The Insane Guide to Living With Mental Illness: The Mixed Episode

Ah, here we are. It’s now time for me to introduce the special circle of hell reserved for the manic depressive: the Mixed Episode. These were meant to be funny, sarcastic guides (like the Depression one was) but somewhere, it’s become all serious!

A mixed episode (also known as dysphoric mania or, for depression with hypomania, agitated depression) bears a little explanation. It is literally a mix of manic and depressive symptoms at the same time. It’s generally considered as the most dangerous of mood states, being that if you want to kill yourself, you have all the energy and frantic invention necessary at your disposal with which realise that particular dream.

However, if you believe the DSM-IV, relatively few people with bipolar disorder experience these episodes. The reason? It is strictly defined as mania and depression for a week; leaving out hypomania, thus nobody with bipolar II or cyclothymia has ever had a mixed episode. From my forays into BipolarLand, reading and research, please take it from me (and the dissenting voices in the psychiatric community) that the DSM-IV needs updating. But lucky me, eh, bipolar I, so, by the DSM-IV rules, anything goes.

It lies close to my heart. Dysphoric mania is, by far, the most common episode that I experience. Those much romanticized euphoric manias has almost disappeared as I have grown older, and my manias are now increasingly black and almost always psychotic. It’s why I’ve escaped being diagnosed with depression. I’ve been suicidal and depressed many times in my life, but the manic edge which accompanies my depressions has exempted me from being considered clinically depressed. It is one of the reasons, I suspect, that even when I’ve been in front of a psychiatrist absolutely suicidal, the relentless diagnosis of bipolar I has always been returned.

It is difficult to describe how it feels; imagine the white noise of racing thoughts pitched at total destruction and despair, horrible images, frightening visions, flights of ideas punctured by the bleak feelings of failure, endless energy overriding utter, utter exhaustion, nameless guilt, manic lack of inhibition, rambling and ranting, restlessness, the damaging impulsivity and grandiosity of mania, terrible agitation, rage, anxiety, panic, psychosis, paranoia and fear. It can be constant, or can fling you from mania to depression and back again extremely quickly.

A mixed episode landed me in hospital, and mixed episodes are almost totally at odds with normal functioning; it is simply impossible to go about your normal life when in a mixed episode. Everything is frightening or an insummountable challenge.

Yes. They’re no fun. So, here’s the Insane Guide to the Mixed Episode. I found it difficult to be sarcastic about mania, it’s almost impossible to be lighthearted about the dysphoric kind. So this guide is kind of crap.  Apologies.  Read the previous ones instead by clicking on the category, The Insane Guide…

The Mixed Episode

Manic, depressed, who the hell cares, you can have it all! Welcome to the mixed episode. You may never leave. I really mean that.

1. Eating and self-care

2. Social etiquette

3. Hobbies

4. Sleep

5. How to deal with those around you, who may not be so excited about your insanity as you are! Includes lovers, friends and the medical profession.

6. The future

1. Eating and self-care

Have you eaten? You can’t remember the last time you ate. You probably should eat, but you can’t focus long enough on anything, let alone the thought that you need food. Everything feels like it’s been put there to test you, and you find yourself by the kettle in tears of frustration. You can’t even do that, a task that wouldn’t tax a five year old. You can’t do anything.

You brush your hair and teeth, on automatic, and neglect to put on underwear, simply forgetting. It doesn’t feel very important. You can’t really concentrate, your clothes are a jagged mish mash of colours and shapes, old blood stains seeping through the cheap fabric. You look in the mirror but you can barely focus on the image. There’s pictures in your head, horrible pictures, that seem to permeate everything you try to look at.
2. Social etiquette

You did go out for a drink but found yourself crying at a table alone. You’ve been trying to talk to your friends but you just can’t, you can’t communicate at all. The words, rapid and free flowing, are not making sense. People can’t keep up with you. They listen, for a second, but you’re going too fast, and they drift off, nod, and turn their attention from you. You don’t look right, your eyes are fire in pitch from lack of sleep.

Self pity kicks in, and you’re convinced that everybody hates you, more than hates you, wants you dead. You are ferociously, wildly, suicidal and you begin to feel angry at those around you- why can’t they see that, why can’t they help you? The strong desire for someone to reach out is not as strong as your desire to be alone, so you leave, and walk quickly into a cold night, frightened at every single sound that you hear.

3. Hobbies

Nothing from the outside makes a difference; you can’t concentrate on a film, the things that used to calm you down don’t and your panic is rising. How can you slow the thoughts in your mind? So you have new hobbies- running on the spot, talking to yourself, anything to calm down. You’re exhausted, your whole body is screaming out to stop, but you can’t. Relentless, frantic energy grips you and there’s nothing you can do to get rid of it. Absolute rage and frustration courses through you, and the room is wrecked. You get up and write disjointed prose, the words jumbling up, making no sense at all.
4. Sleep

You tried to sleep, you lay down, but your head felt like someone was chainsawing inside, so you got up again. You want to sleep, but you can’t, you’re restless and anxious and the dark shadowy shapes in the room seem to be moving.

5. How to deal with those around you, who may not be so excited about your insanity as you are! Includes lovers, friends and the medical profession.

You’re depressed, you know you’re depressed, despair, sorrow and complete hopelessness is flooring you, but the doctor doesn’t know what’s wrong- you’re not eating too much or sleeping too much, you’ve had more energy than you’d had for some time and although you sit and talk for half an hour, nothing makes a difference.

Your friends are long gone- something you did or said, you can’t remember. Loved ones keep their distance, unable to cope anymore with your shouting and seemingly untriggered crying fits. It just compounds your guilt- you’re a bad person, and you know it.

6. The Future

You can’t think straight- tomorrow seems like it’s a thousand years away. You have no idea what you’re doing or what you’re going to do. You’ve been awake for days and are starting to become very paranoid. You don’t know how to feel safe or how to stop, you just want the agitation to calm down, for one second.

Crap guide there. I find it hard to write about. It’s just a horrible way of being and all I want to write is, “I’M SORRY” to anyone who might be going through one. To be honest, I’ve been getting so panicked and bizarre lately that I think I’m not doing too well myself. Today has been a White Noise Day, that is, very rapid, quite scary sequences of thoughts and voices going over and over in my head that frightens me and makes it impossible to concentrate.

Sometimes, I’m tempted to write down everything my brain voices say so that I can understand it. But I can’t, because they move so damn fast that it seems like malevolent gibberish.

The Insane Guide to Living with Mental Illness: Psychosis

I’d written a long, detailed Insane Guide to Psychosis, but WordPress logged me out and it didn’t save.

If you would be so kind as to hallucinate the post and be under the delusion that it’s here, that would be great.

The Insane Guide to Living with Mental Illness: Mania

I’ve covered depression in part 1 of the Insane Guide to Living With Mental Illness, so now it’s time to cover nature’s way of telling you that you’re number one.  I find mania harder to write about; it’s side by side with mixed episodes as the most destructive part of my illness.


You’re manic! Fantastic. “Mania” is Greek for “feeling fantastic”. And I bet you do! Don’t listen to anybody who tells you otherwise. What do they know? They’re just trying to bring you down. You’re better than them, anyway. You’re better than everyone. You’re special, you’re chosen. You’re a genius. The world has been waiting for you. If only you could keep that anger under control!

Becoming manic can be sudden or slow. Sometimes, when people experience mania they also experience “psychosis” (just a diagnostic label to belittle your uniqueness). In this chapter, however, we aren’t going to discuss psychosis because you’re not that mad. In fact, you’re not mad at all! You probably have to battle to keep your thoughts o- hey, are you listening to me?

1. Eating and self-care

2. Social etiquette

3. Hobbies

4. Sleep

5. How to deal with those around you, who may not be so excited about your insanity as you are! Includes lovers, friends and the medical profession.

6. The future

1. Eating and self-care

Who needs food? Food takes time to prepare and eat and time is something that you don’t have. Everything is so slow! Why on earth do people take so long cooking something? If you have a microwave, put everything in there at once. Have you ever wondered if you can iron chicken to make it cook? Now’s the time to find out! It will make it cook faster.

Alternatively, you may be feeling more hungry than usual. In this case, sweets are best, or, even better, go out and eat in a fancy restaurant! Even though you’ve been spending a lot recently, you’re not worried, the money will come from somewhere.

The place is a mess, everything must be perfect. It might be 4am but get that hoover out! Now, what else can you do? Those CD racks are a mess. Maybe you should go for a walk or do some exercise. You have so much energy these days.

And my, you look delicious at the moment. Slap on some extra make up and the less clothes, the better! You’ll turn heads whereever you go! You’re gorgeous and sexy.

2. Social etiquette

You know your friends want to see you, you’re so bountiful and charming. They are fascinated by you- who wouldn’t be? Drink as much as you like, you’re dazzling! You have so many stories to tell, such wisdom to share. They might be looking at you oddly but it’s only because they’re jealous of your wit! And your friends, they seem so sparkling tonight. You feel as if they’re all your soulmates, all you want to do is kiss them.

Every man and woman in the room wants you. You can seduce anybody you want. You can make new friends, everybody loves you. You find yourself on a man’s knee while your boyfriend watches. You know that you look so beautiful and sexy that nobody can resist you. Your boyfriend walks away and you feel a swell of rage rise up in you.

Try not to get impatient when people are set on staying in one place. Coax them to your way of thinking, let’s go, go somewhere, anywhere.

3. Hobbies

You love writing, you’ve been so great at it lately. You have so many ideas, you just wish you could hold on to them for more than a few minutes. You’ve been up all night and are surrounded by pieces of paper with scribbles on them. You decide to use the computer and you write four chapters in half an hour. But there’s loads of things to look at, too- you find yourself fascinated by the extinct creatures of history.

You try to read, but you can’t focus long enough. You pick up book after book, then find yourself obsessed with one passage. It seems to have a special significance for you- almost as if it was written just for you.

Music is poignant, unbearably so- you can only listen to a few bars before the beauty overwhelms you. You put on CD after CD- many of them new. There is plastic wrapping all over the floor, you tear through it to find more music to listen to.

You try to watch a film but you can’t stop talking. Your partner sits next to you, asking you to be quiet. But there’s so many interesting things to be discussed. Eventually, the film is turned off and you’ve been talking nonstop for two hours…

4. Sleep


5. How to deal with those around you, who may not be so excited about your insanity as you are! Includes lovers, friends and the medical profession.

There is no such thing as “too much”- you wish your doctor would stop asking you to take the medication. It’s a waste of time, all it does it dull you and make you depressed. You’ve flushed all those pills away and you’ve never felt better. Nothing is wrong, nothing was ever wrong.

Your friends are apparently concerned, but they’re just jealous. They say you seem to be reckless and uninhibited, which isn’t “normal” for you. You dismiss them- you’ve just been having fun. Your partner is exhausted, but you know they’ve been having fun too. They just want quietness and sleep but you wake them up time and time again to talk about things. You snake your hands to their chest, trying to seduce them, knowing how gorgeous and sexual you are, but you’re confused and angry when they tell you to leave them alone. Some people are just killjoys.

Your boss has had a word with you after you sent a five page document detailing ideas you had about your company to the director. He said you were overstepping the mark, you’re only an admin assistant and that you’ve been working much too late recently on projects that aren’t even yours. You leave work and hit the shops and bars, meeting people along the way. People- they walk away from you, but you follow them, determined to make them listen.

6. The Future

Achievement, stardom, success, magic- but you’ve started to feel a little bit strange. People are commenting that you seem angry, they say you’re picking fights. Your thoughts- once so fast and furious- start to get confused and jumbled. You have a hard time keeping them straight, you find that you get stuck on one word that skips like a faulty record. You’re starting to feel paranoid; everybody seems so hostile to you now, unappreciative of your specialness. You forget to eat, your stomach burning with anxiety. And nothing, nowhere, feels safe anymore…

Next: Psychosis

The Insane Guide to Living with Mental Illness: Depression

Contrary to part 1 of my “Sane Guide to Living With Mental Illness“, here is part 1 of my “Insane Guide to Living with Mental Illness: Depression”.


So you’re mental! Congratulations! Your journey here may have taken you many years or you could simply have fallen off the doorstep of sanity one day and into the garden of madness. Either way, welcome!

Insanity isn’t an exclusive club; we welcome people of all ages, genders, shapes, races and cultural backgrounds.

Now, let’s get started. Being mad, you’ll want to know just how to wear your madness well, what the etiquette is in our club and how to make the most of your insanity. Each category will have five subcategories:

1. Eating and self-care

2. Social etiquette

3. Hobbies

4. Sleep

5. How to deal with those around you, who may not be so excited about your insanity as you are! Includes lovers, friends and the medical profession.

6. The future

So let’s get started with depression.


You’re depressed! Well done. It might have started one day: you were walking home from work and you felt the bottom of your world fall out. There was a hole in the earth that you could fall through, forever. And you did. I’ll keep this short; after all, you can’t waste valuable staring-at-the-ceiling time reading this. If you can read it at all. It’s difficult to concentrate when you’re depressed. Reading the back of the pill bottle can be a daunting task- those damn letters just won’t stay still! You might find that your vision is a bit blurry- don’t worry, this is caused by the constant trough of tears that have been welling up in your eyes.

Do you remember what you were like before you were depressed? You probably thought you were a pretty good person. Well, you’re not! Say that to yourself every day: “I am a bad and disgusting person”. All you’ve ever done is make mistakes in your life. There you go!

1. Eating and self-care

When you’re depressed, there’s a limited source of food available. After all, you won’t have the energy to cook something, and if you try, you’ll probably forget and burn it. So stick with these staples: cereal, chocolate, wilted old fruit. If you can get to the shops, that is. If not, just order takeout food. It’ll make you happy!

In fact, you may not be feeling hungry at all. This is normal. Don’t worry about eating. It’s too much of an effort anyway. You could drink tea to keep going or, even better, alcohol! Alcohol is well-known to make you feel better. If you feel depressed, hit the bottle and you’ll be right as rain in no time.

If you do feel hungry, overeat! Overeating makes you feel better. It means you won’t have to eat as much next time. This saves valuable energy. Try to get some fish oil in your diet (omega 3), it’s been clinically proven to be more effective at treating depression than anything else in the world!

You might get a lot fatter but that’s unimportant; no-one cares what you look like, anyway! There is no cure for ugliness! You’re fat and useless even if you’re 110lbs!

As for your appearance, you have two choices: either remove all mirrors from your room (who’d want to look at you anyway? ) or stand staring into one for hours on end measuring your every flaw, and let’s face it, you have many!
Since you won’t be leaving the house much, there’s no point in brushing your hair and teeth and absolutely no point in changing or washing your clothes. As you’re depressed, you’re not going anywhere so who cares what you look like! If anybody- lovers, friends, social workers- express concern, lie and say you changed your pants earlier! They’ll soon back off.

2. Social Etiquette

Who needs friends? Not you! Let your friends know that you don’t need them by pulling the phone out of the wall or ignoring your mobile as it rings for the fifth time that day. Try not to panic if that tinny ringtone irritates you; everything is going to irritate you, or, you just might not care at all! It’s great to be free of these social conventions.

Your friends will stop ringing eventually. But if you want to make a half-hearted attempt at sociability, make sure you meet your friends in a pub. That way you can drink! It may be very difficult for you to go outside, after all, the world is a hideous place. Show your friends you care by crying on them, shouting at them or treating them to miserable, stony silence. It’s okay; they don’t really like you anyway.

3. Hobbies

Before you became depressed, there may have been things in your life that you enjoyed doing. You may find that now you have no absolutely no interest in these things; in fact, the thought of doing them fills you with dread or total indifference. This is normal. None of it matters. Nothing matters.

4. Sleep

Sleep is important so you should get as much of it as possible! It’s much better to sleep in the day time because that’s when all those boring things you don’t care about; your job, your family commitments, your friends; are at their most demanding.

Of course, feel free to sleep at night time, too. When you are awake, remember that nothing is as fulfilling as lying there looking at the ceiling- what a fun way to collect your thoughts!

You may be finding it difficult to sleep. Panic and anxiety could be tearing through you, making you feel as though your own skin is infected. You may feel like you’re dying. Never fear, abusing prescription medication (which can be obtained from the doctors, more in part 5) or alcohol can help.

5. How to deal with those around you, who may not be so excited about your insanity as you are! Includes lovers, friends and the medical profession!

So, you’re depressed! Those around you may not be so excited about this as you are. But who cares about them? They don’t care about you.

Your friends and family may plead with you to talk to them. Don’t! They are trying to bring you to their side. Who wants to be there? You’re certainly not good enough for that. They may say they love you and care for you; they don’t! Don’t succumb to guilt. It’s all a ruse!

They may convince you to go a doctor; resist this for as long as possible! Nothing’s wrong with you- you’re wasting their time! Being depressed is all your fault. There’s nothing they can do to help. It’s all up to you! You don’t have depression. You’re depressed. Big difference! Depression is serious. Do you really think you’re that important?

The doctor may prescribe antidepressants. He’s trying to control you! He wants you to be a happy pill popping patient! Can’t he understand that there’s nothing wrong with you? Being happy is overrated- you’ll never be happy again.

However, if you’re finding sleep difficult, just tell the doctor that you’re depressed due to lack of sleep. Bingo! Happy little sleeping pills for you so you can spend all day every day in bed! Score!

Your employers or tutors may be worried about you. You’ve missed a lot of school or work, haven’t you? Tell them that you’re fine. They’ll believe you! If you lose your job or school place because you don’t have the energy, all the better! It wouldn’t have done you any good anyway.

Your lover may lie next to you night after night wondering why you don’t want to touch them.  Or they may have stopped calling.  It doesn’t matter.   They don’t really care.

6. The future

Ha, this is a joke category. What future? You don’t have a future. I mean, look at you, you can barely get out of bed and cook yourself a meal. You spend your whole day abandoned to the horrible thoughts in your mind, you could be shot and you wouldn’t feel it. Everybody hates you and you’re a failure at everything you do. The world isn’t meant for people like you- you should just kill yourself. Why not kill yourself? Then you wouldn’t feel like this anymore. You will never feel like anything else ever again. It’s either death or this is the rest of your life. Can you imagine this being the rest of your life? Then kill yourself. No one will miss you. Nobody cares.

I hope you enjoyed part 1 of the Insane Guide to Mental Illness! Tomorrow: Mania- Nature’s way of telling you that you’re the best.

My Friend, Brendan Hollywood.

I was asked to write something about my friend Brendan for Cook’d and Bomb’d, a prominent comedy forum on which he was a poster, and the stamping ground where we met, over two years ago. It was a kind of textual variation of, “Our eyes met across the room…” From his introductory post there, I knew he was amazing and that we would be friends. Now I walk past cafés and smile, remembering us in the window. It’s only been three weeks. Only one week since his funeral. It feels like a thousand years ago. Like it happened in a different world, to a different person.

I had to tell the forum of his death. It shocked people- he was incredibly well-liked, for his wit, his eloquence, his humanity and his intelligence.

I have never seen such a reaction on a forum. The internet is cursed and blessed for its facelessness and anonymity. We can walk as tall as supermodels if we desire; can be men or women, can be geniuses or fools. From anywhere, to anywhere. It is hard to miss people online; threads of communication can be abruptly stopped, for so many reasons, an identity, wiped, to be started again. And Brendan was utterly himself and he will be genuinely missed there.

Brendan was an extraordinary writer. He never wasted a word, he was gloriously gifted. His book, “I Am A Modern Monster”, about the life of Alex Tower, is a fantastic piece of work. You can read the first chapter here and you can download the whole book here. Please, if you know any literary types who may be interested in publishing it, pass it on. It truly is a work of splendour and it deserves to be read. Download it and you’ll see.

So, I wrote something about Brendan. It was difficult. His death has brought back a lot of memories about my dad’s death. Two people with similar problems that I loved and I couldn’t save, in the end. I close my eyes and see my dad’s deathbed and my dad, and I try to think of something else. At least London’s streets did not have our footsteps upon them; but they have mine and Brendan’s. Our routes, our cold arses shivering on plastic seats in an empty train station, I remember them all.

Above all else, I want him to be remembered. The pain of remembering is not like the pain of being forgotten. He will be remembered. Not just by me, and those that loved him, those that he loved, like his family, even those who only knew him by his words on a forum. I want him to be remembered by you, and everybody who reads this. Like I do with my dad, who I write about all the time, to keep him here, to let people know, he was here, this incredibly important person to me and to others, cannot be lost. Will not be lost.

I am posting it here you can understand who he was, to me at least. A tribute to my friend. I don’t think anything I say, do or write can do justice to the wonderful person that he was, and how much he is loved by me and so many others. But I tried.

Brendan Hollywood.

Neil has asked me to write a bit about Brendan. I’ve sat here for a good hour trying to put into words what kind of person he was. I can’t tell you who he was to the others that loved him; to you, to his family, to his other friends, to his lovers and companions over the years, because I can’t speak for anybody else. I can only tell you who he was to me.

If he’d been writing this himself, it would have been done and dusted fifty five minutes ago. Although there would probably be as many cigarette butts withering in the ashtray. The last time I saw him, we were wheeling a massive table up the Blackstock Road. It was about five minutes from my house but we took turns smoking the whole way there. We wheezed and puffed our way up three flights of stairs. Our hands- mine, short and stubby, his, long, slim and stained yellow at the fingertips- were shaking in the winter windchill as it blew our laughter into the afternoon traffic. Physical labour wasn’t something he was fond of- he could be incredibly lazy- but I needed his help, and he would never refuse someone in need. It’s weird to be sitting at the desk now, looking to my door, the last time I saw him, the last time I put my arms around him. He seemed out of sorts that day and hugging him goodbye after he drank the coffee I made him (I don’t drink coffee, but I always kept a jar in my flat for him when he came round, since he was absolutely hooked on it), I thought, I’ll see him again soon. I didn’t, I never saw him again, although we spoke many times. I was supposed to see him shortly before his death, and I missed him because I was asleep. He had always been there for me; and I regret deeply that in that last week, I wasn’t there for him.

If Brendan was writing this, every sentence would be filled with something self-deprecating. He could be a harsh critic of himself. In snatches of clarity, he could sometimes see himself how we saw him; how violently funny he was, how intelligent, how full of potential and talent. Every single post he made here sparkles with his customary wit. He was an extraordinary writer, but his confidence failed him often. He had already written two books, the latter, “I Am A Modern Monster”, constantly edited, sent to various people, seeking approval and reassurance that he was worth it, that he was a great writer. We could tell him til we were blue in the face; and one thing this forum offered him, amongst so many others, was the confirmation of his talent. He was instantly likeable. His friends I’ve met, and his family, all uniformly love and adore him, and believed in him, his talent, and his gifts. He glittered.

My friendship with Brendan actually started here. He was this funny bloke called john self. I was, then, Banana Woofwoof (“you can’t greet me with “Woof!” anymore- you have to say, “Hello! Here is my raincoat!” now…”) I thought he was fantastic, from the first introduction post that he made. It was clear from the offset that this was someone incredibly special. He sent me various PMs thanking him for being so friendly to him. I then convinced him to come to a meet I organised- which was, by most accounts, a failure. But I met him. I have never so immediately clicked with somebody. He was obviously incredibly nervous so I thought I’d say, “Shut up, newbie”, to him which for some reason made him laugh and we warmed to each other totally. We dispensed with the usual polite pleasantries and spent most of our time huddled together giggling. He made me laugh so much. There was a man at the bar- “the chinless wonder”, as we called him, we had created a whole life for. We renamed the area, “Smug Rapist’s Alley”- don’t ask.

From there, the complicated, wonderful Brendan Hollywood became a part of my life.

We saw each other often- he would rob the Silverlink of their paltry fares from his home to mine. We sat in many cafés, chainsmoking, then eventually going outside to smoke. We visited each others’ flats. He was the only friend I ever had who travelled across London at 5am just because I needed him. We met in familiar areas- Finchley Road, Finsbury Park, Crouch End, to sit in empty afternoon pubs, cokes in hand, talking about our days, our lives. He’d roll endless cigarettes, talk quickly, listen, laugh that uninhibited, wonderful laugh that he had, always dressed smartly, with ever-changing haircuts and ties. When we weren’t together in person, we spoke on all ends of the internet, on here, on MSN, on other websites we both frequented, on the phone, by text, smoke signals, Morse Code. I have chat logs, texts, e-mails, messages that at the moment I still can’t really bring myself to read through. We rarely ran out of things to talk about. Brendan, no matter what mood he was in, was always interesting.

Brendan had been through it. He had an alcohol problem that had landed him in rehab and hospital and had dogged him throughout his life. He also suffered from depression that he struggled with until his death. He could be, as well as hilarious and open, sad and withdrawn. Our friendship, when he was drinking, was fraught. I lost my father to alcoholism and I couldn’t bear to lose Brendan, too. In the end, it got to the point where I told him that I wouldn’t see him when he was drinking. I would talk to him, of course, and be there for him to talk to, but I could not see him when he was drunk. It was a bit of a rubbish incentive that worked up until a point. He would send long messages saying how he wanted my love of him to be “present tense”- “if it had been in the present tense, would have been a beautiful, wonderful, utterly-reciprocated delight. Sounds pathetic, doesn’t it? Anyway, I want that back; I want that present tense back”.

It was always present tense, though- I loved Brendan almost as soon as the first time we shyly met up, and did throughout our friendship, and will, forever.

I had been through it, too, suffering from manic depression, as I do, and landing myself in hospital. We actually bonded over that experience. He was a fantastic friend to me, and we were close. Brendan was one person who was understanding, someone who was patient, someone who listened to me, helped me, cared for me, loved me and most importantly, someone who made me laugh when the world seemed unfriendly and grey. No-one could get me out of a bad mood like Brendan. There was a time he came to visit and I was flipping out over something unimportant. The first thing he said as he walked through the door made me crack up laughing, and my anger was forgotten. With everything he had been through, he had time for other people, and he was someone to swap, “Fun in the mental hospital” stories with, although other people sometimes looked at us weirdly when we would laugh our heads off at tales of our outrageous behaviour, stories that are painful until shared with someone who had been there, too. I could tell Brendan anything. He was there for me through what were two of the most difficult years of my life. We confided in each other, sharing secrets, stories and cigarettes. We had fun, singing along to our favourites (Bowie, Morrissey, both whom he idolised), pulling ever more ridiculous faces while singing to make each other laugh. Sometimes, as you know, recording the awful results.

Brendan discussed his problems with alcohol and depression both in real life and here with a disarming candour that no doubt many people had found incredibly helpful. He was aware of his problems and he was strong, much stronger than he gave himself credit for. When he slipped, he would pick himself up again and again. His outlook on life, although sometimes tempered by depression, was almost unwaveringly hopeful. He talked about the things he loved passionately. The passion was contagious. His love was strong: for his family, for his friends, for writing, for comedy and music, for art, for untempered silliness and laughter.

So, I think I’ve gone on enough. To my extraordinary, complex, wonderful, hilarious, intelligent, witty, loving, fun, fantastic, courageous, giving, passionate, immensely talented chancer of a friend, I will give you the advice you gave me for the day I made my ascent: whatever you do, don’t kick god.

You are so loved. And you will be missed more than I can put into words.

The Sane Guide to Living with Mental Illness

Wow, this blog has gone right off topic recently. Flippin‘ friends dying, they’re so inconvenient.

I am still nowhere near caught up on e-mails so please excuse me if you haven’t received a reply from me.

I am fairly sane at the moment.

This is somewhat of a revelation; I can’t remember a time in my life when I have been fairly sane. Oh, glimmers of sanity have squeaked through the black tarpaulin of madness but by and large, even my most coherent writings have come from a chaotic planet.

I am not incredibly depressed, nor am I manic. I’m not fantasizing about suicide- it’s been a few months since I’ve white-knuckled safety railings at the riverside.

Anxiety and paranoia, yes, excessive worrying- well, that’s just me- and my ongoing battle with weight and eating continues. A lot of sadness and sorrow and anger at recent events. But mood-wise? Steady, in a mildly depressed kind of way.

How do I judge my own sanity? By not comparing myself to other people. I’m never going to be Completely Sane. The lovely thing about the world is that you’d have to look a long way to find someone who is.

I’m never going to not have manic depression. Even now, with a somewhat clear head, there are “residual symptoms”.

Anxiety and paranoia. An ongoing battle with weight and eating habits (and not-eating habits). Still having trouble sleeping. The reckless nervous energy that is 50% me and 50% manic depression. A mild, niggling, irritating depression that blunts my experiences and emotions. Intrusive thoughts and panic. Narcissistically worrying about being narcissistic.

But this is good.

It was only a few months ago that I was ravingly psychotic, swallowing a huge dose of Lithium and on the verge of utter annihilation. Every little victory- the return from self-destruction- I cherish. To judge my sanity, I compare myself, to myself.

Every time I cast mind back to six months, a year, a year and six months, I’ve been ill. For most of my life, I’ve been ill. I’ve clung on to the merry-go-round of madness and am barely alive because of it.

So, while I’m feeling relatively together, here’s my sane guide to living with mental illness. Bear in mind it’s from the perspective of “been there” rather than “been told”. Feel free to ignore everything, though!

1. In times when you feel better, don’t expect the unexpected.

If you’re like me, this is much easier said than done. I’m a born worrier. I worry about everything. When I click “Publish”, I’ll worry about that, too. Talking about myself all the time? How self-obsessed. And in my self obsessed way? I’ll worry about that. I worry about everything I say, everything I don’t say, and everything I don’t do, and everything I do.

So I find it hard not to worry about the next episode of illness.

I know it’s probably coming, so I find it difficult to enjoy not being mad for a change. Experience has taught me that these lulls in time are the calm before the storm. I’m a rapid-cycler, and pockets of sanity are brief for me.

But, this time, I’m trying to think, “Maybe this will last longer than a few weeks”. You never know. So don’t try to will your next psychotic breakdown or manic episode. Relax, if you can. Take your medication, try to be okay.

2. Keep taking your medication, even if you feel better.

Ah, this old chestnut.

I’ve only been treated for manic depression for the past year and a bit. But every time I’ve felt “alright” and decided to ditch my medication and miss appointments, I’ve become ill again, very, very quickly. It has nearly always resulted in a messy hypomanic or manic episode and has meant that my antipsychotic gets upped to deal with the “crisis”. Or, there are times I’ve quietly skipped my medications and lied about it and become suicidal.

Something I believe, and have emphasized a lot here, is that mental illness is partly biological.

Sure, nature can embellish it, but I strongly agree with the idea that there is a biological basis for most mental illnesses- almost certainly some forms of depression, manic depression, anxiety, schizoaffective disorder, addiction, schizophrenia (their symptomatic similarities to biological illnesses such as epilepsy only strengthens my conviction) and possibly personality disorders, eating disorders and DID.

I don’t subscribe to the belief that mental illnesses are “labels”. Cancer, diabetes, asthma, etc, aren’t labels, they’re illnesses. And so it mental illness. Once I got past that, I found it easier to write with conviction, without worrying about “labelling” myself. I have got manic depression. Whoop.

I’m not on the gravy train of the “medication is evil”. It doesn’t mean I like to take them, though. I hate taking my medications, I always will. I hate the ritual, I hate the weight gain, I hate the exhaustion. I can see the argument- especially in countries where you pay for healthcare, such as the USA, and where medications are advertised like sweets. But if you take something and it makes you feel better, well, I think that’s okay.

And I don’t think people appreciate how difficult it is to continue taking medication for mental illness. On one hand, the side effects can be close to unbearable. I do entirely understand the stance that medication can numb you. But if I hadn’t been treated for manic depression- and medications are a huge part of that- I would most likely be dead.

So on the other hand, we come full circle to…

It’s not a cure. It’s to help you cope and live with your illness, to alleviate some of the more frightening and terrible symptoms that you are living with.

So when you feel better, don’t stop taking medication and don’t miss appointments, however tempting it might be. You might be feeling better due to sheer force of will, help from people, or maybe your illness just shifted somewhat, but, if you’ve been taking medications for a while, there is almost certainly something in them that is helping, too.

3. If it’s not working, say so.

Lithium made me physically sick and didn’t help at all with my illness. But because it was the “gold standard” for bipolar 1 disorder, I didn’t speak up, and quietly waited to feel better.

I never did and after the third or so bout of vomiting, shaking and passing out, I told the psychiatrist that I didn’t want to take it anymore.

Likewise, Seroquel helps me sleep, quells psychosis for the most part but it’s “antidepressant properties” are non-existent in my case and it turns me into a zombie. So I am being slowly switched to risperidone instead.

Of course, there may be times you can’t tell your medication or treatment in general isn’t working. So this one’s for those around you who know you- if you can, let someone know. I was manic for a while on Lithium and it was Rob who noticed I was, not me. Insight is an occasional companion sometimes.

4. Get support.

It can be isolating to live with mental illness. And not everything is as culture tells us it should be; lots of people don’t have close friends or family to rely on. And that isolates us further. Sometimes, family and friends don’t understand. Sometimes, you just don’t want to talk to them anyway.

There are support groups around the country that you can speak to and make friends at. The Manic Depressive Fellowship (now the much more PC Bipolar Organisation) holds regular local support groups, and The Support Line has some links and phone numbers for people with depression. Rethink also offer support groups for illnesses such as manic depression, depression, anxiety, schizophrenia and personality disorders, amongst others.Other “service user” groups include The Perceptions Forum, run by mad people for mad people, centering around the psychosis experienced by people with psychotic illnesses.

There are also tons of online forums that exist to support people with mental illness. A great one is The Mood Garden, which has forums for depression, self harm, anxiety and panic and substance abuse.

There are other good forums and support groups for problems such as anxiety and eating disorders.

5. It’s good to talk. Therapy is important too, but if you’re not going private, bring a book.

I was diagnosed with manic depression over a year ago and I’m still not in therapy. Medications can be good, but I think therapy is just as important. Having someone to talk to, learning ways to cope with an illness that you might have forever and taking the strain from ear-bashed loved ones is valuable.

I am finally speaking to a therapist soon- about friggin’ time an’ all. As biological as mental illness might be, sometimes, treatment is complicated. For example, I can’t take antidepressants. It’s been done a few times, and each time has been the same- hello mania. Treatment, then, is needed to help me cope with depression. I also have, as you know, Body Dysmorphic Disorder and problems with eating disorders, that pills don’t really help.

And even if you have a tidy mentally interesting diagnosis, life still happens, and it’s hard. Quite aside from regularly lapsing into depression because of my illness, there are life-things I struggle to cope with.

And again, it’s a little-thought line that dealing with the diagnosis itself it very difficult indeed. I still have trouble accepting my illness, however lucid and sage I seem here. Like any life-long illness, coming to terms can be hard.

The fall-out from episodes of illness can often be extremely hard to cope with. The strain it can put on your relationships, jobs, physical well-being, finances and other areas can sometimes be the beginning of a downward spiral. (After bad episodes of illness, I hate myself and feel so guilty and worthless I want to top myself. But there are always people I can’t look in the eye, and I find it very difficult to speak to friends and to manage the practical aspects). Psychotic episodes, in my experience, can be the worst as it’s a side of you people may have never seen before, and may find very hard to understand. It is really good to talk these things through.

So, if you’re being treated, push for therapy. You might have to wait a while, though. If you have specific issues (or your loved ones do), such as bereavement, substance abuse and “youth” related problems, there are many free counselling services around that you won’t have to wait so long for, such as Cruse and the Mind Guide to Counselling.

Also, never forget that if you feel you have no-one to turn to, there are confidential counsellors available by phone and e-mail such as the Samaritans. It’s their job to listen, and they can really help in a crisis.MIND also offer free counselling.

6. Mentalist- know thy services.

It’s not inevitable that you’ll need to go into hospital in an acute episode of illness. Whereas sometimes it may be the only option (such as needing to be sectioned for your own safety, and the safety of others), hospitals can be extremely traumatic. They are boring, above all else, and the surroundings can leave a lot to be desired.

If you, your “team” and those around you think you may need somewhere safe to be for a while, there may be other options. For example, there are crisis centres. I am lucky to have (and to be visiting next week with the CPN) a women’s only crisis centre.But look up mental health services in your council directory and ask questions. There may be a crisis centre near you.

You can also enlist the help of a crisis team if you want to avoid admission to hospital. Most councils have a community mental health crisis team who can give you ongoing support and evaluation at home.

7. If you can’t work, get benefits advice and help claiming them. And get someone to keep an eye on your finances.

I have been too disorganised and unwell to even begin to sort out my benefits. My CPN played a huge part in helping me, as did Islington People’s Rights. Now I’m finally on Income Support, Housing Benefit and DLA.

If you’re able, find out what to claim and how, and try to get independant help and advice from local people’s rights services or from the Citizen’s Advice Bureau. If you have family or friends, enlist their help in getting forms for you and helping you fill them out. There are also online services and resources such as the Advice Guide and Rethink.

When you have a mental illness such as manic depression, borderline personality disorder or schizophrenia, you might be, like I have been, impulsive and reckless with cash. When I’ve been working I’ve gone on many a manic spending spree and completely cocked up my finances. The “oh no” bank statement is not your friend, so, embarrassing as it might be, it can be a good idea to ask a friend or someone close to keep an eye on your spending for you.

8. If you’re reading this, you’re alive. Nice one.

Mental illness can equal terminal illness. It’s true that many people with mental illness will go on to commit suicide. Even with the best of care and support, it is not altogether unavoidable.

But being alive, day after day, is a victory. It’s not a failure, it’s not “being weak”. Whatever help you receive, it’s ultimately you who is responsible for yourself. So if you’re managing to continue living, no matter how horrible things get, even if in the past you’ve tried to commit suicide, you are alive and you should try to have some pride in your self.

Again, this is an “easier said than done” rule but I think it’s worth pointing out.That’s all from me for tonight- jesus, it’s a Saturday night. I’m going whip out the media player and turn on the lights so I can pretend I’m at a club or something.

I’ll be writing more trying-to-be-helpful things about living with mental illness in the future. Please feel free to suggest stuff.

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