HEROIN IS A DRUG TO MAKE THE WORLD GO AWAY

THIS IS A BLOG ABOUT A LIFE WITHOUT HEROIN



Showing posts with label breakdown. Show all posts
Showing posts with label breakdown. Show all posts

Monday, 29 October 2012

What it's Like to Go Crazy: Dr Kraepelin Writes...


IF YOU'RE WONDERING why I say I think I need counselling for the trauma of having lost my senses some 18 months ago, here are some lovely quotes from one of the classic psychiatric texts of all time, Emil Kraepelin's Manic-Depressive Insanity and Paranoia that put it all in a nutshell...

The very last paragraph quoted here describes me with unfortunate accuracy in the throes of hyperacute manic psychosis.

Their linguistic utterances alternate between inarticulate sounds, praying, abusing, entreating, stammering, disconnected talk, in which clang-associations, senseless rhyming, diversion by external impressions, persistence of individual phrases, are recognised.

That's exactly what happened to me!

HERE'S DR KRAEPELIN:~~~~~~~

From the slighter forms of mania here described, imperceptible transitions gradually lead to the morbid state of actual acute mania. The beginning of the illness is always fairly sudden; at most headaches, weariness, lack of pleasure in work or a great busyness, irritabihty, sleeplessness, precede by some days or weeks the outbreak of the more violent manifestations, when a definite state of depression has not, as is very frequent, formed the prelude. The patients rapidly become restless, disconnected in their talk, and perpetrate all sorts of curious actions. They run out of the house in a shirt, go to church in a petticoat, spend the night in a field of corn, give away their property, disturb the service in church by screaming and singing, kneel and pray on the street, fire a pistol in a waiting-room, put soap and soda in the food, try to force their way into the palace, throw objects out at the window. A female patient jumped into the carriage of a prince for a joke.


Mood is unrestrained, merry, exultant, occasionally vision- ary or pompous, but always subject to frequent variation, easily changing to irritability and irascibiltiy or even to lamentation and weeping. Such, fluctuations of mood are very clearly seen in the following letter of a manic patient : —

" When I think of my rude behaviour towards you at the last visit, I do not know how I am to atone for it. I ask you for pardon from my heart ; as far as it hes in my power, such a thing will never occur again. As I now understand, I should have given you an answer and I did not do so. O God, how discourteous !"

Mood is mostly exalted in mania, and in lively excite- ment it lias the peculiar colouring of unrestrained merriment. The patients are pleased, " over merry " or " quietly happy," visionary, " more than satisfied," " cheerful in this beautiful world"; they feel well, ready for all possible sport and banter, "penetrated with great merriment," they laugh, sing and jest. They are "enraptured with everything," " the happiest woman " ; happiness has come upon them ; " now the days of roses are coming." The group of patients in manic excitement (Fig. 3) reproduces the expression of this mood in varied colouring from quiet cheerfulness and proud self-consciousness to unrestrained cheerfulness. Sexual excitability is increased and leads to hasty engage- ments, marriages by the newspaper, improper love-adven- tures, conspicuous behaviour, fondness for dress, on the other hand to jealousy and matrimonial discord. Several of my patients displayed in excitement homosexual tendencies.

Extraordinary Distractibility of Attention certainly plays an essential part in defective perception. The patients gradually lose the capacity for the choice and arrangement of impressions ; each striking sense-stimulus obtrudes itself on them with a certain force, so that they usually attend to it at once. Accordingly, if their attention can for the most part be quickly attracted by the exhibition of objects or by the calling out of words, yet it digresses again with uncommon case to any fresh stimulus. The picture of their surroundings and of events remains, therefore, for them more disconnected and more incomplete than it would be, if it suffered merely from encroachment on the process of perception.

The Flight of Ideas often becomes very distinctly noticeable to the patient's own perceptions. They complain that they cannot concentrate or gather their thoughts to- gether. The thoughts come of themselves, obtrude them- selves, impose upon the patients. "I can't grasp all the thoughts which obtrude themselves," said a patient. "It it is so stormy in my head," declared another, "everything goes pell-mell." " My thoughts are all tattered," "I am not master over my thoughts," " One thought chases the other ; they .just vanish like that," — these are further utter- ances, which give us a glimpse into these processes.

In depressed patients also flight of ideas occurs not alto- gether infrequently, though certainly without being very recognizable in the scanty speech of the taciturn patients ; sometimes it appears distinctly in copious written utterances.


He hears the voice of Jesus, speaks with God and the poor souls, is called by God dear son. There are voices in his ears ; the creaking of the floor, the sound of the bells take on the form of words. The patient has telepathic connection with an aristocratic fiancée, feels the electric current in the walls, feels himself hypnotized ; transference of thought takes place.


They have already died a thousand times, always come again, can practise magic, can help people by prayer, can make themselves invisible. A patient had " the feeling as if he would get money from somewhere " ; another declared that
he was the most distinguished private detective ; a third called himself the " sanitary physician of all the natural sciences and natural medical science " ; a fourth said that he would be the most famous man in Europe ; a fifth stated that he had found a female 193 cm [6 feet 363⁄64 inches] in height and would get for her 40,000 marks. Female patients boast that they are related to the royal house, are fourfold queens, earthly somnambulists, have a beautiful voice, are going to place the imperial crown on their husband. A female patient declared that she was the Sleeping Beauty, had pricked her- self with the spindle, and was now waiting for the Prince. The patients often narrate all sorts of journeys and adven- tures, secret experiences ; they have encountered men who made assaults ; they were received in the capital with honour. Many patients complain of persecutions, they have been ill- used having been struck with the fist 130 to 150 times ; they are fired at, whipped with rods.


Occasionally the delusions of the patients call to mind those of the paralytic. They possess millions, diamond cups, get a golden crown, have created mountains, built whole cities. A patient wrote that he would offer his fiancee a life such as no princess in the world had. " In Munich I shall build for myself Castle Miramare, in Feldafing the Castle of King Max formerly planned, make Munich the most beautiful city in the world ; I have already designed three hundred magnificent buildings, the most beautiful in the world. I shall construct railways and gain millions by that."


Delirious Mania.

A Delirious State fills up the picture in a further group of cases, whicli is not very large. This state is accompanied by a dreamy and profound clouding of consciousness, and extraordinary and confused hallucinations and delusions. The attack usually begins very suddenly ; only sleeplessness, restlessness or anxious moodiness may already be con- spicuous one or two days, more rarely a few weeks, before- hand. Consciousness rapidly becomes clouded ; the patients become stupefied, confused, bewildered, and completely lose orientation for time and place. Everything appears to them changed ; they think that they are in heaven, in Herod's palace, in the " Christchild Hospital." Mistakes are made about the people in their surroundings ; their fellow-patients are near relatives ; the physician is a Royal Highness, an ecclesiastic, a black devil, A female patient, who in numer-. ous similar attacks always fancied that she was surrounded by historical celebrities, Louis XIV, Caesar, Elizabeth, called that her " historical delusion ".

At the same time numerous hallucinations appear. Some- thing is burning ; birds are flying about in the air ; angels appear ; spirits throw snakes in the face of the patient ; shadows come and go on the walls. The patient sees heaven open, full of camels and elephants, the King, his guardian- angel, the Holy Ghost ; the devil has assumed the form of the Virgin Mary. The ringing of bells is heard, shooting, the rushing of water, a confused noise ; Lucifer is speaking ; the voice of God announces to him the day of judgment, re- demption from all sins. The patient carries on dialogues with absent people, receives revelations ; his thoughts are borne from one voice to another. The coffee smells of dead bodies, his hands as if rotten ; in the house there is a smell of burning ; the food tastes of goat-flesh or of human flesh, the water of sulphur. His head is very giddy, full of fever-heat. The patients think that they are lifted and thrown into an abyss ; they swim with the king in the ocean ; everything is falling to pieces round them.


The patients do not trouble themselves at -all about their surroundings ; they do not listen, they give no information, obey no requests, are resistive, strike out. Their linguistic utterances alternate between inarticulate sounds, praying, abusing, entreating, stammering, disconnected talk, in which clang-associations, senseless rhyming, diversion by external impressions, persistence of individual phrases, are recognised. Other patients only display a slight restlessness, whisper flights of ideas to themselves, when addressed look up astonished and without comprehension, obey simple requests, give irrelevant answers, smile, weep, cling to people, suddenly begin to sing a song or scream. A female patient called out abruptly, " I am justice ; do not touch me ; I am omniscient ; away from me ! " Waxy flexibility, echolalia, or echopraxis can be demonstrated frequently.


All in all, a decidedly inconvenient affliction...




                     


If you want to see what mania really looks like, only real film of an actual episode will do and this is the only genuine-looking clip I have ever found... I think in doctorly terms, if she stayed that excited all day, she would be termed "moderately manic". BTW just because she knows the camera's there doesn't mean she must be putting on an act. Watch closely her eyes, her emotional lability, distractability and disinhibition... it's not easy to fake any of that and I don't think I've EVER seen bipolar mania convincingly portrayed on television or film. Most actors get the elevated mood and grandiosity right but display nowhere near the correct degree of hyperkinesis, pressured speech, cognitive disorganization or generalized excitement... THEY'RE NEVER MANIC ENOUGH!...

MANIC EPISODE #1: TRISCH GOES NUTS
Only one clip was ever posted up; some years ago now the brilliant Trisch Li was found dead in her garage having gassed herself to death... terribly sad... but bipolar disorder has the highest suicide rate of any psychiatric illness with one patient in five eventually succeeding in taking their own life...




ANYWAY, HERE'S SOME MUSIC... Lovely trance!

This is not bad:



♩ ♪ ♫ ♬ ♩ ♪ ♫ ♬ ♩ ♪ ♫ ♬ ♩ ♪ ♫ ♬ ♩ ♪ ♫ ♬ ♩ ♪ ♫ ♬ ♩ ♪ ♫ ♬♩ ♪ ♫ ♬ ♩ ♪ ♫ ♬ ♩ ♪ ♫ ♬ ♩ ♪ ♫ ♬ ♩ ♪ ♫ ♬ ♩ ♪ ♫ ♬ ♩ ♪ ♫ ♬

Monday, 2 July 2012

New Drug Worker

I MET my new druggie keyworker properly today and he seems to be OK. More than OK. Good. Very good.

We started out not on the best terms last week after he did a bonecrushing handshake on my broken fingers and then suggested we combine keyworking sessions with the "open to all" group he chairs every week. Because I have very mixed memories of clinic-run drugs groups, especially when former workers have pushed too hard and tried to force me into going, I thought Uh-oh.

Then I remembered that I have enjoyed many groups in the past, when I was in the mood to go. What I didn't like was the inconvenience of going to and from the clinic midweek. That is no longer an issue, now that I live so close.

One former worker had wanted to combine keywork sessions with her group because she didn't seem to want to be botehred to make time for me. Two other workers tried to bully me into going. So I just didn't go, except when I felt like it. Which happened to be on the weeks when I wasn't pushed into going. (Some people think I'm stubborn, but I don't think I'm any more contrary than an average person. I just don't seem to be on the outside...)

When I last went to groups my mental health was too much of a problem for me to make any progress there. One week I'd turn up hypomanic and dominate discussions by chat-chat-chatting. One particular week I remember putting in three times more input than the entire rest of the group combined. In other words it was a dialogue between me and the guy chairing it, with everybody else looking on. Then somebody did pipe up to disagree on what I considered a simple point of fact, and I was so offended I vowed never to return. Within a week my mood had switched from manic to miserable, and I didn't want to speak to anybody, so I didn't go. A week later, depression had intensified and was topped off with paranoia, so I couldn't face a room full of people. The group happened to start as my keywork session ended, so I went in for the sake of it. But the bitch invigilator insisted we pair up, interviewing whoever happened to be sat next to us. One person would pretend to be a drugs-worker and the other the client. The surly crackhead beside me, who had made it clear he was there solely to fulfill a court-ordered Drug Treatment and Testing Order and who had already been twice reprimanded for reading The Daily Mirror in-group, didn't appear to have any willingness to any sort of recovery at all. I took one glance in his direction then skedaddled out the door. And that was me and groups done with until today.

I really enjoyed today's group as it was all about me. In other words I was the only person to show up! We filled out some kind of risk-assessment sheets and I got the first of my tapering scripts: 24mg for this week; 23 for next. All being well I should be OFF METHADONE and DRUG-FREE for nearly 2013.

That's if the Mayan Calendar doesn't terminate us all in the meantime, sending computers crashing worldwide and aeroplanes dropping out of the skies.

O sorry, that was the Millennium Bug, wasn't it? You know, the bug that didn't do anything at all, but cost lots of money for large corporations to have written out of their systems.

If the world does end, I'm sure the heroin supply will dry up first. And after that the methadone supply, as the world pharmaceutical system goes into crisis.

Urban Legend has it that methadone was an innovation of the Nazi party, to keep several of the heroin-addicted German top-brass in opiates during the dark days of the Second World War. The most famous of these was Herman Goering, head of the Luftwaffe, who had been a morphine addict for years. But rumour has it that even Adolf Hitler himself was addicted to heroin. Obtaining a reliable supply of any opiate was of course very difficult, hence the introduction of methadone, a completely synthetic opioid.

According to Wikipedia, methadone never gained widespread support in Germany and the reasons are telling:

The reason for its swift abandonment as an alternative to morphine was due to the adverse effects it had on German soldiers during early trials. In contrast to morphine, which was used to alleviate pain in the injured but also to boost the esteem, stamina, and drive of German soldiers in combat, methadone had effects that have been described as such; "Dolophine (Methadone) had many adverse effects on the soldiers to whom it was given, leading to apathy, lethargy, and decreased willingness to engage in combat".

And you wonder why I complain about methadone's side effects!

I don't, by the way, believe Hitler was a junkie, or that methadone was devised as an evil Nazi plot to keep the German, or any other, population in subjugation. It is true, however, that methadone was originally patented in Germany and the patent "appropriated" (some might say stolen) by the Americans after World War II. Because methadone didn't make a particularly good painkiller, despite being an incredibly addictive opioid, it never found its way into general medical use until the  "substitution therapy" as a treatment for heroin addiction was pioneered by Dr Vincent Dole in New York in the 1960s.

The old trade name Dolophine, by the way, echoes the Latin dolor, meaning pain. Whether it was also a pun on Hitler's first name Adolph is very much a moot point...

In the UK, methadone never gained acceptance as a treatment for heroin addiction until the early 1970s. Up until that time, heroin addiction was usually treated by heroin prescription. Though the British system proved open to abuse by certain dodgy doctors such as the famous Dr Petro (Petrovski) who would write out scripts for heroin and cocaine to anybody who claimed to be addicted, the principle of treating heroin addiction with injectable heroin has been shown to be sound, with far higher success rates than for oral or injectable methadone.

For a long time I feel I wasn't even given a chance by a system that told me that if I couldn't recover on methadone syrup, I was somehow just not trying hard enough. The clinic always assumed I simply needed even more methadone, which is how the dose went past the 100mg mark, and would have gone a lot higher than the 135mg peak, if only I'd assented to yet more increases. Looking back, it's hardly surprising that treatment for addiction to one drug with another, entirely different drug should have failed. I don't feel I failed methadone, I feel methadone treatment failed me. It wasn't until autumn 2010 when the quality of the street gear fell so low that many daily-using addicts were testing opiate-negative, that methadone began to hold me properly. And I don't think it was any coincidence that around this time I had two severe mental breakdowns. The insulation that heroin put up between myself, my life, and the world was now gone, and my mind, left totally bereft, simply couldn't cope.

I'm just so glad finally to have got to the stage where methadone "works" for me enough that I can at least go days on it without climbing the walls, even if I am sweating like a rancid pig. Even if I am having to take antipsychotics to cope with the adverse effect the stuff has on my mind.

Best of all, I'm glad to be in a clinic ~ at last ~ that is willing to detox me the way I want to be detoxed. The old place were suggesting a drop from 20 to 15mg in one go. That's a 25% reduction! The same as dropping someone from 100mg to 75mg overnight and expecting them not to go crazy. Personally I'd like to see the clinic from the London Borough of Crudsville struck off the medical register. The treatment I got there was the worst in my entire life.

Anyway that's another nightmare relegated to the cesspool of the past, where it belongs.

My one ambition is to get OFF this noxious drug they insist on treating me with, to get ON with life.

PLEASE PLEASE, I want a FUTURE...


Illustrated: Methadone Man and Buprenorphine Babe; stop the drug clinic! (my old one)







*******


MUSIC:
Here's another Like A Prayer, a very laid-back rendition from Madonna's Re-Invention tour, 2001..
.
 
 
 
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ROBERTA FLACK: THE FIRST TIME EVER I SAW YOUR FACE
 
This is specially for Bev, who reminded me how much I loved this song...