Peel me off this velcro seat

There’s been so much I haven’t related about my struggles with food of late. I’ve been coming to resent my blogs more and more, and let’s be honest, the division between yeswehavenobananas and masterkidderminster was always more of an ADD whim than a reasoned division, something that has allowed a lot of the food-related problems I have to run into the broader diaries in Unforgiving Minutes and the like. Quite aside from the blogs, I have come to resent too, more and more, the role that food plays in my life and the amount of energy it takes to try to cook the food I need to stay as well as I can be. When I am not moving forward with my cooking, I resent it, and since I am such a perfectionist and since I am limited in my choice of ingredients and condiments, my cooking abilities often depress me more than they console me (and all cooking should be consoling). The fact, too, that no matter how hard I try, my efforts don’t bring me any closer to [long reveries, confrontations with the boss on the subject of being articulate, or not, being the last of a long series] being healthy, and coping, whilst every single slip counts immediately. [further morning meeting reveries involving berating my colleagues for a lack of willingness]. More

I’ve got the Baboon Butt Blues

I’ve had an itchy arse over the last few days and also an itch around my crotch. I took a look in the mirror last night and found that, as suspected, I had a fungal infection around my anus. It isn’t the first time. Indeed, I have had recurrent fungal infections for over a decade. One time when it was worst, I was having the worst problems I have ever had with mood and concentration. More

Blog rage

I am feeling furious and unfulfilled.

All day I have been absolutely exhausted. I got up late having eaten Weetabix last night and slept very shallowly. I have been feeling completely exhausted, like I do sometimes, with a heavy, tingly tiredness in my legs that feels like I have run a marathon. I get this sometimes. A feeling completely disproportionate to the amount of exercise I have been doing.

I have been able to do nothing since I got back from work. I read a little, but barely a chapter or so, and managed to write no more than a paragraph. I am angry with the amount of time I get for writing. I can’t deal with it. And now for the last hour or so I have been on the computer, writing a little of my blog, which is still consigned to Bebo. I have been trying to rectify that, by looking into why on earth a second domain has disappeared on my host, but I am completely lost in the system, unable to make head nor tale of the control panel system, and getting lost with submitted requests for help having disappeared in the system now irretrievable, and unanswered. I cannot install Wordpress on the second domain I hope to put my blog on with some drafts of short stories and the like. I have forgotten my password to one of the log-ins and it is none of my normal ones. That or it doesn’t tally with the log-in name I am using perhaps in error. This kind of problem should be easily rectified in the system but it isn’t.

Anyway, the main thing to report is my absolute bloody tiredness. I’m fed up with it.

Morning: green tea and Weetabix again, because I got up so late, having left my mobile phone downstairs last night (in part I think I wanted to do some writing,  though I can’t remember what I was doing, but then I got tied into some porn because I had been having many many sexual fantasies and thought it would contribute to my not sleeping. I was up for another half hour or so then finding porn and looking again for ADDerall.)

So, yes, my morale is pretty low and I know I will find little time for cooking. My priorities have cycled round again. I come back home to play guitar, and to write. And I am still dreading moving into this house. I Am feeling like I need complete freedom from everything right now. I need shot of all responsibilities.

Binge

Took the chance today and yesterday to work with Jaffa down his pet project, a community based on woodlands not too far away from where we’ve been set up for the last couple of weeks. Now I’ve barely spoken to the guy and though I like him, I always figured he had me down as one who hasn’t paid his dues - an easy enough assumption to make when I cover up so much about my past and had to adopt this neutral, non-suspicious persona for so long. Anyway, it turns out Dasha has been speaking to him, letting him know I’m one of her trusted few, so he comes over and tells me about the place. He’s one who has to be won over like that, one way or another. Offers to take me down for a bit of wood chopping and such. Offered, too, at a time the police were turning up to give us grief so it was perfect timing. I think he knew it.

More

US vogue for Bipolar diagnosis - draft

I haven’t had the chance to read the New Scientist for months now. It’s one of my favorite magazines, with The Ecologist, which I haven’t read for years since I cannot find it in any of my local newsagents. I have been trying to streamline my life and the projects I am working on, something that I find I am better able to do when I am eating well; I’ll never get anything finished if I am working on so many things at once and reading so many books at the same time. Unfortunately, science is sometimes the thing that gets left behind. I have so many books on science I have bought and not got round to reading, though it is something I always find fascinating. I am in danger of becoming ignorant on the subject despite a reasonably developed natural aptitude for it.

In any case, I picked one up a week or so ago. The main story was Climate Change, a guide for the perplexed. On opening it I found that the main editorial was called “Mania for Treatment,” about the apparent overdiagnosis of bipolar disorder in America.

Until a decade ago it was an exclusively adult disease whose diagnosis required serious symptoms, including hospitalisation for mania. Today in the US children as young as 3 are being diagnosed, often based on the observations of worried parents.

I happen to have read a lot about manic depression, or bipolar disorder as it is now more commonly known. In fact I spent much of my adult life preoccupied with the illness, believing myself to be manic depressive. Briefly at university I was on Lithium Carbonate, the preeminent treatment for the disease. The editorial, and the article which accompanied it reminded me of a documentary, The Secret Life of the Manic Depressive which was first shown on the BBC anything up to a year ago. This was something I had been planning to write about for the blog, since it raised a number of issues, and so, armed now with additional material, I found it on YouTube and watched it again.

The documentary is one in which Fry talks about himself at times rather too much. This led to one psychiatrist, Oliver James, to speculate that his true diagnosis may not be manic depression at all, but narcissistic personality disorder.0 Whatever the truth of that it is clear that Fry is rather self-absorbed. While this might be understandable in one with such a terrible disease, Fry’s manic depression doesn’t quite seem Byronic, and so while he may be personable as a guide, there are times, when he is expressing his own reservations about treatments he has never himself yet felt the need for, for example, or when he is introducing us to one after the other of his famous friends who talk about their struggles with their moods, and with drink and drugs while simultaneously enjoying lifestyles most manic depressives would love to experience, that the viewer might prefer to have a more detached, pedestrian host. If I am to be honest, I felt little sympathy for Fry when he spoke to camera, leaning on the door of his Mercedes and talking about his depression. It’s not that I feel that wealth particularly keeps one insulated from mental pain, though to a degree it does, but rather perhaps that I find his manner unconvincing somehow, and I don’t see his depression. I can’t feel it.

I am currently working on a short story entitled Lithium Elysium, the latest version of an idea I have had for five years or more when I was facing whether to confront my demons and take Lithium. That was my medical quandary back then when I suffered from, or believed myself to suffer from bipolar disorder. The idea behind the story has stayed with me. My last such quandary was whether to take medication for what I now consider must be ADD with strong traits of Aspergers. Most recently, from September, I took a drug called Strattera, a norepinephrine reuptake inhibitor. I stopped for several reasons, not least because I felt it wasn’t doing much besides making me overwhelmingly tired at inconvenient times of the day. I suppose I also had wanted a stimulant. Indeed, a mere few days ago I was surfing the internet trying to buy Adderall without a prescription, buoyed on by the fact many writers, including W H Auden and Graham Greene (who was, incidentally, bipolar), have taken the similar benzedrine to write. My writing is so important to me that I would certainly use such a substance if it would help me finish a novel that could then help to manoevre me into a position in my life where I could write without it, eating healthily and having time for exercise and time to write and give time to my loved ones.

            I gave up Strattera, as I gave up Lithium, without consultation, because I wanted further to pursue an area, food, that I believed my psychiatrist had insuficiently taken into account – he had as good as summarily dismissed my arguments for the first few consultations, essentially denying that anything other than MSG, food colours and Aspartame could affect behaviour. I could not pursue my diet and continue to observe any reactions I had from food in the food diary I was only beginning to consistently take, if I could not exclude the effect of the drug from my observations. I also believed that he was prescribing the drug in part because it could be used for both bipolar disorder and ADD, he was keeping his options open, whereas I had been coming to the conclusion that I had been misdiagnosed with bipolar disorder, or that the diagnosis no longer applied. I did not think it was the right drug for me. I had not stocked up on the drug before going away to Prague, and so there ran out. Afterwards, because the severe lulls that came with the drug, the drowsy periods I had experienced, were associated with the first few times I took it, and the time I began to take it again having run out the first time, and because such lulls might severely affect me in my job in which I found I had to be ‘on the ball’ at all times, I did not start back on the drug but really made a push to exclude gluten for good. And lastly, the drugs contains artificial colours! I thought that was a sign of the exact lack of joined-up-thinking that characterised my doctor’s denial of the link between food and behaviour.

            Strattera contains several additives to provide the tablet’s colours. These are:

E172, which is “Toxic at ‘high doses’, and banned in Germany” (http://www.ukfoodguide.net/e172.htm)

E171, similarly defined.

E132 or FD&C Blue 2 which is “Best avoided by people with allergy reactions as it can cause skin sensitivity, a rash similar to nettle rash, itching, nausea, high blood pressure and breathing problems,” and “one of the colours that the Hyperactive Children’s Support Group recommends be eliminated from the diet of children.” It is also “Prohibited in Norway.” http://www.laleva.cc/food/enumbers/E131-E140.html

Finally, Shellac is considered not suitable for vegetarians by some. (http://www.veggieglobal.com/nutrition/non-vegetarian-food-additives.htm)

I had already by this point become agitated by the presence of food colourings in Holland & Barret’s vitamin tablets. It is absolutely unnecessary and so utterly infuriating. For a while I opened the tablets and swilled them around in water before drinking them, but the taste is horrendous and this took too long in my morning routine.

            But the absurdity of this situation in which drugs are seen to be the entirety of the solution to the problem, is so much the worse in America.

            One of the lads interviewed in the documentary, Ian Jenson, who had been diagnosed as bipolar at the age of eleven showed his drugs to the camera, swilling them down with Coke.

SF: “Prozac, [indistinct but clearly another drug trademark], Adderall, Klonopin is like a tranquilsier type?”

SJ: “Yes”

IJ: “This is Ambien which I take,”

SF: “Oh it’s a sleeping pill isn’t it?”

IJ: “Concerta which I take in the morning…that’s like Ritalin kindof.”

Ambien is used by the US air force as ‘No-go’ pills for pilots to relax and sleep after a mission. Amphetamine is used as a ‘go-pill’ to get them to concentrate on their missions. I suspect this is one of the reasons British forces and other members of coalition forces were killed in friendly fire incidents. Incidentally, British troops report than it is routine for American forces to eat at Burger King and McDonalds restaurants both in Afghanistan and in the Gulf.4

At various points in the documentary Fry asks sufferers what they would do if there was a button they could press to get rid of the disorder, to turn it off. Looking at the way mental illness, and, in the case of air force pilots, mental wellbeing1, is treated in America, it sometimes seems as if this mechanistic metaphor is precisely the way that human mental function is viewed by medical practitioners and authority figures – you press this button to turn them on in the morning, and this button to turn them off at night.

Richard Dreyfus, who Steven speaks to about the medication he uses to control his manic depressive illness has a similar story to Ian Jenson.

“So you are on a pharmaceutical regime. Can you tell us what you take?”

“It’s different things. It’s things having to deal with manic depression and ADD and concentration and sleep and anxiety.”

“And lithium.”

“Lithium was the very first thing I took, for many many years. And now 20 years later, 23 years later, I am just about not taking it.”

Fry repeatedly talks about the problems of Lithium Carbonate phrophylaxis, the primary treatment of Manic Depressive illness. He does so in a way that makes me very uncomfortable. Lithium works, and as numerous experts attest, it reduces the risk of suicide, perhaps the only drug that reliably does so. And yet there is a stigma surrounding the drug. A stigma that very directly led to the death of one beautiful and intelligent young woman shown in the film – a section of film that is very moving, and hard to watch. A stigma that Steven, if anything, by parading his own dilemma about medication, does nothing to dispel. Indeed, Steven talks up some of the facets of the internally-complex myth against Lithium, such as by stating again and again that once on it, an individual should stay on it or risk an increased rate of relapse (this is true of the first year).

            Still, in Dreyfus’s case we see the truth of the long-term nature of the medication used to treat bipolarity. This raises some serious issues since though we should give short shrift to baseless myths surrounding medication, and though we should endeavour to banish the stigma around effective medications and their judicious prescription, we should certainly thoroughly investigate all the alternatives and be sure that we only have recourse to medical interervention when it is absolutely necessry. Lithium, though very effective, is toxic, can cause excessive weight gain and acne in young children. Methylphenidate, which is an ingredient in Ritalin and the Concerta  used by A Jenson, has been associated with stunted growth. “Valproate can trigger excessive hair growth and, in adolescent girls, polycystic ovary syndrome, a leading cause of infertility.” Two of the medications Ian Jenson is taking in the film are listed as for short-term use. And so, we must return to the question posed by the New Scientist, which was told by one paediatric psychiatrist that “only 18 per cent of children referred for a second opinion actually had bipolar disorder,” are many of these diagnoses entirely spurious?

            According to Fry, “Consultants in Britain don’t agree with labelling children at such a young age. The norm in Britain is 19.”

Dr Kay Redfield Jamison, whose excellent book Touched with Fire, Steven Fry is seen reading at one point, said in a question and answers session following a lecture in 2000 that “The Average age of onset of manic depression is 18, probably younger. Which means a lot of people get sick much much younger than that average age.”2 So, clearly, this would fit in with Fry’s observation that conceivably, the spate of bad behavious and thieving he famously went through and was expelled from school for might have been avoided had he been diagnosed earlier. And yet there’s a big difference between the age at which Fry was expelled from public school, and a child of three years old who has barely had a chance to blow raspberries out of turn.

            Jamison, manic depressive herself, elaborates. “Mood disorders are unlikely to hit in primary school, but they certainly do. And the things that you should be concerned about would be sudden change in academic performance, or the ability to concentrate, total inability to attend to what a child is supposed to be doing, crying, anger, rage, physical violence, withdrawal from other people.”

            “Also, the symptoms, basically, in many respects like you see in depression or in agitated states in adults.”

            A reassuringly exhaustive list which, if followed, and especially when followed with an eye to heredity, since manic depression rarely – as good as never – occurs wihout having been often comprehensively telegraphed by a family tree heavy with anecdote, would preclude the scandalous failures outlined in the article.

            Kiki Chang, the consultant who diagnosed Ian and Tod jenson (at the age of six and eleven) has some reservations with the apparent trend for diagnosing bipolarity at a young age, “Once you get down to age two or three it’s very normal to have complete discontrol over your mood. Tantrums and crying one minute and laughing the next minute.” In this he echoes the concerns of child psychiatrist Gabrielle Carlson, quoted in the New Scientist who demands “when children are only 2 to 4 years old, how can they be ‘grandiose’?” Nevertheless, Chang, like one Susan Resko, executive director of the Child and Adolescent Bipolar Foundation who is quoted in the New Scientist defending the diagnosis in the cases of children as young as 5 or 6 years old, believes that early intervention is justified:

“…I certainly have colleages who are clear that they see it in three year olds… Certainly I have seen children who I think were four and a half who fit the bipolar criteria. They’re having wild mood shifts and they’re having unsafe behaviour. They’re not functioning, they’re not developing correctly. They’re losing a lot of time in their normal development.”

This idea of ‘normal’ development is something I personally find disturbing. Normal development for me, with my specialism as a writer, involves vicissitudes and involves sometimes anger and resentment: life is patchy, difficult at times. And besides, the early clashes and developmental slips of Einstein, Churchill and Eddison formed their character. It’s difficult to imagine now how such a man as Samuel Johnson could come into being even in today’s England without being dosed up by some concoction, as we can see from this description by novelist Fanny Burney upon meeting the renowned Dr Johnson at the home of that other ‘eccentric’ Sir Isaac Newton, a man who was so determinedly a creature of habit that he would give his lectures irrespective of whether anybody turned out to see them, wrote in her diary:

“His mouth is almost continually opening and shutting as if he was chewing. He has a strange method of frequently twirling his fingers, and twisting his hands. His body is in continual agitation, see-sawing up and down; his feet are never a moment quiet; and, in short, his whole person is in perpetual motion.

“His dress, too, considering the times, and that he had meant to put on his best becomes, being engaged to dine in a large company, was as much out of the common road as his figure; he had a large wig, snuff-colour coat, and gold buttons, but no ruffles to his shirt, doughty fists, and black worsted stockings.

“His attention was not to be diverted from the books, as we were in the library…having fixed upon one, he began, without further ceremony, to read to himself, all the time standing at a distance from the company. We were all very much provoked, as we perfectly languished to hear him talk; but it seems he is the most silent creature, when not particularly drawn out, in the world…. Dr. Johnson being taken from the books, entered freely and most cleverly into conversation; though it is remarkable he never speaks at all, but when spoken to; nor does he ever start, though he so admirably supports, any subject.”

(One thing that might stand out in this report is that Johnson stands out from the crowd as a remarkable individual by virtue of his lack of ruffles on his shirt. It may be considered what the contemporary and future analogue of these ruffles might be.)

I have no time for the early anti-psychiatry movement, for R D Laings and others who blamed parents for their children’s mental difficulties, but I do think there are many parents in the Western world, and especially in the US, who latch on to quasi-Taylorist ideas of an ‘average’ child’s development, that is, that children should follow any number of developmental steps, and then push for interventions the second one such point is missed. Such parents are, I believe, so fretful about the competitive world that awaits their children that they are liable to hothouse them and to raise them in a way that may be at times neurotic and pushy and which will very often then precipitate the kind of putatively aberrant behaviours they are ever-vigilent for. The film Garden State is one film which highlights this concern, but also Igby Goes Down, basically a modernised version of Catcher in the Rye, a novel I suspect may have been written by an author who suffers from ADD, and which also deals with a child on whom there are many expectations and who ends up with psychiactric problems, covers some of the same ground. Both are, incidentally, very watchable.

            The problem of hyper-vigilence, that is, of parents and close relatives looking out for the symptoms and prodromes of, for example, mania and depression is a serious one that often exacerbates an illness by making normal social interaction impossible and engendering neurosis and anxiety. It has been shown that the prognosis of those with serious psychiatric disorders, no matter what they are, tends to be worse for those who return to live with parents and close relatives, and much better for those who live with friends. I feel strongly that the loose usage of psychiatric categories in the American media, and the equally loose and inconsistent use of psychiatric disorders in American fiction leads to a situation in which many parents become hyper-vigilent in this exact manner, creating and then exacerbating situations. If a family home becomes like the Stamford Prison experiment then I would not be surprised to see ‘mood shifts and unsafe behaviour,’ indeed, I might be surprised if I did not see it. No doubt I sound like I am traducing American parenting, but we live in a very dysfunctional society with a very dysfunctional culture, and in the exact same way that children may become difficult and moody in the family unit, the family unit may become dysfunctional as a result of the way our society is structured.

            We do live in a very competitive world and there can be few people who are sane who do not have at times an overpowering anxiety due to this fact. Parents in Britain are known to fight and resort to all manner of behavious for places for good (state) schools for their children. Parents are asked to deal with all manner of information, to make difficult decisions from whether to opt for MMR to how to best ensure their children are fed, something that is a logistical nightmare as any reader of this site must know or will soon learn. They are then asked to deal with information about all manner of psychiatric disorders detailed in the latest editions of the Diagnostic and Statistical Manual of mental disorders and the drugs that friends and celebrities are taking and swear by.

            The New Scientist expresses the concern that some of the children diagnosed with bipolar disorder may indeed have manifested symptoms of it as a result of medication, either because they were misdiagnosed as having ADHD or given anti-depressants.

            Dr Kay Refield Jamison answers one question on this topic thus:

 

I’m loathe to get into specifics… In general, people who have classic manic depression are more susceptible to adverse effects from anti-deppressants in general.

 

            She also broaches the topic of ADHD:

 

One of the concerns, one of the major public health concerns now, I think – particularly in the States – is the overdiagnosis of ADHD, of Attention Deficit Hyperactivity Disorder.

 

And many kids who have a history of bipolar illness – and it is a very genetic illness, early onset tends to be particularly genetic and particularly difficult to treat.

 

And kids… the last thing you want to do with those kids is put them on stimulants. And that’s been a real problem. I was in Chicago not too long ago, there was just a horrifying situation.

 

We were talking to a priest who had just done a funeral mass on an eight-year-old child who had … whose mother was bipolar, father was bipolar, and he was diagnosed with having Attention Deficit Disorder and he hanged himself.

 

And it’s just … this is something a lot of us are seeing increasingly as people that should have been diagnosed clearly as having manic depression as young children, but just because they had problems with attention or, quote, ‘acting out’ or whatever, are being misdiagnosed.

 

I personally and professionally don’t know that teachers ought to be in the position of having to make a lot of clinical calls. Because they’ve got other demands on their time. They’re not clinically trained to do so … but just acting as a sort of general triage system of picking up on those things and, you know, sort of pointing kids in the right direction.

 

            So here we have two issues, the possible triggering of manic and hypomanic episodes by the overzealous use of medications, and the use of strong drugs on very young and vulnerable children largely at the behest of the pharmaceutical industry (which, sadly, has power enough to make both parents think they know what they need, and doctors think they know what the answer is). The New Scientist puts forward several reasons for this trend:

            They range from the broadening of the definition of bipolar disorder, to the trend of viewing everyday behavioural difficulties as a medical problem. In the background is, as ever, a pharmaceutical industry that encourages drugs to be taken up for a broader range of disorders and by new patient groups (New Scientist, 15 April 2006, p 38).

            Some would go further. Many people charge that the Diagnostic and Statistical Manual of Mental Disorders upon which American psychiatrists base their diagnoses far from the objective scientific guide it claims itself to be. In the words of one reviewer on the Barnes and Noble website:

 

The DSM IV-TR is a great book to promote diseases that fit the armaments of medications that the pharmaceutical companies would like physicians to use. The problem with the whole DSM serie [sic] is that it is mostly subjective and based on speculation. The DSM is not based on hard empirical evidence but on a consensual system by few well-connected psychiatrists on the payroll of the pharmaceutical companies. These same psychiatrists also happen to belong to the American Psychiatric Association and/or work as hired guns/consultants for the APA, which also happens to receive yearly funding or gifts from the pharmaceutical companies $500,000 worth. The whole process is deceitful and shameful!!!3

 

I could write an essay on this alone, and in the future I am sure I will do just that. For the moment though we will return to Fry documentary and another issue that it raises.

            Jamison, who I respect very much, has spent much of her career defending Lithium, and persuading others to take it as she herself has done for many years. I suspect she would have been quite critical of Fry’s handling of some of the material in his documentary in which his own discussion of his dilemma, whether to take Lithium or not, and his celebrity friends sometimes got in the way of the subject at hand, but one thing in the documentary did arise which took me right back to my early days of research into nutrition around five or six years ago. This is because Fry meets Liz Miller, a woman who was twice locked up in ‘Bedlam,’ Bethlam psychiactric hospital in London during manic episodes. She was sectioned and describes the time social workers, police and doctors knocked on her door to overpower her as being “just like the KGB calling”. Since that time, though, she has found that she can maintain her illness without drugs, by supplementing her diet with omega III fatty acids.

            Everybody has heard by now of these oils, which are contained in oily fish, and which can be supplemented in our diets. The reason she gives for their efficacy in such disorders as manic depression is their use by the body to build cell membranes in the brain which are more permeable to chemical messages than those constructed from other dietary fats. This was the same thing I read of those years ago.

            I never killed myself of course, and neither did I attempt to do so. I did experience very serious depression. I retreated from others and walked around on my own, bunking school to walk around zombie-like for hours at a time. One day at school I copied something from the board and found myself writing the word “suicide” automatically. I saw no future for myself and despised myself. If dogs barked at me I thought they hated me, and I couldn’t blame them.

            It is only recently that I have come to be agnostic on the question of whether I was manic depressive or not. There is no history in my family of the disorder as far as I can see, and though I don’t know much about certain sides of my family, I think I would probably know. There are signs of Asperger’s disorder, of obsessiveness, of reclusiveness, of a lack of social skills, of lack of concentration, of the underachievement of ADD, but I know of no one who killed themselves or experienced hospitalisation. What I can say is that there were times I was grandiose and I showed real lack of judgement and impulsivity, pressured speech and euphoria. I became paranoid and religious, things assumed significance and connectedness all around me. I remember one time beginning an article intended for the New Scientist in which I think I wrote (or intended to write) that as a writer, a creater of worlds, I could see that the Gaia theory of James Lovelock, with its interconnectedness, was very much the way that we creaters, meaning myself, but also God, would go about things. I prayed, and prayed, reluctantly, that I might be the reincarnation of the messiah – telling myself that it’s not such a great gig after all, and that there must be few takers, that God would be grateful for my celestial CV. I sent off money, cash, to publishing companies with one or two sheets of typewritten paper, trying to get their attention, telling them I was going to be a sensation.

            The development of my problems seemed textbook. It is so long ago now that I cannot summon it but in snatches of this and that. But when I first swung up, I remember it being pure. I said to myself, so this is what contentment, even happiness is. But then later, it was never quite so simple. There was the irritability, the drive, the anxiety. Nothing stayed still. My impressions of people, my philosophy changed and changed again. There was nothing firm. Nothing to work on.

            Now I can clearly see that ADD could take on many of the features of manic depression in a certain individual since it could provoke a reactive depression – one that is a result, that is, of some outward life events rather than an organic disorder itself – which might easily become cyclic with the seasons and their natural endowment of pessimism and optimism. Those who suffer ADD have many things to become depressed about. They are gifted again and again with more ideas than most people would have in a lifetime, and yet they are less able to see them through, since they become distracted and restless, unable to be consistent in their fidelity to one single project. They may be gregarious and extrovert, but may be gauche and lacking in social skills and decorum. This is especially so if they have traits of Asperger’s. Consequently, they may lack friends. People may reject them, hate them with a passion most people hate with only once or twice in their lifetimes. This is not now a question of denial. If anything I have been reluctant to acknowledge the possibility that I was myself mistaken when I approached doctors those years ago with the concern that I was manic depressive having recognised so much of myself first in a biography of Spike Milligan, and then elsewhere. Most of my identity has been established with manic depression a part of the mix. For years I felt I could not have children, could barely involve myself in a relationship. It was a deep dark secret, and I myself became deep and dark and secretive. When I hid “manic depression” it meant that I had to dissemble about those points in my life that “manic depression” had interfered in my life. The times I had left college. The times I had been hidden away from the world, writing and praying and masturbating and speaking to no one. And manic depression followed me, stalked me. I went to live in the Czech Republic and the house in which I first went to learn the language, a house owned by one of the other students, was the house of a talented actor and comedian, a manic depressive, a house that had been taken from him by the communists who claimed, wrongly, he had been pro Nazi. I felt too that I had come back from the edge through a supportive family, of course, but also by my own wit and intellect, my research, and my insight into myself and my sangfroid. I had felt too, as Miller does, that the prognosis of manic depression is contingent very much upon lifestyle – if you self-medicate, whether through drink or drugs, it will worsen, whilst if you eat well, supplement with omega III fatty acids, and exercise regularly, you can survive, even thrive. Throughout university I went to the gym regularly, ran on occasion, and rode my mountain bike sometimes. I was active, and paid attention to my diet and my lifestyle. I felt too that the categories and divisions of the DSM were socially-constructed to a degree. I remembered times when I passed through isolated patches of, for example, obsessive routines that were commented on by others. I felt that one disorder could, to a degree, morph into another, that mental disorders could be seen as organic in origin but expressed contingently depending upon any number of factors from lifestyle to personality. I was privately derisive of those such as my girlfriend who told me that manic depression was so bad I certainly could not have had it. So much of it was there, and had there been any scope to deny it I would have done so years before when I was confronting myself with the evidence in the medical library of my university. Writing had saved me. Modern research had saved me. But also I had saved myself. Now it is a question of six of one, half dozen of the other. I may have been manic depressive, and I may not. What is certain is that my symptoms, in terms of mood, were ameliorated by my supplementation of omega III fatty acids and Spirulina, or blue green algae. What is certain, too, is that one set of symptoms fell away, leaving my brittle personality, my anxiety, my tendency to solecisms and non sequiters, to neologisms and reveries, absolutely intact. I still experienced depressions. I still do. Sitting in the house today, working on this, I have been down. I couldn’t be with people, because I have a compulsion to write, to express the ideas that continue day after day to press down on me, but I have been down nonetheless, possibly because I am writing this and not the fiction, the novel and stories, I carry around with my day after day; possibly because my personality was formed over such a period of fluctuations of mood; possibly because there remains an infirmity in my brain. I don’t know. What I do know is that it is now, today, and for the last five years or so, so much more stable than it once was from my fifteenth, sixteenth, seventeenth years, that it is incomparable.

            The documentary shows Fry shopping with Miller in what looks to be a farmer’s market. She is buying fish, and cheese. She tells him that she has been continually warned that by not taking medication, she risks relapse. And yet for fifteen years she has managed to avoid that eventuality. On reading up on the internet those years ago. On looking at the links from a bipolar critical thinking forum which I subscribed to which helped me self-monitor for thoughts skewed up or down, I believed that however terrible manic depression is, still, at least I had been born at the right time, on the cusp of a revolution in treatment. I learned so much more clicking through those forums than I did studying my degree.

            Another part of the documentary piqued my interest was one in which Fry met another old friend, celebrity chef Rick Stein. Stein has always come over to me as more likeable and more genuine than most chefs, and here he was talking about his father, who killed himself by jumping off a cliff. He was manic depressive. Of course, Rick worried that he might inherit the disorder. He did not. And of course, so often where manic depression has led to suicide, its tendency to be passed on is all the more strong because of the stress that inevitably accompanies a parent’s suicide. This needn’t happen, of course, but it seems to me that this scenario presents the maximal probability of inheritance. What’s more, as Stein goes on to say, his father always considered him as being the most similar to him in the family, and so, worried over him.

            Rick is a chef known for his fish dishes. He seems to cook little, or nothing else.

            This is perhaps little more than idle speculation, and indeed on watching the film the second time today I saw that his father was pictured in a fishing boat himself. I ondered how much fish he ate. I would like to ask Stein some questions myself, and hope to do so in the future, to establish what he thinks himself about all this.

            In any case, I believe that though Lithium is a reliable drug, still, all possible avenues should be explored and Omega III supplementation and diet are among the most promising areas for further research.

 

 

 

Dr Liz Miller, incidentally, has a website through which she gives medical consultations: http://www.med4u.co.uk/index.htm , and you could do worse than to click through her Amazon listmania and read a few of the reviews http://www.amazon.co.uk/Essential-medical-student-reading/lm/R2583Y1PTVCX75/ref=cm_lm_byauthor_full/026-3502337-7590007 .

 
0 http://www.guardian.co.uk/commentisfree/story/0,,1929064,00.html , James does seem to have an axe to grind of late, and does have form in what seems to be a dangerously hubristic way of diagnosing people without seeing them, since I believe he once wrote that Mandelson may be suicidal having been chucked out of office. Perhaps he can be forgiven for his occasional tendency to talk sense, and I did at one point read his column and was really looking forward to reading his book. It may be that he has become bitter after his contracting of ME, and that the endless didacticism, ideology and vitriol he comes out with are a result of this. But then I have ideology, vitriol and perhaps didacticism of my own, exemplified by the fact no doubt that I believe his ME could be seriously ameliorated by a similar diet to the one I follow myself. And Christ, will people please stop thinking that writing Blair’s name into some neologism or twisting it one way or another is somehow a mature way of expressing dissent! 

1. http://www.ingentaconnect.com/content/amsus/zmm/2007/00000172/00000001/art00013;jsessionid=2paggdxce9he0.alice?format=print&token=00541a280eb2d4cdf34e26634a492f2530332976335a666f3a7b2f2d4063767c6b635d7d6b6cc95547db

2. http://aladdin.unimelb.edu.au/speeches/jam-trans2.pdf

3.  http://search.barnesandnoble.com/booksearch/isbninquiry.asp?z=y&isbn=0890420254&TXT=Y

 

4. http://www.guardian.co.uk/Iraq/Story/0,,2007386,00.html

http://www.guardian.co.uk/military/story/0,11816,1271361,00.html

http://www.guardian.co.uk/afghanistan/story/0,1284,1256511,00.html

http://www.guardian.co.uk/military/story/0,,2036079,00.html

Rather more satirically, http://www.thetoque.com/world_issues/20060301/mcdonalds_recalls_ship_from_persian_gulf.html