Mental Patient About Town

I’m just coming out of a week of severe depression in which I have done nothing but lie in bed chewing the duvet. The usual stuff: being dehydrated but lacking the motivation to go to the kitchen and get a glass of water, every minute seeming to last hours with even the sound of the clock ticking being painful, the belief that the depression will never end and that suicide is the only way out.

I feel cheated. After several years of resisting more medication I finally relented recently and accepted that I need more drugs. But the consultant didn’t want to prescribe a mood stabilizer until she saw how I get on with the anti-psychotic amisulpride. I have been slowly increasing the dosage over a period of a few weeks and I’m now almost at the level where miraculous results might be expected. I do feel less angry and less dysphoric, but that might just be the way the moods are cycling rather than the effect of the drug. It’s a game of wait and see.

It looks to be shaping up to be another wet Summer. This doesn’t help. A couple of Summer’s ago, when it was pleasantly warm and sunny, I would get the tube down to St James’s Park even on days when I was depressed and unmotivated to go for a walk. Just sitting in the sun and feeding the squirrels made me feel better. Now I just sit at the desk and watch the rain or lie on the bed and listen to the rain. In Winter I love being cosy indoors with the sound of the wind and rain outside, but for Summer I have different expectations. I need to be outdoors with the sun on my skin, preferably with it warm enough to wear shorts and a t-shirt. I like the sense of ease and relaxation that Summer sun brings, the feeling of days being endless and unhurried. The pace of life seems slower and this suits a mental.

And then there’s the diet. I’m back on the weight loss diet in earnest, the belief being that it’s easier to lose weight in Summer ie. the heat makes you less hungry (and other truths/myths). I suppose the plus side of the wet weather is that I’m not having to endure days of sweat-stained fatso suffering, I’m not being bullied by the heat.

The BBC Proms season starts next week which means I go through the annual tug of war: loving the music, loathing the culture. Having concerts to listen to on Radio 3 will give my days a bit more structure. When I’m semi-depressed (my default setting) I like to listen to classical music, though when I’m full on depressed I find listening to music painful. I hope to attend a couple of concerts, money and health permitting. I can sit there snarling at the British upper middle-class at play. I’ll look forward to that.
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Also noted

Psychiatry on the couch: psychiatry within the NHS is being devalued just at a time when exciting discoveries are being made, says Dr Paul Keedwell in The Guardian.

However, anti-psychiatry is still alive and kicking, and, I believe, leading to decreased access to medical aspects of care. Rufus May, the latest antipsychiatry incarnation, was the subject of a recent Channel 4 documentary featuring Ruth, a young doctor with a diagnosis of bipolar disorder who was hearing voices. On this programme May encouraged her to stop medication that had been prescribed for her by a psychiatrist. Instead he used an unproven strategy of relating the content of her voices to childhood experiences. Although I accept that some views are ‘balancing’ rather than ‘balanced’, the amount of airtime that views such as this are given is worrying.

The article goes on to say:

Psychiatrists need to get smarter. They need to promote their ‘unique selling points’ within the NHS. We need more psychiatrists, not less. We need more research, not less. We need better quality inpatient care, with less pressure on beds, and more trained nurses with more time on their hands to speak to patients. All patients should have access to a psychiatrist if that is what they want, as is the case in the private sector. Also, psychiatrists should press for all psychology undergraduate courses to include some neuroscience and genetics in their curricula.

Challenge to the ‘team’ ethic, also in The Guardian.

An article in the British Journal of Psychiatry has questioned whether the broad-based team approach is putting patients at risk. In response some people vigorously defend the multi-disciplinary team.

One service user and psychologist, Liz Miller, suggests the article represents a “biological bite-back”, and is a response to the successes of the service-user movement, which has challenged the authority of psychiatrists. “The biological model [of care] is based around treatment,” she says. “I am not saying it doesn’t have a place, but the idea that psychiatrists somehow have a deeper understanding of mental illness is bollocks.”

Bollocks? I do think psychiatrists have a deeper understanding of mental illness by virtue of the fact that it is an illness and doctors diagnose and treat illnesses. But then I’m resolutely a patient, not a service user.

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Not mental health related

The Travels of Franz Kafka , a website that chronicles the many places and social interactions of Kafka. A photographic journal collection of his life as he traveled.

Regular readers of this blog are in for a shock: I actually managed to go somewhere and do something!

Last Thursday afternoon I travelled down to Whitstable on the Kent coast and stayed overnight. I spent Friday exploring the shoreline, eating seafood and lying on my back listening to the sea.

I managed to pull off this extraordinary feat through a friend giving me the loan of his girlfriend for a couple of days. Ruth agreed to accompany me and undertake general hand holding duties. She did very well, though she didn’t quite get the hang of it at first: she had the idea that we’d, “pop down to Victoria”, “hop onto a train” and “mooch around and look for somewhere quirky to stay”.

I had to explain that I don’t pop anywhere, certainly can’t hop and would never dream of mooching. Everything I do has to be meticulously planned in order to reduce anxiety. My preference would be to be accompanied at all times by a couple of guys from health and safety wearing those florescent yellow jackets and carrying clipboards. I’d like risk assessments carried out on every activity I perform.

Whitstable has lots of quaint and quirky hotels and B&Bs, but unfortunately I don’t do quaint and quirky. I do bland and predictable so we stayed at the Premier Inn. It’s true that its location wasn’t exactly scenic - it appeared to be on the edge of an industrial estate - but it was very standardized and safe.

The trip was marred slightly by the fact that on Thursday night I couldn’t sleep - despite having taken olanzapine, amisulpride, valium and zopilcone. The problem started while I was reading Private Eye’s description of Dr Raj Persaud as suffering from, “cuttus pastus plagiarensis (or Ripov’s Syndrome as it is sometimes known)”. I just couldn’t stop laughing. I then lay awake for several hours, finally dropping off while reading the hotel’s bible. In my opinion the bible isn’t of much use, but it does help you drop off to sleep. I like Revelations, which is the biblical equivalent of a Hollywood disaster movie.

Friday was just perfect. I wandered around the harbour and found a spot on the beach to watch the tide come in. Ruth went shopping. This surprised me as Whitstable’s main shopping street is only a few hundred yards long. Nevertheless she managed to shop away quite happily for several hours. I had a quick look in the gift shops later on and bought a few postcards to send. I had amazing cod and chips in a seafront restaurant.

As a holiday - albeit for just one night - it worked: I have returned to London feeling less jaded. I have gone back to going for walks through Hyde Park and I have managed to crack on with the task of “deep cleaning” the flat.

That said I’m left feeling sad that I can’t go away more. I don’t have the money, but also I don’t have the emotional resilience to handle changes to routine. More than ever in the past few days I have been wishing that I wasn’t a mental.

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Also noted

The gain in Spain means looking on the sunny side: Clare Allan writes in the Guardian about going on holiday.

Fear of change is a far more powerful deterrent. Many people with mental health problems cling to the familiar; any change in routine can feel like a threat to survival.

Exactly.

Smoke ban for mental health units, reports the BBC.

I bet it’s going to be fun on mental health wards in the next few days.

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Not mental health related

Ten very rare clouds

Yesterday I managed to go to the launderette for the first time in over two months. I’m now wearing clean clothes and my duvet and sheets smell fresh. It may be a small thing but this has lifted my spirits.

Keen to build on this success I’ve just got a haircut and as well as paying my bills at the paypoint shop on the Earls Court Road. Being a poor person means I have metres for the gas and electric, so I pay a higher tariff. Something’s not quite right there, I keep thinking.

But I mustn’t grumble. I have gone a few days now without major problems with paranoia or believing people can hear my thoughts. The dysphoric mania has returned but it’s not too bad. I wasn’t able to update this site Monday or do much of any use but today I’m able to sit at the computer and I haven’t head butted it so far.

With regret I have to say that I have abandoned the idea of updating this site on a scheduled basis. The plan was to do Monday, Wednesday and Friday. It’s just not working. Although it only takes an hour or so to read through the mad news sources (at the top right of the page), this is more than I am able to manage regularly three times a week. I seem to have about two days a week when I’m able to read for about an hour and construct a few sentences - the problem is I don’t know which days these will be. I go for days at a time where I do nothing but stare at the ceiling or for days at a time where my thinking is completely chaotic. To summarize, I’m far too unwell to maintain a publishing schedule - even one that only involves monging around on the web, creating a few links and writing some sarcastic comments. So from here on this site will probably be updated a couple of times a week, I just can’t say on which days.

My mood remains highly volatile. I’m reducing the amount of olanzapine I take with a view to giving it up as the dose of amisulpride increases. This could explain my erratic tearfulness. When I stopped olanzapine before I became very tearful as well as experiencing an odd mood of laughing and crying at the same time. I have been taking olanzapine for six years with only brief breaks. It’s very likely I’m experiencing withdrawal symptoms. I’m alarmed about what will happen when I stop it completely.

To complicate matters further I am having mid-life crisis type thoughts. I have been making lists to try and work out what I can do to make myself feel better about my life situation. I have come up with a plan for how I could turn things around within a year. The top goal is to lose weight, following on from that is to attempt to socialize more and to be better educated. I’m now looking at Open University courses in earnest, but also thinking about how I can educate myself. I like the idea of being an autodidact and it’s made easier by the web. Essentially I’m a self-taught web designer. I’m wondering if I can be self-taught in poetry - one of my chief interests. I know I should probably learn something practical - like PC repair and maintenance - it’s just that I have absolutely no motivation to do that. I have very little motivation to do anything except lie on my back and stare at the ceiling. If I’m going to attempt to do anything it might as well be something that sparks my imagination; something that makes me want to live.

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Also noted

A work culture not a welfare culture, trumpets a press release from the Department for Work and Pensions published today.

Freedom of choice will be central to radical welfare reform plans, the Secretary of State for Work and Pensions, James Purnell said today.

James Purnell outlined his vision for the future of the welfare system, devolving power, and opening the door for local providers to offer their own solutions to unemployment.

Mr Purnell set out a radical approach to developing employment schemes. He said the Government recognised one of the strengths of local providers is the potential to develop new solutions to existing problems.

Under the new “right to bid” process every serious idea will be properly evaluated, by a DWP commissioning team, who will report to the Secretary of State and the Permanent Secretary.

There’s much talk of radical reform, but Work and Pensions Secretary James Purnell doesn’t manage to get the word “slashing” in there - as in, “slashing the amount spent on benefits”. No discussion of benefits is complete without using the word slashing, here at Mental Patient Heights we feel that James has rather let the side down.

Never mind, he gets to talk about radical reform in the Daily Mail and the Financial Times gets all giddy thinking about how much money private companies are going to make from welfare-to-work schemes:

The “open invitation” to new ideas extends across welfare provision, including proposing welfare to work schemes that would pay private and voluntary sector service providers from the government savings made from finding jobs for the unemployed. “I’m not ruling anything out,” said Mr Purnell.

The measure is a further sign that Britain is willing to open up the “multi-billion pound” welfare-to-work market for private and voluntary providers envisaged in the Freud report, an independent examination of welfare reform.

It’s good to hear that James isn’t ruling anything out. I wonder if he’s considered providing a welfare system that meets the needs of disabled people?

Controversial diet drug approved, reports the BBC.

Evidence suggested one in 10 people might develop mental side-effects including low mood and depression, anxiety, irritability, nervousness and sleep disorders.

However, taking it can also lead to weight loss, but also improve general health, lowering blood pressure, and cholesterol levels.

Dr David Haslam, the clinical director of the National Obesity Forum, said that he welcomed its approval for NHS use, and predicted that it would be prescribed to many patients.

He said: “We can be absolutely reassured that they have looked closely at the evidence and made an appropriate decision.

“This is a very good drug, and there are very many people who have tried everything else, including other drugs, with little success, who might benefit from it.”

But Professor Alan Alan Maryon-Davis, president of the UK Faculty for Public Health, said: “Whilst these drugs may be right for some patients, they are not the long-term solution and may have potentially serious side-effects.

“Ultimately the answer has to be: eat a little less and move a little more.”

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Not mental health related

Vector Portraits 1989-1997. Photographs made while travelling 50 to 70 mph in Los Angeles and other parts of the Southwestern United States.

I have finally managed to convince myself that I should try more drugs. I had an appointment yesterday with the consultant and based on my new found willingness to start pill gobbling I expected to come away with armfuls of mood stabilizers and antidepressants. However in a shock development the consultant said she was reluctant to prescribe more medication at the moment and that she wanted to see how I get on with the anti-psychotic amisulpride.

I believe that the consultant’s thinking relates to my diagnosis. It’s now, “probably schizoaffective disorder”, for those of you who don’t know that’s a combination of the symptoms of schizophrenia and manic depression. I think she wants to see how things shape up on a higher dose of this anti-psychotic. I was never able to tolerate a higher dose of olanzapine due to sedation.

The schizoaffective diagnosis has come along because I have started to experience thought broadcast, the belief that people can hear my thoughts. However I think I already had some of the negative symptoms of schizophrenia and have done so since my early 20s. I have this odd need for isolation and social apartness. Notoriously, my idea of an intimate relationship is to have a twenty minute chat every month or so. I manage to get along with just a handful of close friends. I’m sure most people would think I’m a bit weird, though I like to see myself as some kind of friendly alien. Of course being unsocial has made some aspects of life difficult, especially work. And symptoms like paranoia have repeatedly sabotaged my attempts to get an education.

The consultant appointment cheered me up as they almost always do. I know many people don’t like psychiatrists but as I’ve said before I generally get on well with them. I’m convinced that a couple of crack consultants, armed with some graphs and pie-charts, could sort out most of my problems in no time at all. I think I need a rigorously scientific , clinical approach: this would enable me to get to grips with all these messy emotions cluttering up my life.

Unfortunately the emotions are getting in the way a bit at the moment. They are extremely volatile. While I was happily joking with the consultant, twenty minutes earlier on the bus I was struggling not to cry. The risk of crying in public is ever present, essentially it’s there every time I leave the flat.

I think I have a case of the old low self-esteem. I have been encouraging a couple of people I know to go to college, but my going to college is completely out of the question. I just know that my paranoia would go into overdrive in a crowded environment. And it’s bad enough thinking that people can hear my thoughts when sitting on a bus. How would I cope in a classroom?

I have got to the point where I’m having to measure success in very small increments. Yesterday’s major achievement - apart from not crying on the bus - was to return the DVD to the library. It took me two weeks to build up to this and the fine was £19.20 ie. much more than the value of the DVD. I wouldn’t mind but the film - Hannibal Rising - wasn’t that good. I’m not keen to see psychiatrists knocked - well, apart from that smug clown Raj Persaud (who has just been suspended from practising for three months for being a word thief).

My ambition in life now is to successfully complete a mission to the launderette and to get a haircut. If I can scale these heights of achievement I would like to start regularly going for walks through Hyde Park again. From there I may even progress to start riding my bike.

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Also noted

Many hospitals are failing to meet needs of panic sufferers, reports the Mental Health Foundation.

“The National Institute for Health and Clinical Excellence (NICE) guidelines for treating panic attacks are obviously not always being followed,” said Nicky Lidbetter, Chief Executive of the National Phobics Society (NPS). “A&E is often the first port of call for a panic attack sufferer, as they sometimes feel they can’t breathe or are having a heart attack. We know that A&E departments are very busy and under resourced, but it is essential that staff get it right because the standard of care and advice offered in accident and emergency can impact on the severity and duration of future attacks.”

Nicky Lidbetter continues, “The National Phobics Society has found that the focus in A&E departments is very much on physical health, and often there is a lack of professional skills in dealing with mental health issues. It is inappropriate for a panic attack sufferer to wait for long periods of time in a crowded waiting room, only to then be sent home without treatment or advice – and this is an all too common occurrence.”

My experience of panic attacks is having them on the tube. I am now unable to go on the deep underground lines like the Victoria or Piccadilly. However despite having a number of attacks it never occurred to me to call an ambulance or go to A&E. I guess that I was lucky in that I realised I was experiencing a panic attack and that what I needed was calm. Obviously you wouldn’t get that in an A&E department.

Medical News Today reports, Being Fat In Today’s World Invites Social Discrimination.

Health care providers’ efforts to convince overweight patients to lose weight are largely unsuccessful, Komesaroff believes, possibly because they do not understand the key issues that obese people face.

“The experience of being obese is often painful,” he said. “Many obese people have major social and psychological issues that doctors and public health policies [often] do not address.”

Nearly 50 percent of the participants (37 of 76) described poor mental and emotional health, including depression, related to their overweight, study data showed. Nearly all (72 of 76) said they experienced humiliation and discrimination regarding their weight, either in childhood or as adults. Twenty participants - more than 25 percent - regularly tried to lose weight quickly by going without eating anything for periods - essentially “starving” themselves.

While waddling down to the library, clutching the DVD in my great fat fingers, I had a couple of building site workers take the piss out of me. One of them did an impression of a roly poly type walk as I went passed, the other laughed and then puffed out his cheeks. I was surprisingly cool about it and remained unintimidated by these two intellectuals. But then I’m back on the diet and just keep telling myself that if I lose two pounds per week I’ll be thin within a year.

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Not mental health related

New York black and white photos

Benefits and Work are reporting that Stephen Timms, Minister for Employment and Welfare Reform, appears to be distancing himself from the government’s welfare reform advisor David Freud.

A number of Benefits and Work members who complained about Freud’s inaccurate and harmful misrepresentations have received a letter from the Office of Stephen Timms, Minister for Employment and Welfare Reform.

The letter attempts to disown any responsibility for Freud’s now notorious Telegraph interview, claiming that “the contents of Mr Freud’s recent press articles were not prompted by research commissioned by the Government, and reflect his own views.”

The article lists the factual errors made by Freud in the Telegraph interview:

David Freud, an extremely wealthy former City banker, claimed in an interview with the Telegraph in February that “disability tests are done by people’s own GPs”, that 5-7% of incapacity claimants are working in the black economy and that two thirds of claimants should not be receiving incapacity benefit.

The first of these statements is simply wrong and the other two are contradicted by a wealth of the DWP’s own research findings.

If the government’s own advisor gets it so wrong it’s unsurprising that there are so many inaccurate media reports concerning welfare reform.

In campaigning mode, Benefits and Work questions the role of the Child Poverty Action Group (CPAG) in an upcoming welfare reform conference.

Child Poverty Action Group are prominent supporters of a £528 per ticket Welfare to Work Conference at which David Freud is one of the keynote speakers. Other speakers include the Secretary of State for Work and Pensions, James Purnell, and Lesley Strathie, Chief Executive of Jobcentre Plus.

CPAG’s logo appears alongside the DWP and Jobcentre Plus logos on all the publicity material for the conference, taking place on 25 and 26 June in Birmingham. In addition, the campaigning group are running a joint workshop with the DWP on child poverty.

I think it’s got to the stage where many people now question the independence of charities. The advice sector, for instance, is wholly dependent on government funding and could only manage a few mealy-mouthed words about commitments not being “followed through” when the government cut money for the disabled.

Mind Week this year was an anodyne non-campaign on debt, designed not to offend anyone. The other mental health charities are largely just as keen not to upset their paymasters.

As an old-timer I think I owe it to the younger madsters reading this site to point out that there was a time when charities were openly critical of government. That, of course, was before the critics all got well paid jobs with pensions.

Back in the 1980s - when we all had big hair and shoulder pads - things were far more confrontational and I think the world was all the better for it.

Now it’s down to private companies like Benefits and Work to do the campaigning. What strange times we live in.

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Also noted

Doctors “ignoring drugs warning”, reports the BBC.

The CSM considered research evidence for risperidone and olanzapine - two widely sold drugs and usually used for conditions such as schizophrenia - sending an urgent message to GPs four years ago.

“Evidence reviewed by the Committee on Safety of Medicines indicates an increased risk of stroke which particularly applies when these drugs are used by elderly people with dementia,” the CSM said.

It added: “The Committee has advised that risperidone or olanzapine should not be used for the treatment of behavioural symptoms of dementia.”

The File on Four programme this report is taken from is available in podcast form.

Also from the BBC, Nurses to be rated on compassion

Nurses are to be rated according to the levels of care and empathy they give to patients under government plans.

Health Secretary Alan Johnson told the Guardian newspaper that he wants the performance of every nursing team in England to be scored.

He suggested the results, compiled by regulators using patient surveys, could be displayed on an official website.

But he ruled out rating individual nurses and also said it would not affect pay.

Perhaps they could rate individual nurses “cuddle factor” and display the performance results on their name badges like the staff in McDonalds. Just a thought.

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Not mental health related

New York City waferfalls

I am in severe danger of repeating myself here as I yet again report that things are pretty grim. However, it’s a quiet day for mental health stories so I may as well write about myself.

The thought broadcast - believing people can hear what I’m thinking - is back. It’s not as bad as it was, it’s more of a nagging doubt than an absolute conviction, but it’s still very difficult to deal with.

I’m completely unmotivated to do anything, especially if it involves leaving the flat. I desperately need to go to the launderette but I’m not sure if I can face it.

I received a copy of the letter the consultant sent to my GP. It lists my symptoms but it doesn’t encapsulate the consequences, you don’t get a sense of how difficult I find daily living. It’s such a struggle just to do basic things like keeping the flat clean and shopping. Shopping is especially difficult at the moment as I have severe problems with paranoia and become convinced when entering a supermarket that the guards are following me. My constant looking around, especially at people behind me, attracts attention and this doesn’t help.

If all this weren’t enough, I’m also having mid-life crisis type thoughts about being so unaccomplished. Being a mental patient on benefits is not much to feel pleased about. I have thought about doing something like an Open University course, something I could list as an achievement.

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Also noted

The impact of polyclinics on mental health care is unproven and potentially damaging, the Mental Health Foundation warns.

People experiencing mental health problems, for whom a GP is usually the first port of call, account for a 1/3 of GPs’ consultation time.

90% of people with mental health problems receive all their treatment from primary care services.

There is an urgent need to examine how the proposed shift away from GP surgeries to much larger polyclinics will impact on the primary care of these patients, says the Foundation. Of particular concern is how the loss of the local ‘family GP’ will impact on patients’ willingness to present with mental health symptoms.

Of course the experience of speaking to family GPs about mental health issues is not quite as heartwarming as the Mental Health Foundation suggests.

“Mental illness is petrifying”, reports Psychminded

Day-to-day life as an inpatient on a psychiatric unit is being documented on an internet blog by a woman diagnosed with bipolar disorder.

Mandy Lawrence, aged 45, was admitted into a six-bed NHS psychiatric unit in Bedfordshire on Friday last week and is writing about her experience.

The blog is believed to be the first by a patient while an inpatient on a mental health unit.

It’s worth noting that There and back has also been blogging while being an inpatient.

Profile: Dr Raj Persaud, by the BBC.

The TV psychiatrist and alleged word thief has nine degrees! To have put all that effort in and then get caught with your fingers in the till - terrible.

“Hunger hormone” depression link, reports the BBC.

High levels of the “hunger hormone” ghrelin have an antidepressant effect, US researchers claim.

He said the results made sense from an evolutionary standpoint, as hunter-gatherers may have had a survival advantage in remaining calm and collected in times of hunger in order for them to successfully find food.

This is all very well, except I’m not a hunter gatherer - unless that includes foraging trips to the Earls Court Road.

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Not mental health related

American gothic on Flickr

Things are not going to plan here. I’m supposed to be updating the site three times a week with mental health links but it’s not working out due to illness. I’ll tell you about my week.

Things began well. One Monday I had a lengthy phone call with a journalist from the BBC who contacted me via this site. BBC 2 are planning a documentary looking at mental health from the point of view of the patient. It sounds like they are talking to a lot of people and that it will be thoroughly researched. They also spoke to Seaneen and I sent them a list of various people in the madosphere who I thought should contribute. I stressed to the BBC chap that Seaneen would be the ideal mental patient on telly as I think the way she talks about her experiences would resonate with people. I really hope they pick her to appear. I’m not very keen about appearing on television and I can’t imagine why the BBC would want me - I doubt they are desperate to reach the fat-bloke-in-their-40s demographic. It’s unlikely there have been any BBC management reports stressing that there needs to be more fat blokes on our screens: “…we’re not serving the fat bloke community! Fat blokes are an underrepresented section of the BBC audience…”.

Just as this conversation ended my support worker came to the flat and we headed off to Chelsea’s famous Kings Road to look in the bicycle shop for a new saddle for my bike. I have had the bike for over four months now. There have been many excuses for why I don’t ride it and the latest is that the saddle is uncomfortable. The truth is I’m just lazy. There is - for crying out loud - a cycle path that goes from outside my front door all the way down to Kensington Gardens (well, with just a short break) and from there through Hyde Park to Westminster. I could, for instance, cycle down to Hyde Park, walk around the Serpentine and then cycle home. I’d get both the puff-puff exercise of riding the bike and the relaxing experience of walking through the park. It would be ideal if it weren’t for the fact that I’m such a lazy fat bastard.

From the bike shop I returned home and updated this site. Updating this site should be a very straightforward process that presents me with few problems. It takes about an hour to an hour-and-a-half to click through the mad news sources and to make a few worthy or sarcastic comments. Done three times a week - Monday, Wednesday, Friday - this would be far from arduous and would provide a service to my fellow madsters. The site gets a modest but respectable 70 to 100 views a day and generates just the right amount of comments from my urbane and sophisticated readership. I wish I could settle into a regular pattern and maintain this site, however…

After my chat with the BBC, my walk down the Kings Road and time spent working on this site I thought I’d end the day with a walk through St James’s Park: a pleasant Summer evening, what could be finer?

I was on the tube - reading a book of Allen Ginsberg poetry if you must know - when I started to believe that people were communicating with each other about me through rustling newspapers. First the woman on my right would rustle her newspaper and then the guy to the left would rustle his paper in reply. Then the woman on my right would reply. Worryingly it didn’t immediately occur to me that this was paranoia - in fact I was too busy thinking how devious they were for using this method. I was also trying to work out what they were saying about me. I was completely caught up in this and had lost the much touted insight.

I got off the tube at Westminster with an angry glance over my shoulder and headed out into the street. I walked along for a minute feeling unsettled and then reached the Whitehall junction. Seeing a couple of people smoking cigarettes got me thinking that people were using cigarettes as devices to send secret messages about me. My initial reaction was anger, but then I started to laugh. I thought how ingenious - I never would have thought of that! I walked along marveling at this until I reached St James’s Park. Sitting there on a bench it was easily more than half an hour before I realised that all this was just paranoia.

Things haven’t returned to normal. As I walked home Monday I kept having feelings of suspicion of people around me and this has carried on throughout the week. It’s very difficult to define what I am suspicious of exactly, I just have this ever present nagging feeling of suspicion. A few times I have had the belief that people can hear my thoughts but this is not as pronounced as it was a few weeks back.

I haven’t wanted to go out, but I had to go to Earls Court Road on Wednesday. I needed to charge the electric key and buy food. I knew that I was going to have paranoid ideas and sure enough I thought that the staff in the paypoint shop were laughing at me, ditto the staff in M&S. The woman at the counter in M&S gave me a very concerned look but I think this was due to me constantly looking around and especially at people behind me. This behaviour adds to the overall care-in-the-community look I have about me.

After starting amisulpride last week I was feeling optimistic. It worked on my feelings of rage within a few days and I hoped it would work for other symptoms. I’m still building the dose up so I suppose there is time yet for it to work. I just want quick results.

It’s occurred to me that I suffer from Psychosis Lite rather than the full fat version. There are, after all, people on psychiatric wards for months if not years on end with psychotic symptoms that don’t respond to medication. I should probably consider myself lucky in that I seem to have short bouts of symptoms ie a month of thought broadcast, a few weeks of dysphoric mania and a week dominated by paranoia. However I never seem to be free of some symptom or other and added together it is very disabling.

I am left wondering what R D Laing would make of all this. Would he blame my mother? I don’t, but then I accept that my illness is biological. In that sense I should blame my father as mental illness runs in his side of the family.

I have finished reading The Divided Self. I didn’t find it an excellent read or engaging as people had suggested. In fact I found it quite tedious, with only the final third being in any way enjoyable - and part of that pleasure was laughing at it. The case studies - so carefully constructed - read like the work of an imagination overreaching itself. I just didn’t find the arguments convincing. I don’t think biological psychiatry has all the answers - I’m just as likely to scoff at the vague references to “chemical imbalances” - but I think it goes some way towards providing an explanation. It’s heading in the right direction.

It’s a very quiet day for mental health stories, even the Daily Mail is relatively sane. However in a time of need you can always rely on another tabloid to step up to the plate, and in this instance The Daily Express doesn’t disappoint: NEW BENEFITS SCANDAL EXPOSED.

A record 51,790 claimants pick up stress-related incapacity benefit and cost hard-hit taxpayers £122million every year in Britain’s sicknote culture.

The payments – which have soared from just 5,700 before Labour came to power in 1997 – reflect a growing awareness of illnesses linked to stress at work, insist officials. But critics suspect many claimants are workshy scroungers malingering at the taxpayer’s expense.

The first thing to note is that there’s not really anything new, nor scandalous. It turns out that some people are signed-off work due to stress. It could well be as officials believe that there is more awareness of the role of stress in illness or that stress is just the new name for what doctors would have previously generically labeled “mental illness”.

However, you have to admire the writing - or sub-editing - skills here, particularly the phrase, “workshy scroungers malingering at the taxpayer’s expense”. Workshy. Scroungers. Malingerers. So many tabloid folk devils in one sentence.

The article continues in the same vein and ends with the now obligatory factual error concerning doctors writing sick notes. Here Matthew Elliott of the TaxPayers’ Alliance helps us out: “Surely a better system would be to have Government-approved doctors to assess the worth of people’s claims”.

That, as every incapacity benefit claimant knows, is what already happens.

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Also noted

Twice the punishment: prisoners with mental illnesses suffer neglect and alienation, as well as the sentence handed down. The WI is campaigning for change, reports The Guardian.

Not content with cake baking and appearing naked in calendars, the WI are taking on prison reform.

Following three months of debate in every branch in England and Wales, delegates at the Women’s Institute (WI) national conference in Liverpool yesterday voted overwhelmingly – 6,205 in favour and 173 against - to call a halt to the inappropriate imprisonment of people who are mentally ill. This heralds the start of a powerful WI campaign which will see ministers, MPs, courts, health and prison authorities called upon to introduce far-reaching reforms.

The article notes the role mental health - and failed care in the community - may play in the rising prison population.

Some mental health experts believe that the under-resourcing of health reforms in the late 1980s and early 1990s has contributed to the rapid rise in prison numbers. The prison population in England and Wales has soared (pdf) from just under 45,000 in 1990 to almost 83,000 today. An estimated 5,000 people at any one time are thought to be too ill to be there.

The BBC reports, UK society “demonising’ children”.

Public bodies are legally bound to put the best interests of a child first in decision-making. But the commissioners said this key legal safeguard had failed in some parts of the youth justice system for England and Wales.

“The system is dominated by a punitive approach and does not sufficiently distinguish between adult offenders and children who break the law,” says the report.

“Compared to other European countries, England has a very low age of criminal responsibility and high numbers of children are locked up. Too many children are being criminalised and brought into the youth justice system at an increasingly young age.”

Carers “ignoring their own health worries”, reports the Mental Health Foundation

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Not mental health related

Ever used a slice of bacon as a bookmark? Strange found bookmark stories. Fascinating.

Thursday’s appointment with the consultant went well. I have finally overcome my fear of medication enough to try a new drug. I am now on the anti-psychotic amisulpride (or Solian to use its brand name). I also came away with a stash of valium. I’m not sure whether I’m going to need these and was thinking I could sell them on the Earls Court Road: you get a good price on the black market.

There was some discussion about my diagnosis. I have been experiencing thought broadcast (believing people can hear my thoughts) which the consultant described as a, “first rank symptom of schizophrenia”. As I understand it, things point towards schizoaffective disorder though the consultant said she wanted to see how I respond to various medications before making a final diagnosis.

The amisulpride may have started working. I feel a lot calmer. Last week I was like one of the infected in the film 28 days Later, filled with murderous rage. My throat was sore from talking aloud (to myself) and I think I’d reached the stage where I was so desperate that I would try anything to make the feeling of anger go away. Suicide was top of my list of options.

I’m still waking with this feeling of heavy sadness but I do feel better. I’m able to sit at the computer and yesterday I was able to venture out to central London.

I went up to Foyles on the Charing Cross Road to buy The Divided Self by our old friend R D Laing. Don’t worry, I’m not going to go all anti-psychiatry on you (I’m not that mad), it’s just that I have heard about R D Laing so much I thought I should read one of his books. Apart from anything else, I’ll be able to reply “yes” the next time some po-faced accusing anti-psychiatrist yells, “Have you read any R D Laing? Have you read any R D Laing?”. Ironically, as people except anti-psychiatrists seem to know, R D Laing rejected the term anti-psychiatry.

My views on the anti-psychiatry debate are very straightforward. In response to the question, “Is there such a thing as mental illness?” I say - of course there fucking is! To me it’s like asking is there such a thing as cancer. I don’t know how anyone can spend two minutes on an acute psychiatric ward and come away with the idea that schizophrenia and manic depression are not illnesses. People are not expressing themselves differently, they are clearly ill. I am clearly ill.

I have had a couple of people go anti-psychiatry on me, one of whom was a former close friend who had the fabled Cultural Studies degree. I would have been quite happy to talk through the issues - as I’m generally quite happy to talk through the issues on just about all subjects - but I wasn’t allowed to speak. I had to sit in silence during this bizarre deluge of abuse. It was one of the strangest things I’ve seen. I wonder if this was what Foucault had in mind when he talked about discourse?

I was going to join in the anti-psychiatry debate on Mental Nurse, but it feels like a waste of effort. Views tend to be very entrenched and uncompromising - on both sides. Debate, when it comes to anti-psychiatry, is probably the wrong word. Don’t get me wrong, I think Mental Nurse is an excellent site, it’s just that the debate goes downhill whenever the subject of anti-psychiatry appears.

My views are obviously shaped by the fact that on the whole I quite like psychiatrists. I have got on well with most of the psychiatrists I have met. I was very interested in Seaneen’s post on doctors vs. nurses. Unusually perhaps, I much prefer doctors. I get on okay with social workers. I haven’t got on too well with nurses - and I’m likely to kill the next therapist I meet. I like discussing my symptoms in academic language. I don’t like people thinking they can empathize with me when it’s clear they don’t understand what I’m talking about.

I’m kind of rambling now so I’ll wrap up. I feel a lot calmer and I’m probably well enough to get back to writing on this site. I hope to go back to updating Monday, Wednesday and Friday with links to mental health stories and sarcastic/worthy comments.

Things are still pretty grim here. I didn’t update the site Monday as scheduled as I couldn’t find the energy or motivation to get out of bed.

My support worker came round Monday afternoon. He realised there is a problem and phoned my care co-ordinator (it seems I haven’t been discharged from the Community Mental Health Team (CMHT) after all). She in turn spoke to the consultant and my appointment has been moved forward two weeks - I’m seeing the consultant tomorrow. We’re supposed to review my medication. In practice this will mean me asking for valium and the consultant offering sodium valproate. I’ll probably end up taking sodium valproate as to be honest I’m past caring.

I should really give the higher dosage of omega 3 a go, but I’ve had the prescription for over two months and haven’t got around to collecting it: this is one of many signs of my extreme lack of motivation. Another is my inability to return a DVD to the library. The fine I’m going to get will be more then the value of the DVD.

As a result of watching BBC Springwatch - as well as tuning into their webcams throughout the day - I have come to the conclusion that what I really need is a cottage in the country. I’d like somewhere near the coast, possibly in Saxmundham in Suffolk. I could spend my days either birdwatching at Minsmere or pottering around the garden. Evenings would be spent watching the crimson sunset with a nice glass of wine, listening to a symphony on Radio 3.

You know, to be honest, I’m an ungrateful bastard. Many mentals who are housed by the council end up on a rough estate with the ever present risk of harassment. I have a lovely flat in a quiet tree-lined street and still I’m not happy. I waste away the hours fantasizing about winning the lottery and retiring to Suffolk when I should be thankful for what I have. Hyde Park is just 20 minutes walk away; though with my lack of motivation it might as well be the other end of the planet. Instead of wishing to win the lottery I think I should concentrate on wishing for an end to this depression.

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Also noted

Pathways to Work not working, reports Benefits and Work

A report commissioned by the DWP shows that the Pathways to Work programme has had very limited success in relation to long-term incapacity benefit claimants. A further DWP report suggests that Pathways primarily helps those who would have moved off incapacity benefit within a year in any case.

The report ‘Evidence on the effect of Pathways to Work on existing claimants’ looked at claimants who had been receiving incapacity benefit for at least a year and who were put onto the Pathways programme in pilot areas. It found that after 18 months only three to four percent had entered employment of any sort, whilst even fewer had done so when only jobs of 30 hours or more were taken into account. Moreover, there has yet to be any examination of how long these claimants remain in work.

I believe the terms used is “parking”: the Pathways to Work contractors ignore the hardest to help while concentrating on the easiest. In the recent Panorama programme it was pointed out that Pathways has a poor record for people with mental health problems - of course, that may well be because the people are not well enough to return to work.

I can vote, I can pay tax - so why can’t I sit on a jury? asks Clare Allan in The Guardian

Most people probably aren’t even aware that those with mental health problems - wherever they might stand in that enormous bracket - are barred from jury service. But in fact, according to figures from the Ministry for Justice, 750 people a month are disqualified from service on the grounds that they are receiving treatment for a mental health condition. That’s 9,000 people being told each year that although they may be employed, pay tax and vote like anyone else, as far as jury service goes, their judgment is invalid.

I have a terrible confession to make - I’m relieved that being a mental lets me off jury service. I couldn’t cope with the practicalities - or even simple things like time keeping - associated with being on a jury. Is this such an awful thing to admit?

The Press Association reports, Best’s ex-wife reveals Gazza fears.

The ex-wife of footballer George Best has recalled the “circus” surrounding his alcoholism amid rising concerns for Paul Gascoigne’s health.

Alex Best, speaking on GMTV, said fans would flock to pubs where her ex-husband had been seen. She said: “People used to come for miles to watch him drink, it was a kind of circus.”

“People used to come for miles to watch him drink”: bored with the telly, fed-up with the gardening centre or Homebase? What would motivate people to want to watch someone drink themselves to death?

“Dad solved other people’s problems - but not his own”, reports The Guardian on R D Laing.

I found this fascinating. To tell the truth I know very little about R D Laing as my brain switches off every time some po-faced anti-psychiatrist mentions his name (that should read brandishes his name like a weapon). Maybe I should read some of his work.

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Not mental health related

The Ukulele Podcast