative because whilst not perhaps intended to be so if not juxtaposed with belief and faith it can come across simply as criticism for the sake of it. I guess what I long for is to be one that the ideas people come back to and say thanks for your input we couldn’t have done it without you, the one tasked with finding the bear traps and figuring out the way to circumvent them.

It is I believe not important to me to be the Glory maker, I seek some respect rather than adulation, I like to make people laugh and think rather than obey, I would sooner be John the Baptist than Jesus, rather Sherpa Tenzing than Edmund Hilary. I want to get every last man, woman and child safely home and safely away from harm, no one is left behind on my watch. I know this is important to me I just hope that I am able to achieve it and that there are not paths along which I have walked strewn with those whom I have missed.

Song Of The Day ~ David Bowie – Ashes To Ashes