An OK Christmas

WOW, I'm spelling Christmas with a Ch-. I must be in a good mood.

Yeah it was quite good. Of course I opened the £20 bag at midnight. Cooked up a lovely brown shot. Then cooked up the rest, which was really dark brown. So I saved the really dark one for Xmas morning and took the weak one first.

I had been feeling like I'd drunk a petrol tanker full of black coffee. (Only I hadn't touched any caffeine at all that day.) I hoped the heroin would calm me down. And it DID.

On Xmas morning I had the great big gloopy shot dripping with brown heroin at about 11am. Apart from going over the spoon later that day for the absolute dregs, that was my last ever shot. It went partially into one of my collapsed veins and I felt OK.

I didn't get to Binky's house till past 1:30, even though she is only 10 minutes away, because I was too paranoid to leave my house. I thought someone was hiding somewhere in the hallway, down the cellar or up the stairs. I kept hearing creaking noises and was convinced some psychotic housebreaker was after my stuff. I'm not worried about my person. Just my stuff. So I hid everything and took the tellybox with me. When I opened my door I saw upstairs's water was dripping into the hall and THAT had caused those sinister creakings. The mountains of unopened mail in our hallway are completely soaked through. But I was right to be para. There were people going up the road at 8pm on Xmas Eve dressed in fluorescent jackets making out they were some kind of officials, knocking on doors just to see who was and wasn't in. They were so obviously housebreakers I glared at them as I swooshed past and one, the dodgiest of the two, said "Merry Christmas!" in a criminal type voice. You know really fake.

On the way to Xmas Dinner I had a sudden urge for Advocaat, so I got a £7.99 bottle of Cooymans (Warninks is too expensive). In fact I had orders for a whole array of drinks so I turned up with half a distillery worth of hard liquor. Then when I got there nobody really wanted much. I drink snowballs so weak that even after five I was nearly sober.

Hey but I wasn't manic or depressed either. So how wonderful is that. Neither did I get sudden rushes of ridiculous enthusiasm over nothing, that take two hours to come down. And eventually all join together to form a type of "episode". Perhaps the Advocaat acted as a mood stabilizer. Maybe the eggnog was by a goose who lays golden ones..? Or else it was one of my very rare totally euthymic days.

Binky's housemate Trudy spent hours slaving over the hot stove. She kept saying she had burned the potatoes because they were crispy on one side. But I kept saying they were perfectly done. Don't most people like crispy potatoes? I know I do.

At 3pm HM the Queen came on, so I started yelling and everyone said they were coming but they didn't so I watched it alone with a catatonic person. Then everyone came in and questioned me closely on what Her Maj had actually said. But I couldn't remember any of it. [It was actually about the Olympics. And people surviving Xmas on their own. And something else I cannot recall now. Oh and it was the first Queen's Speech shot in 3D. She looked very cool wearing the special glasses on the news.]

I had tried to avoid eating too much by way of cheese crackers and Quality Street partially because I thoroughly enjoy being on a puritanical diet. But I still couldn't eat the entire turkey dinner. It was really nice though. Trudy excelled herself. She said she's never cooked a Christmas Dinner before, but you wouldn't know it.

So I ate half, then went out to the kitchen for a fag. A terrible film came on ITV called Tangled. It's about Thumbelina or Snow White. Or Sleeping Beauty. The one with the long hair. Rapunzel! And how awful. Like a cartoon that they've had half a stab at 3D-ifying. And everybody too apathetic to switch channels. Oh and then people started dropping off to sleep. So I went home with half a bottle of Advocaat still left. Yes, me, who is supposedly alcoholic of the century, according to some former substance abuse workers. I never finished it until 5am, when I was up watching the foreign shopping channels and wondering what Camilla Parker Bowles was doing for Xmas.

Like I said I went over the dregs on that spoon but there was barely anything. So technically that was my last shot. I didn't even bother trying to find a vein. My veins are now completely hammered.

I have been sleeping all at the wrong times. Drinking methadone like there's no tomorrow. Amazingly, I don't feel that bad. The first day on that stuff is always the worst, no matter how much I take. So feeling OK on day one is a good sign. Ukh: I hope I can keep it up to spend the rest of my life drug-free.

A member of my family recently said to me: yes you give up heroin but what do you replace it with? At that moment I didn't want to say this, but a nice flash of mania is nicer than any drug. It's supposed to be your brain's reward system going totally nuts, so no wonder. There's a lot to be said for pacing back and forth laughing insanely. Real paroxismal belly laughter, at my own witty ideas. (The more manic I get the less of a crap I give about anyone else's thoughts,feelings or opinions. I know that doesn't sound good but, hell, it's so much better than being depressed. Or being on drugs. Depressed people feel nothing. People on drugs would like to feel, but don't think they can afford to get hurt, hence the drugtaking. And maniacs are just cuckoo.) I kind of wish for the new year that I could be "normal". If normal means totally mentally and physically well, deliriously happy and stratopsherically rich, then I'm willing to go for it.

Anyway I hope Xmas was entertaining for you all. How was YOUR day..?





HM THE QUEEN: CHRISTMAS MESSAGE 2012




HARD TRANCE

I put this up before... but I like it...




How can I have nearly missed this?
QUEEN BEATRIX OF THE NETHERLANDS CHRISTMAS MESSAGE 2012
VINCENT, WHAT IS SHE TALKING ABOUT..?



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Random Drunk Found In Cellar/Not Looking Forward to Tomorrow

I FELT LIKE I WAS GOING MAD yesterday. 5AM and the house resonating to the rumblings of somebody's coughing, wheezing, snorting, gurgling and so on ~ which seemed to be emanating from somewhere just outside my door.

So when, at 8AM, I eventually dared to open the said door to investigate ~ the hallway was empty. So I crept down to the "wine" cellar (never seen a bottle down there, except my own methadone which once dropped out of my pocket when I was trying to top up the electricity) ~ where I was confronted by the sight of a homeless looking bearded giant in a grey anorak, sprawled unconscious across the concrete floor, snoring for England.

Then I was idiot enough to lean slightly on the door. There was an ear-splitting squeak and I ran and hid behind my own door, which slammed loudly. I stood cowering like a panic-stricken roborovski as terrifying shuffling and shambling sounds stumbled up the cellar steps, into the hallway and up the main stairs where they seemed to disappear into somebody's room. I barely dared breathe, in case we had a homeless psychotic killer on the loose. (Well he seemed to vanish into Potishell's room, so he could well have been a psychotic burglar, if not a part-time murderer too.)

I had a much better day on Sunday than Saturday, when I only got up to collect methadone, then scurried back to bed, where I remained all day and all night until the Psychotic Intruder Snoring Scandal at 5AM. I get waves of depression and waves of excitement; nothing connected with nothing. All this crap from cognitive Therapy, implying that depressive mood is caused by negative cognition. Well my first sign of depression is nearly always massively increased sleep. At first the dysphoria comes in waves, seemingly unconnected to anything going on. For example: last night I was spooning coleslaw into a hot baguette when a heavy sinking feeling came over me. It happens like that a lot. I'm not thinking depressive thoughts at the time. Usually I'm not thinking anything. The negative thought process seems to arise in reaction to an already depressed mood ~ definitely not the other way round.

My hypomania improves my self-confidence massively, which remains high afterwards until depression eventually takes it down. So I think those CBT smart arses want to drastically rethink their theory. I'm sure that negative thought process ~ habitually telling yourself you're no good and that all you do will fail will perpetuate a depressive mood; but they most certainly do not cause it.

Surely I'm not the only person to experience things in this way. Please, some depressives get in touch and describe how it is for you.

I couldn't face the idea of xmas ~ not xmas dinner at Binky's house in mixed company where everyone except me and the duty care manager will have schizophrenia ~ without heroin. So I blew £35 on two miniscule bags, one for today, one for tomorrow. After that, I've promised myself NEVER AGAIN. O promises, promises...

{The bags truly are microscopic: less than you used to get for £10 in each and about a sixth of the potency. And this is the best stuff going!}
O and by the way it's not schizophrenia, or anyone from Binky's house that I cannot face:~~ IT'S BLOODY XMAS!

I do truly resent having to give money to Disorganized Crime (if drug dealers are gangsters then most are truly amateur ones) ~ wasting all that cash just to feel NORMAL. If methadone does give "normality" then it's a very unpleasant state to be in. I've told myself no matter how bad I feel for the rest of my life on methadone, that I'm just going to have to fight through it and make the best of the state of sickness methadone seems to induce in me.

The only time methadone has ever made me feel truly wonderful was when it brought out in me symptoms of full-blown psychotic mania (well I was taking no other drugs at the time so those of you who want to believe my mental problems are entirely drug-induced, even though they began in childhoood, will have to recognize that methadoen has turned me from a depressive into a full-blown manic-depressive.)

I am truly sick to death of relying on an illegal substance just to be able to cope with my day. I have lived without heroin before. Trouble is: before and after heroin I was mentally sick. But if I'm going to have to live my life clean, yet mentally deranged, then so be it. There are worse things in life than manic-depression ~  I can't think of all that many, but being on hard drugs is probably one of them.

I do apologize for all this self-pitying whingeing. At least self-pity is a sign of self-esteem. Far healthier than self-loathing (self-pity's opposite). I just want to be off heroin. Surely "I'm worth it", as the shampoo ads say..? Fair dos: xmas is the single worst day of the year, but I shouldn't need heroin to survive even that.

My New Year's Resolution is to STOP HEROIN FOR EVER and within the next 12 months to STOP METHADONE TOO. You see why I'm so put out at "having to buy heroin" just to cope with a day I'd rather was just expunged from the calendar? There will be no blow-outs. No last hits on New Year's Eve. I've already got the gear for tomorrow, so that's a fate accompli. But after xmas day, there's no excuse left for drug-taking. Not even in my drug-skewed mind, which is supposed to invent justifications for everything. That's part of the "illness" of addiction. (I do get a bit wearied by NA members' parrotings about their "mental illness" (of addiction). They wouldn't know a mental illness if it slapped 'em round the face. And quite a lot DO deserve a slap with a wet fish: eg for constantly mistaking my manic states for crack cocaine intoxication. The drug clinic seem to be able to distinguish even mild mania from drug intoxication and yet NA can't? Maybe that's because NA have one-track minds, even more so than methadone clinics. Well whatever...

As you can probably see, the only xmas spirits I ever believed in came in bottles. Because I don't believe in drinking any more, I don't believe in xmas either. Nonetheless:

I WISH YOU ALL A VERY MERRY CHRISTMAS AND IF IT CAN'T BE MERRY THEN MAY IT AT LEAST BE TOLERABLE !

See you afterwards

G XxXxXxX




Aren't xmas songs horrible? Except for this one:

BAND AID: DO THEY KNOW IT'S XMAS


 
O and this. At least this one captures the true spirit of xmas
POGUES & KIRSTY McCOLL: FAIRY TALE IN NEW YORK


BTW if anyone's wondering why I insist on spelling the holiday with an X, that's because THERE IS NO CHRIST IN CHRISTMAS  ... But there IS a DOWNTON ABBEY SPECIAL on ITV at 20:45 so DON'T MSIS IT!

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Please Let Me Stop Heroin For The New Year

NOBODY who has followed this blog for a long time will get at all excited about this, as the number of times I have tried and ***FAILED*** to kick the habit, even with the help of methadone, is too many to remember!

Over the past week or two I haven't used very much gear at all. I was hypomanic, my mood was high. When I feel like that I don't NEED that nasty stuff!

I found myself using it the last couple of days purely because I felt so horrible. A lot of this horribleness might be incipient depression, which often manifests physically. I have this pervasive feeling of physical discomfort and dysphoria ~ it's the type of feeling I couldn't describe to a doctor, because it isn't distinctive enough, and I have no "symptoms". I have just been feeling negative, tired and crappy. And the sunlight streaming into the top deck of the bus yesterday morning was downright painful. I think it's no coincidence that when I feel "high" and manic, lights make me feel very high indeed. So the mood's changing polarity and so do my reactions to things. I bought more heroin late last night and that made me high again. It's as if the gear brings out the tiny bit of hypomanic high left in me. (A speedy high, so I couldn't sleep. Not ordinary heroin-induced drowsiness at all.) (I was still feeling very slightly excited yesterday morning, despite feeling depressed: all these symptoms run on separate cycles.) Anyway I don't know where I'm going now. I'm hoping that maybe I was just going to feel ill for a couple of days, that the illness will pass and so will the "need" for heroin.

I can't believe I'm back to using gear again for self-medication. Self-medicating is the hardest habit to kick. I'm in a situation where methadone is NOT helping like it should. Feeling cold and physically and mentally uncomfortable on methadone but not heroin is a bad thing. I WANT the methadone to work for me, but it just does not work the way the clinic believe it "should" do.

If I'm still having this problem in the new year I'm going to insist they change the methadone to some other drug. My worker said they CAN give morphine XR pills in rare cases where methadone isn't tolerated. Well I'm not tolerating it. (Also methadone seems to burn as it goes down ~ which is seriously not nice.)

Sorry if this is an unfocused post. IF ONLY I could dump that brown shit ~ yet again ~ but this time for good. Wish me luck. Because I think I'll need it  ... Or better still, pray to God for a miracle...

 "With God all things are possible." (Matthew 19:26.)

Down. Out. Whatever.

THE "HYPOMANIA" I so thoroughly enjoyed disclaiming experiencing, which was most certainly REAL has almost entirely withered and died. Yesterday I was so tired I couldn't even watch Helen Mirren in The Queen (again) without falling asleep. So I went to bed in the mid-afternoon and awoke around ten or eleven PM not feeling good. Then I took a tiny bit of quetiapine (my antipsychotic, which I'm meant to be on at 300mg every day) and finally drifted off again after one AM. I had a dream about going on holiday to India with a geat group of friends. Only our hotel room was over a river and the vivd blue sea was fenced off for five miles with huge, bizarre plants growing along the beaches. The swimming pools all along the length of the road on which we were staying were all for guests of other hotels. I kept thinking of Louise and Tilly Bagshawe, the chick-lit writers and how terrifying it must be to depend for one's livelihood on something as capricious as the sales of paperback novels.

I woke up experiencing pervasive mental discomfort, induced by the dream, that carried on all morning. I only got up at 11AM. I felt too depressed to do anything. So I didn't bother showering. I was fully clothed anyhow and utterly freezing cold. So I went down the post office where the enormous queue was moving so torturously slowly I could barely handle being there. Then I phoned an idiot foreign drug dealer. I said "I'm just checking you're around," and he said "why you checking I'm around". He is so stupid. So I had to actually spell it out: "BECAUSE I WANT TO COME AND SEE YOU. I'LL BE ABOUT TEN MINUTES". I got on the bus feeling horrible. I saw this dealer. These days I get no pleasure or excitement from the process of scoring; if I feel anything I feel stressed and just wish I could be at home. So I got two "bees" for £20. Then I had to go to the needle-exchanging pharmacy where another drug addict was getting his and he looked at me weird, presumably because of my weird speaking voice. Then I went into McDonalds and that was almost unbearable. I had to wait for them to make my £1.49 double cheeseburger from scratch as I stood there, tired and sweaty and just wanting to be somewhere else.

Almost all the symptoms of hypomania have vanished, except for an occasional indistinct generalized feeling of excitement, which I thoroughly doubt another person could notice or pick up on. Music which only a couple of days ago induced in me sensations of highest exaltation is still going around my head but I only feel irritated by it. My own thoughts, if they are "racing", feel oppressive. They weigh on my brain. The bus-ride home took a hopelessly long time with sunlight not blocked by tall enough buildings, shining straight to the back of my brain and it felt like it was poisoning me. I drudged all the way up my own neverending street, tired and utterly freezing cold, not feeling at all good. Binky rang me twice today and I can barely bear speaking to her. So I got home and took two thirds of the heroin and ~ WOW! ~ I feel a lot better. The indistinct but torturous sensations of physical discomfort that I've experienced all week ~ even when feeling manic ~ have evaporated. And the horrible mental discomfort that I've only felt since crashing down is markedly reduced since banging up this gear. (Otherwise I wouldn't want to be typing any of this now.)

If you're wondering why all the indulgent details, this is for my own purposes. I want to remember exactly how mood swings really feel, in detail. My memories of the past two weeks are so fragmented, they're like a pack of playing cards thoroughly shuffled then scattered all over the floor. For all my complaints at the time that I didn't feel that high, I felt normal, I now remember last week as a period of massively elevated moods. My emotional reaction to music, lights and colours became so extreme it actually outdid Ecstasy. I might have compared my emotional upswings to MDMA or other drugs but they're never exactly the same. While the "hedonic activation" of MDMA is there, the "lovey-dovey-ness" is almost entirely absent. I'm thinking of writing a book about Mood Disorders ~ for sufferers and their families and for medical professionals looking for a more personal viewpoint. One thing I want to do is explain how to differentiate the symptoms and behaviour a person high on speed or coke might display in contrast to the far more expressive, expanisve and excitable highs of mania. One person we know was actually diagnosed with suspected LSD intoxication because one thing she said, among a great many others, implied that this was the case. This person, when she is ill, will speak aloud many of the ideas racing through her mind as if they are statements of fact. When I last saw her she also said she was having Jesus' baby and Sting's baby and that we couldn't go outside because of the snipers on the roof. The staff should really have known better.

Well I must go and extract £60 from Binky. She owes me money and if I don't get it now she'll only go and spend it on earrings. Or something.

Ukh! I've just remembered why I felt so dreadful this morning. It's only four days till Xmas, which I'm doing at Binky's mental health hostel; and I was wondering how on earth I'm going to cope...

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FIND YOUR WAY MIX BY TEKIU TEKIU  ~~ "EMOTIONAL TRANCE"
BEVERLYBABE AND BUGERLUGS THIS IS FOR YOU...



NIRVANA: LITHIUM  ~~  THIS IS FOR YOU, ANNA GRACE ...





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Marvellous Weight Loss!

DID I TELL YOU how severely I lost my appetite last week? So extremely that I could barely eat and drink 500 calories a day. I put off going near food for hours because the prospect of eating just made me feel sick. I never felt hungry, just nauseated. A feeling that made me want to touch food even less, even though I know from experience it means I "need to eat".

I LOST NEARLY 5KG IN A WEEK! That's 11 pounds. I'm so happy. It's worth any amount of nausea to lose that weight.

I desperately needed to lose that weight as I was just a few grams under ONE HUNDRED KILOS. That's 220lbs or FIFTEEN STONE SEVEN! Overweight women like to say that I don't look fat, which is true. My silhouette in clothes, even at this extravagant poundage, looks normal. But when I wear a wooly hat my face looks like the moon, which I don't like. As my house is freezing, so I wear a woolen hat all the time. I even sleep with it on.

Well the diet is going to pot. I consumed nearly 1500 calories in food and drink yesterday. 1500 is the most a person in my position should ever consume. All this crap about a man needing 2500 cals a day. Well yes, maybe, if he works as a hod-carrying bricklayer and wants to look tubby then yes 2500 is fine. But THE VAST MAJORITY OF THE WORLD'S POPULATION SURVIVE PERFECTLY WELL ON CONSIDERABLY LESS THAN THE 2500/2000 Calorie a day recommendations of western health professionals!

I went to India in 2000 and saw their portion-sizes. Their main course is like a western starter. They don't eat puddings or sweets at all, with the possible exception of some fruits that aren't too expensive. (Most Indians are poor.) But more to the point, ALL Indians I saw were thin, with the single exception of the police, who everyone knows live on bribes, backhanders and money scammed from the people they are meant to protect.

5 kilos a week isn't bad. At this rate I can stop worrying about weight loss in another seven weeks. Though I can never go back to the diet I was on before. The ONLY diet that works long-term is a permanent, life-long change in diet. Anyone who believes they can go "on" a diet for a few weeks and then somehow sustain the weightloss achieved despite reverting to their previous lousy eating habits is sadly mistaken.

I'm hoping to go down to 10 stone/130 pounds ~ wish me luck!

PS my mood is down to "normal". Even though it felt perfectly normal before, I insist it is more "normal" now. I'm not pacing around laughing uncontrollably today... know what I mean?...

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PARROTLETS ~ MINIATURE BABY PARROTS...



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Shopping with Binky

BINKY and I just went on the most marvellous shopping spree in Oxfam (for those of you not au fait with the British high street, that's a high-end charity shop) ~ where we both purchased new trainers (that's "sneakers" to you Americans) and I decided to buy myelf a book collection: The Perrin Technique: How to Beat Chronic Fatigue Syndrome/ME by Dr Raymond Perrin; Nobel House by James Clavell and Fame by Tilly Bagshawe. Intellectual titles, all three!

Then we met a crack-addicted prostitute who had just been in a bitch-fight. This was Agatha, my friend Paddaddster's woman... Binky kept laughing because I've been "gauwching" today. Gauwching is junk-speak for "heroin-induced slumber" but it's not really as straightforward as that. I've not been sleeping all week. And every time I wake up, I feel like my stomach has been scrubbed out with liquid drain cleaner. I had to eat a 500g pot of fruits of the forest pro-biotic yoghurt this morning in order to feel better and it did work a treat. I can't believed I stooped low enough to take nasty heroin again. True, my knackered-out body feels some need. But my mood has been far too superior ever to require chemical stimulation. The natural highs of hypomania far outstrip any chemical substitute.

We went to the council offices to get my pensioner's bus pass. Binky kept telling me to keep still and not say too much. She's complaining that my ear infection manifests in a even louder voice from me than usual. Then she said, "Actually you should get up in the middle and walk around saying some stupid things. Oh no. You'll probably do that anyway...?" She says I'm still hypomanic, but not as hypomanic as yesterday. I think I had about six or six-and-a-half hours' sleep last night. Binky passed all my paperworks across the desk then said this is my friend who is really unorganized. Here's all the letters you need and the passport photos. He should have sorted this out a year ago." The lady who dealt with my claim said I ought to get a letter telling me to pick up my pass from the local Post Office in six-to-eight weeks' time.

It's taken more than a year to sort this Freedom Pass. Deshane, my old Support Worker told a bare-faced lie about having attempted to get me one last year and come up against the problem of my being housed by one London borough and yet resident in another. Having checked the present paperwork, there's no way that could have been an issue, because short of asking for proof of address, no other details of one's place of residence impinge on one's application whatsoever. This Deshane is the one who had the impertinence to declare to my psychiatrist that he thought I had obsessive-compulsive disorder, which he referred to as "COD" (surely "COD means "cash on delivery"..?) There was a real pregnant pause in the meeting, which Deshane didn't notice and then my shrink said "Well we're working under another diagnosis." Schizoaffective bipolar disorder being about as different from OCD as cheesecake from jumbo saveloy.

I should be eligable for this pensioner's bus pass on the grounds of "severe mental illness". When my neonatal-looking GP, Dr Lovelace umm'd and arr'd over the forms I pointed out that when manic last year I reached a point where I literally could not read at all (which was absolutely true: why do you think I feel so traumatized by the excesses of that "episode"...(?)) then straight away she said "leave the form at reception and I'll have it signed for you within a week. Do you understand now why my attitude to this disorder is so mixed? On the one hand it opens the door to undiluted euphoric, rapturous transcendent, mystical experience... on the other, it's really disabling and demeaning. And I'm particularly unimpressed by the prefix "schizo". As y'all know, I thoroughly enjoy much of my mania, so I don't want to give that side up. Surely at some time in the future they'll concoct a mood stabilizer able to eliminate depression and yet keep me mildly hypomanic all the time...? Because if "recovery" is going to mean years of mild depression with dragging tiredness, boredom ~ in other words a half-baked, half-cocked "recovery" then I'm not sure how much "better" I wanna get anyway...?

I just love this "bounce mix"; 17 minutes in it gets really bangin' (...)... and 50 mins 30 seconds... and 51 minutes.

I must go and eat a Jogobella raspberry yogurt 500 Calories in 500g ~ so I'm really eating good. This stuff settles my stomach like nothing else in the mornings... Well I simply MUST GO and do a Damn Great Gauwch as well. I've not been sleeping properly all week and I REALLY NEED TO CATCH UP...................






BANGIN' 3-HOUR SCOUSE HOUSE/BOUNCE/DONK-MIX NOVEMBER 2011...




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Mental Health Letter Found on the Street

SEEING as I'm considering becoming a Consultant Psychiatrist, or at least a Clinical Psychologist, the following piece of correspondence, found on my road this morning, was of interest. And because I want an office job, I thought I'd practice my typing by tapping it in here. NOTE: I changed the names (have YOU ever met a guy named Potishell?) and NO it is not me. Check the mood report.  Does that sound like me? No. Also if it was me, they'd probably note an increased rate and production of speech. [Incidentally the mood section does make psychiatry look like a joke; I would rate my mood as 8/10 and yet Binky says I seem "manic".] Here goes:~

Thank you for referring Mr Potishell Pantswell to services and he was seen on the 21.08.12 and I am now writing with my findings and recommendations.

Reason for Referral: Has a history of mental health problems and you have requested a further assessment of his mental health.

Presenting Problem:
Potishell reported that he is feeling well within his mental state, despite experiencing some residual psychotic symptom (sic). He added that he was not quite sure why he had been referred to us and it was more than likely it was suggested that he would need to be linked in with mental health services.

Mental State Examination:
Appearance/Behaviour: A male, with a medium build, from a Black Afro-Caribbean background. He presented as calm, pleasant and engaged well during the assessment with a good rapport and eye contact established.
Speech: Spoke clearly in English with a normal rhythm, rate and tone observed.
Mood: Objectively he appeared stable within his mood. Subjectively he described his mood as okay and he self-scored his mood as 7 out of 10.
Appetite: Okay
Sleep: Expressed that he is experiencing dreams, which at times he finds distressing.
Abnormal Perceptions: Reported that he experiences visual, auditory and tactile hallucinations. He described that he sometimes see's (sic) vivid lines in different colours, hears occasional voices which he ignores and sometimes feels as if someone is touching his chest and he was unable to describe the type of touch. Currently he reported that his symptoms have greatly reduced, however he still experiences some residual psychotic symptoms.
Concentration: Okay
Delusions: Nil
Self Harm/Suicide: Nil
Insight: Good

Drugs/Alcohol:
Has a past 10 year history of crack cocaine, heroin and alcohol dependence. Currently Potishell denied any current alcohol or illicit drug use. [I bet he's lying.]

Police/Forensic:
Was sentenced to 4 years for burglary [naughty boy! What a terrible thing to do!] and is on probation until 2013 and he has to attend probation twice a week. [How dreadful for him.]

Employment:
Works part time as a domestic cleaner at B&Q.

Finances:
Is in receipt of a part time salary and expressed that he was managing on this salary. [What? In London?? Either he has no interests and cheap taste, or else he's surely working or committing crime on the side.]

Treatment:
Olanzapine 12.5mg daily, which was prescribed 2 years ago.

Summary And Recommendations
A 38 year old male, who is experiencing some residual symptoms of abnormal perceptions in the form of visual and auditory hallucinations. He has currently remained relatively stable on Olanzapine 12.5mg, which was prescribed 2 years ago. Currently there are no risk factors exhibited and No self-harm or suicidal thoughts elicited.

Plan:
1: I discussed his case with Dr Mazooramabakhadan and he recommended that you increase his Olanzapine to 15mg daily.
2: Dr Parper could you refer Potishell to the Neurologist and conduct a full physical health check.
3: Potishell's mental health to be monitored accordingly by primary care services.
4: Potishell has been advised that he can present at our 24-hr walk in service if he is to find himself in a mental health crisis.