Part One

INTO THE PRIORY

 

November 2012

First thoughts

I’m being transferred from Ipswich Hospital to the Priory in Chelmsford (Essex). I’m dreading it, being away from Niamh and my life. But I know that if I don’t go in, I’ll probably be sectioned. If I go in voluntarily, I’m more likely to get out faster. I’m hoping I won’t be in for more than a couple of weeks.

I’ve decided to keep a diary whilst I’m there. I’ve been told (by several health professionals) that it’s a good thing for me to do and will help pass the time. I don’t mind the first bit. The second sounds ominous. It’s been suggested that I start writing by explaining how I got to this point.

I can’t really believe how I managed to get this bad. At university (2007–2010), I slowly started to notice I didn’t feel right. I began staying in more, not seeing people, and struggled with how I felt about myself. As my self-esteem dropped, so did my confidence and happiness, and I had quite a short temper at times.

University work (BA Illustration) became harder to do, and doing art was something that I’ve always loved doing. I’ve drawn, painted and taken photos for as long as I can remember, but I couldn’t even bring myself to do any of that. I tried now and again to do things I enjoyed, but they just seemed to slip away from me. If you lose passion for something, then what’s the point?

I felt like I had lost all my purpose and drive. This dragged me down further and I started hiding away and not seeing friends. I only saw my family very occasionally because I was with my girlfriend, Niamh, in a flat in Norwich 40–50 miles from where they lived. Things were mostly okay-ish between us but they did get difficult at times. Generally, Niamh was always happy and had plenty of drive (and supported and encouraged me as best she could), whereas I found it hard to even get up out of bed at times.

After university (2010), we moved back to Ipswich and this was when things got really bad. I didn’t see anyone any more, rarely left the house and wouldn’t talk to anyone, apart from Niamh, for days on end. It was then I think I started to feel like there was a big hole inside of me, like part of me had died. I didn’t really care any more about anything – especially myself. I didn’t care about my health, how I looked or the fact I was on my own for much of the time when Niamh was at work. I stopped doing what normal people would do to make themselves happy. I stayed in bed and wouldn’t eat and never spent any money on myself.

Once you start treating yourself like you’re worthless, you start to think you are worth nothing and life can feel pretty pointless. Why get up if you have nothing, hate yourself and each day feels like a constant struggle? It’s hard to describe how I felt, but each day was like a battle and I would hate waking up in the morning knowing I had to struggle through another day. I was lonely and inside I know I’d given up hope of feeling happy again. I think I’d forgotten what it felt like.

I can see now that I’ve been suffering from anxiety and depression; at least, that’s what the doctors tell me. I also have all sorts of other issues such as OCD. I don’t like the way I look. I struggle to make decisions. I don’t like change. It’s all pretty endless. These all sort of turned into an eating disorder; I think that this was my way of controlling things. I did not mean to be anorexic. It just seemed to happen. People talk about my anorexia as if that’s all there is to it. In a way, it’s got nothing to do with weight loss at all. (It is about control.)

I began to get really thin and started feeling unwell all the time from about 2011. Towards the beginning of this winter (2012) I remember being really cold one day and then felt like I had a really bad bug. My breathing was very laboured and I started coughing up blood a lot. I vomited up large amounts of blood several times. I spent about a week walking around like this, just ignoring it as best I could.

I then woke up one morning and my whole body was swollen. I got up and looked in the mirror and I couldn’t even recognise myself. I looked all fat and bloated, like something out of a horror movie. I was rushed to the hospital and was told I had oedema and my lung had collapsed and I was dying.

(I’ve been Googling ‘oedema’ and it’s essentially this: ‘Life-threatening infections or other critical illnesses can cause a reaction that allows fluid to leak into tissues almost everywhere. This can cause swelling all over the body.’ Not good!)

I was in hospital for a while. I remember being in a room with old people. I don’t know if they have a death ward in hospital where they put everyone who is going to die to keep them away from everyone else, but that’s what it felt like to me. The people around me were all about to die. I think the old man next to me may have died whilst I was there. The staff raced in one day and drew the curtains round him and I didn’t see him again. I often wondered if I was going to die there too.

Hospital was a horrible, isolating experience. I rarely saw a doctor. When they did come, they would bring trainee nurses to look at me like I was an exhibit in a freak show. I had various lung scans to see how bad my lungs were. My left lung had collapsed and was full of fluid that needed to be drained. The only way to do this was to put a long needle through my back and into my lung whilst I leaned forward. Niamh was there when they did this. I looked at Niamh’s face and she looked horrified.

I was discharged from hospital because I think they needed the bed. I felt like I was dying. I was scared to leave to go home because at this point I was in a wheelchair, could barely walk and still felt like I was dying. When I got home, I couldn’t even get up the stairs. I had to drag myself up using the banister. I couldn’t wear shoes because my feet were swollen and double their size. They felt like size 19s.

I started having check-ups and the doctor was so shocked with how I was both physically and, I suppose, mentally that he referred me to a local critical patient team. They then suggested the Priory and said why don’t I go there for a couple of weeks. They made it sound like a holiday, but I think that if I’d said no thank you very much, they would have taken me anyway.

So I’ve packed my bags and here I am ready to go into the loony bin.

I’m scared.

THIS IS HOW I SEE MYSELF. UGLY, EMPTY, DEAD.

On arrival

It’s a freezing cold day. I’m sitting on my own in a room (in the Priory) waiting to see a nurse who’s going to give me some sort of a check-up. I’m staring out of the window thinking how the hell it’s all come to this. Niamh and her mum have been and gone, and I know I’ve messed things up really badly this time. I miss my home and already feel trapped in this strange place. My initial thoughts are that I want to get up, break through the window and leg it all the way back up the A12.

* * *

The nurse carried my bag into the room and emptied it on to the bed to search for anything and everything. She took away a large bag of items and objects that shouldn’t be in there – even my fizzy drinks. I was then given my meal plan, which is actually far less than I would normally eat. The meal plan details the amount of food you will have each day and it will be stepped up depending on whether your weight is increasing enough or not. I’m already beginning to panic as I’m starting to realise what lies ahead. I feel I’m at rock bottom.

* * *

It’s now the evening and I’m still sitting on the end of the bed feeling completely lost. I can’t see how I’m going to adjust to living here. Today, my food has been a yoghurt and a bowl of fruit – way less than what I’m used to.

When Niamh left this morning, I watched her walking away and I knew I wasn’t going to see her again for a long time. Deep down inside, I fear she’s had enough and that this is the last time I will ever see her.

I’m thinking again about how I got here and wish that I’d tried harder to avoid this, but the reality is I had given up.

I’m going to have to meet the others in here soon and, having heard their shrieks and yells all day, I feel scared and unsure what to expect.

In the morning, I know I’m expected to sit and have breakfast with all of them. I haven’t even had breakfast in years, let alone with others watching me. I’m also starting to realise that I could miss Christmas this year. I’ve always loved Christmas. I can’t help thinking my Christmas Day will be spent here in this room on my own.

This place is killing me.

WHAT HAPPENED TO MICHAEL – AND US

So, where to begin the other (family) side of the story? If, as a parent, you have a child who has mental health issues to the point where they have been hospitalised and, to all intents and purposes, sectioned in what someone of my age (fifties) would call a ‘mental institution’, you can’t help but feel a range of extreme emotions. Sadness, anger, frustration, disappointment, disbelief, heartbreak and, not least, guilt and a sense of failure as a parent and as a human being. You ask yourself, ‘How did it ever get to this?’

One of the first things I did was to look back over everything that happened to see how Michael got to this place. With the benefit of hindsight, I can see his oh-so-slow decline – inch by inch at a time – from when he left to go to university in 2007 through to when he collapsed in October 2012. A long, long time – five years. For a while, it was so slow that we did not notice it. We were blind for almost all of it.

He lived with his girlfriend, Niamh, in a flat we’d bought in Norwich and they both did degrees at the University of the Arts. To us, he had everything anyone could ever want. His life should have been perfect. And we were a happy family, all getting along and doing well – it never occurred to us that anything bad could happen to any of us.

We saw Michael and Niamh regularly during their university years. We went up for meals out, at least early on. They came down and saw us. Weekends, Mother’s Day, Father’s Day, birthdays, days out. All much as it ever was. We went on holidays, to America and to Spain. Michael’s appearance changed over this time: he grew slimmer, his hair changed colour time and again, he wore different clothes, had his ears pierced – nothing particularly out of the ordinary with any of that. He was growing up. And he was an art student, after all. He wasn’t studying to be an accountant (thank goodness).

There were some tensions between us, especially as they came towards the end of their studies. We had paid out much – for the flat and 101 other things – and expected them now to get jobs and move into the real world and support themselves. They moved into a cottage back in Ipswich and…nothing much seemed to happen…for ages…and ages. I shouted. Cajoled. Threatened to withdraw financial support. None of it seemed to make a jot of difference. I thought, deep breath, Michael was a waste of space, a freeloader, a pain in the backside. There were moments when I would have been happy to never see him again. I didn’t really think about mental health matters; it wasn’t something that would happen to any of us. I just thought he wasn’t a nice person.

The next two years are now something of a blur – these were tense days, months, years. On and on. Round and round. Down and ever downwards. Michael inching towards his demise. Michael and Niamh moved home two or three times, each to a slightly smaller and grottier place. There were still significant issues between us – I remember shouting, ‘Is anyone anywhere ever going to do anything?’ Niamh did get a job. Michael didn’t. He stayed at home in bed, staring at the wall. There was a lot of anger from me towards him. I had many negative feelings.

As time passed, we slowly became aware that something wasn’t quite right about him and that he was thinner. We did not know what to do. We did not want to confront him and thought we might lose all contact with him if we did. We looked the other way. We hoped for the best – that, somehow, whatever it was would come good.

It didn’t – I remember getting the text, pretty much out of the blue, from Niamh that evening in October 2012. I caught my breath, on the brink. I texted back, ‘Is it terminal?’ A long, long pause. My heart cracking. About to text the same question again, in slightly different words: ‘Is Michael dying?’ As I slowly pressed the keys, another text arrived from Niamh, ‘No’; it’s not terminal. I did not know if it was the truth or a simple kindness. Either way, everything changed that night.

And so Michael went into hospital. We got updates; he had stabilised and was now steady-ish. He wasn’t going to die, at least not now, not at any moment. I remember visiting him in hospital, seeing this once-handsome, six-foot boy who should have been in the prime of his life, slumped stick-like and empty-eyed in a wheelchair. A pitiful wretch. Another mix of emotions: pity, shame, embarrassment, awkwardness. How had it ever come to this without us seeing it all for what it was?

Michael left hospital and, not long after, we were told he was going into the Priory, as if it were no more than a short break to Llandudno. He had reached the end of his journey. We were relieved, not least because, having come face to face at last with this utter horror, we knew it had to be sorted fast, and we had no idea where we would have started resolving it.

Friday 30 November 2012

I woke up at 7am this morning and feel completely alone. I can hear distant shouting from other sections of the hospital. I’m about to head out for breakfast and wish Niamh was here alongside me. I don’t want to talk to anyone and feel angry. I’m so angry because I’ve let myself get to this point and no one could help me.

I’m already getting severe headaches from caffeine withdrawal. I’m used to drinking a lot of coffee and we are only allowed decaf in here. The switch is noticeable and I’m only allowed one coffee with each meal – three very small cups of coffee a day.

* * *

The staff talk to you like you’re a child and we are locked in a small unit with separate rooms. I have only met a handful of different staff members. Some seem more friendly than others, but I can imagine that looking after lunatics like me isn’t much fun. We must never go into each other’s rooms, and staff check up on me every 15 minutes to make sure I haven’t made a run for it. I don’t know where I’d go to, or even how I’d get out, but I would run if I could.

They even check when I’m going to the toilet. I’d obviously been in there too long today as the nurse suddenly shouted, ‘Are you all right in there?’ I answered, ‘Hold on, I’m just trying to hang myself.’ That really didn’t go down too well, but it made me laugh for once. The rest of the time I just felt angry.

THE SIGNS WE SHOULD HAVE SPOTTED

I have put together a rough and ready list of tell-tale signs we should have spotted that revealed Michael was not well in the build-up to hospital and the Priory, and then grouped these under general headings in case you are now where we were all those years ago.

Look for patterns of changing behaviour

We knew that Michael, as he went through university, had stopped doing any outside work. He had a part-time job cleaning plates at a restaurant prior to that. He gave up the football and karate that he had loved to do for many years. He also stopped seeing his friends, some of whom he’d known for ten or twelve years.

We saw all of that as Michael focusing on his degree – and having a live-in girlfriend too – but the benefit of hindsight suggests he was already cutting himself off from the outside world. That’s very common with people with mental illness and something to watch for.

Sometimes, of course, these changing patterns of behaviour are natural; people grow up, move away, develop new interests and change, especially when they are free from the influences of their parents. They can become themselves. Sometimes these changes point towards something more worrying, though: depression, anxiety and other mental health matters. It’s not always simple to tell the difference.

Watch for changes in demeanour

Michael has always been a quiet boy and it’s not always easy to spot the difference between ‘quiet happy’ and ‘quiet sad’. It may be easier to spot the difference with livelier, more vocal children. Sophie was a Tigger-ish teenager; we knew when she was happy and when she was angry and when she was sad. Shouting and slamming doors are easy signs to identify – a child who is essentially quiet and gentle, and kind of monotone, is harder to deal with in some respects.

Everyone is different, of course, but many parents talking about their children who have experienced mental illness list a range of issues to spot here: not talking any more, not sharing confidences and secrets as they once did, being snappy and short-tempered. ‘Shutting themselves off’ and ‘closing in on themselves’ are two phrases that come up regularly in conversations I have with many people who’ve been down this road. ‘Subtle and not so subtle’ changes in personality is another.

Keep an eye on physical changes

As mentioned, Michael’s appearance changed over time: lots of different hairstyles, earrings, hats, clothes. We thought that – and the fact that he slimmed down so much – was part of growing up and losing his teenage chubbiness. And he was a student, and an art student at that, so we expected him to look a bit wacky.

We realised, before Michael was hospitalised, that he was not right and that he was thin, and we did not know what to do about it. We felt that if we confronted him and Niamh, he might turn away from us and we might lose him. So we just kept quiet – seriously, this is the worst thing to do ever – and hoped for the best. We did not see the tipping point between ‘being thin’ and ‘becoming anorexic’.

Get close and stay close

Michael lived 40–50 miles away from us and, as he worsened, we saw him less and less, to the point where, eventually, he made his excuses to miss cinema trips and meals out on Mother’s Days and Father’s Days. When we did see him, and with Niamh ever bright and breezy, he just needed to rally ever so slightly to fool us into thinking that, if he was not quite well, he was not as close to death’s door as he actually was. And, for much of the time, we weren’t really looking anyway so we were easy enough to fool.

If you live with someone who you suspect has issues, it may be easier to spot the signs sooner. For depression, the most common tell-tale signs are, in no particular order: being restless, being edgy and agitated, loss of appetite, lack of energy, sense of tiredness and sleep-related issues. A sufferer may experience one or two or more of these. There are no set rules, but there will be some sort of changes.

Spot other changes

If you looked at a how-to text book – let’s say a how-to text book on spotting depression and related issues – it would give you a whole long list of ‘signs’ to watch for. Examples? Low mood. Feeling down. Loss of concentration. Losing confidence. Feeling guilty… And many more. All correct and tickable off a checklist.

But it’s often not that straightforward. Mental ill-health is messy and nasty, manipulative and devious; it does not fit easily into checklists and boxes to be ticked off one by one – job done, all sorted. Michael, for a long time, did not realise he was depressed. He had a ‘low mood’ because he had moved away from his home and family. That seemed natural enough. He ‘felt down’ because he was doing a degree in an unfamiliar city. Most people would struggle a little with that. It took him years – not months, but years – to realise he was actually suffering from depression.

It unfolded slowly until it took him over. Michael felt sad most of the time and lost interest in what he liked doing: drawing, painting, photography. This – and it’s chicken and egg – rolled itself into always feeling anxious and worried about what might happen. He suffered from low self-esteem – feeling both hopeless and guilty – and this, mixed in with growing levels of irritation and anger, skewed his personality: edginess, a shortening temper, etc. Many people describe depression as a black dog; for us, it’s more of a tentacled monster, with each tentacle entwined and overlapping – one is anxiety, another is depression, and OCD, and so on.

Most of this we simply did not see. We saw a quiet boy who went to university, lived in a nice flat, was supported by us, had a happy girlfriend, was doing a course he loved – all sorts of art every day – and was just growing up and changing and becoming his own person. Wonderful! What more could a parent ask for. Fact is, though, he was his own person – with anxiety and depression – which he disguised well enough and for long enough. The horror of it all only became apparent when he was taken to hospital. The signs were there, though. We should have seen them – or at least some of them.

Saturday 1 December 2012

Last night, I had vegetable kebabs for dinner and then Niamh turned up out of the blue to see me. I don’t think I could do this without knowing I had her there waiting for me at the end of it all. I just don’t think I could do it.

* * *

Meal times are really hard because we get told what to have for breakfast, but then for lunch and dinner we get to choose what we have for ourselves from a choice of three different meals. When my head is all over the place, it’s hard for me to make choices. I can’t come to any decision easily – it gives me panic attacks and I end up loathing myself and feeling guilty about that. It’s a vicious circle.

* * *

The idea behind the meal plan is that it steps up each week, eventually to a point where you are being overfed, to quickly put on weight. I already miss my routines and ways of living. I just miss all the small and simple things that I took for granted, like the freedom to walk down the street or pop to the shop, being able to drive my car or be outside in the sunshine.

I’m not used to being around people either and I don’t like talking at the moment. The staff are always trying to engage with me, but I don’t want to talk and have nothing to say to them at all. I just feel broken and, no matter what they say to me, I feel dead inside.

* * *

Today I have a group session to do with body image. Hopefully, it will help me get a better understanding and try to find a way for me to think more positively. Body image is about how we view ourselves. It is about trying to address what we don’t like about ourselves, which isn’t always something obvious. Not many people in the world love their own body, but the people in this group probably all hate themselves and the way they look.

* * *

We talked about whether others influence the way we feel – friends, family, etc. Also, how the media and advertising can impact young people’s outlook and the idea of what people should look like ‘ideally’. There is a lot of pressure on teenagers to look a certain way: ‘perfect’. The media has a lot to answer for.

THE THINGS WE SHOULD HAVE DONE

We are not experts in depression and related mental health issues, although we have lived through Michael’s story and have learned much from it that we can share with you. There are things we should have done before Michael ended up in hospital and the Priory. If you have a loved one who you think suffers from mental ill-health, but perhaps does not realise it or want to address it yet, you may want to think about these ideas.

Be there

We were always there for Michael in our own way. But we never really believed what was happening to Michael was that bad; remember, we felt nothing like this could happen to a happy family like ours. As an aside, I should say at this point that depression and other mental illnesses can strike anyone anywhere any time. Male, female. Old, young. Gay, straight, transgender. Black, white. Rich, poor. It can be completely at random. There’s often no obvious cause. There’s no one to blame. Sometimes, bad stuff happens to good people. That’s life – it is the way it is. You just have to get on with it.

As he became thinner and seemed out of sorts, we waited and assumed things would somehow come good. We were ‘there’ and helped Michael in all the practical ways – somewhere to live, money, making sure his car had an MOT – and would have done something relating to his mental health issues had Michael said something. He never did. We should have seen it and addressed it anyway, though. That is a huge regret. We should have done something, been proactive.

If you think you see something wrong – your loved one seems to have changed personality in some way or to have lost all interest in something they used to love, for example – it’s tempting, if not natural, as a parent to move in and sort it (bearing in mind you’ve probably sorted out almost everything for them for years and years). You may say something along the lines of ‘You have a problem, this is what it is and here’s how to sort it out.’

As a dad, my default response then (but not now) would have been to shout this. Tracey’s approach would have been to talk around and around the matter before stopping and then starting all over again. Sophie’s default mode would have been to shout too (probably louder and longer than me). Adam was eleven years Michael’s junior and too young to do anything. We did not really have any extended family – a nice uncle or a friendly cousin – or close friends who could have taken us to one side and said, ‘Have you noticed that Michael…? ’ or could have had a quiet word with Michael himself.

From what we’ve learned since, from talking to Michael and other parents and teenagers with similar stories, often a sympathetic rather than a practical response can be most effective. It’s not a matter of confronting, emphasising, directing, leading or pushing someone to do something (however good you might think it is for them). It’s more about just being there, empathising, listening, encouraging and helping them to find their own solution in their own way and time. (Obviously, in an emergency, you may have to take a more practical approach.)

Encourage them to talk

You – if you are Mum or Dad – may be a warm and loving parent, but that does not necessarily mean you are the best person to help in this situation, even though you may feel you love your child more than anyone else in the world and know them best of all. Michael felt ashamed and embarrassed about what was happening to him, and he didn’t want to upset us at all. He talked to his girlfriend, Niamh, who protected him as best she could, including shielding him from us. Michael has also benefited from sharing his story with professionals who have suffered from depression like him.

At some point, someone suffering from mental illness – and it may take them some time to realise this – needs to talk about it to someone; it’s pretty much the first step towards their eventual recovery. How you get them to talk and who does it – a big sister, a best friend, a family member who has had similar issues, a medical professional – can be tricky. Raising it head-on, however gently, may lead to anger and denials if it’s too early; there may be tears of relief if the timing is right.

Somehow – and it’s often gently and slowly does it – a conversation needs to begin. It can be effective to ask how they are and how they’re feeling. You (or whoever is doing this) might want to mention you’ve noticed such-and-such (such-and-such being that they’ve stopped doing something they used to enjoy, for example). You need to try to get a sense of how open they are about this; remember, they may not have seen it for themselves yet.

It’s wise to avoid putting whatever it is you’ve noticed (maybe signs of irritability, tearfulness) into the context of some sort of labelled illness – ‘depression’ or ‘anxiety’ or whatever. Too soon, too strong. It’s also sensible to avoid telling, instructing or even suggesting – the sort of feeling, however well meant, that you can identify the issue, put it in a box and pack it away with just a simple chat. You have to go at their pace, and give them time and space – if they are not ready and you press them, they are more likely to become defensive.

Listen

My natural inclination with my children even now (although I have finally learned to curb it) is to identify their problem and then tell them what they need to do resolve it. I suspect that many parents, particularly fathers, are much the same; talking to teenagers these days, I often hear the same type of comments over and again. There is often a sort of sense of ‘Dad’s great, nice guy and all that, but he does tell me what to do all the time.’ The phrase ‘bull in a china shop’ was used when I was young; it’s appropriate here.

I do recall conversations, as Michael was starting to seem down and becoming thinner, when I offered a range of ‘advice’ along the lines of ‘For God’s sake, cheer up’ and ‘Eat something – put some meat on your bones.’ None of these comments helped at all. Looking back, I can’t imagine why I thought they would. I suppose shouting made me feel a little better but I can’t think it was of much help to anyone else.

Getting the issue out in the open – to the point where the sufferer acknowledges it and wants to address it – has much to do with listening – to what they say, how they say it, when they want to say it. Had I realised Michael was struggling and raised it with him before he recognised it himself, I suspect the outcome would have worsened matters. Michael would have become defensive and hidden himself away more and I would have felt angry and frustrated. Having talked to parents and teenagers, there seems to come a point when the sufferer knows they are in difficulties. That’s the moment to start the conversation ideally – not always easy if you can see them declining before you.

Get advice

Get professional help as soon as you can – NOW – even if it’s just you rather than you and your loved one at this stage. We’ll talk more about where to get help as we progress through the book. But at this point it is worth stating that although the formal and informal systems are often, in our experience, messy and tangled and rather hit and miss, there is a lot of help out there. You may have to work a little to find it. (We’ll help you with that later on.)

Your GP is a good place to start. Michael had mixed experiences with GPs – generally, as he went through one after the other for help, they offered him pills and different pills and fewer pills and more pills – but always pills, pills, pills. He felt that none of them – possibly because they had no direct personal experience of mental illness themselves – really understood or engaged with him at all. But these days, we are told that every practice has someone who focuses on mental health. GPs also offer a signposting service to self-help groups in the local community, for example. That’s invaluable.

You may find that there are many self-help groups locally, perhaps for eating disorders or depression, that are run by volunteers who have personal experience of these issues. For Michael, someone who has had the same issues as him understands him. Someone who has all the paper qualifications in the world and as many letters after their name as you can fit on a page but who has never suffered mental ill-health does not really understand him. Simple as that.

I suppose it is a little bit like a pregnant woman who goes to see her GP. If that GP is a man, he can say all the right things, and offer good advice, and generally be very useful. But he has never personally experienced pregnancy, labour and childbirth so, when push comes to shove, he doesn’t really know in quite the same way that a female GP would who has had children herself.

If I had to summarise ‘what to do’, it’s really a matter of being there, ready to talk and listen, and, in the meantime, getting help from your GP – you may be feeling stressed and anxious because of this (so take care of yourself too) – and talking to local people with personal experience via self-help groups. They will almost certainly talk to you, offer a shoulder to lean on, share thoughts and ideas. They will understand.

Sunday 2 December 2012

Last night, Niamh came to see me. It is a 100-mile round trip and she only has an old car and not much money really. She made me a Christmas tree to have in my room. She has always tried to help me and do the best for me, I’ve been very lucky. We got to hang out for a bit, but I felt crap. I feel like my life is over and I don’t know how to change the way I think. I’ve tried so many different things and ways to overcome this but nothing ever works for me. It’s why I’ve ended up here.

I’ve tried going to about four or five different GP surgeries, which never really worked for me because they don’t quite know what to do with someone like me. They can offer pills and I’ve tried quite a few different ones. The one I’m on currently is called citalopram. It can work for some people but I don’t like being on pills or having to rely on them. I don’t think it’s right for someone to have to take a pill that makes them numb or, worse, want to kill themselves.

I’ve tried cognitive behavioural therapy (CBT), which again can be useful if you’re open to the idea. CBT can be used to treat people with a range of mental health problems. It’s all about how we think, the actions we take and how we feel. So, obviously, if you’re thinking negatively then the most likely outcome or outlook is going to be negative. If you’re in an awful place, it can sometimes be hard to focus your mind on change. Some people don’t want to get better or, like me, have given up completely.

* * *

Today for breakfast, I had Weetabix and for lunch I’m having fruit and custard which is seriously weird. Well, it seems weird to me that that’s my lunch. Of all the things they could give me, they chose that. Why would anyone do that?

* * *

I was weighed this morning and have come in at a whopping 45 kilos. At this point I don’t even know how I feel about that. At least I can say I’ve achieved something not many people can do. You have to have determination or in my case such self-hatred to get to that.

* * *

Today was kind of productive. I lay in bed and watched the entire Lord of the Rings trilogy back to back. Then for dinner I had a Spanish omelette before heading back to my room to cry – at least I have a new routine to get into.

I don’t really sleep very well here. Partly because I get checked on every 15 minutes. Also, being weighed in the early hours of the morning doesn’t help.

It’s difficult to sleep when I’m always on edge and my mind is always ticking. Thinking about the next weigh-in and wanting to go home. It’s all over the place.

ANGER EXERCISE 1: SNAPPING THE CANE

This book is part memoir, part how-to. We want to share Michael’s story – the family’s too – from beginning to end so that you can see how it feels to suffer from mental illness – to be inside Michael’s head for a while – and to experience what it’s like, albeit at arm’s length, as part of the family. Mental illness, after all, does not just affect the sufferer but their partners, parents, brothers and sisters, wider family and friends to varying degrees. It causes misery, breaks relationships and can pretty much ruin everything, at least for a while.

At the same time, we want to offer some ‘how-to’ – not exactly advice and guidance as such, as we are just ordinary folk rather than professionals with lots of qualifications and years of expertise. But we offer our thoughts and ideas for you to consider – some of these may help you and your loved ones; others won’t but may suit other people. That’s the way of mental health. It’s your call.

As Michael raises various issues such as anger, stress and anxiety in his diary, we are going to offer practical suggestions of things to do. We are going to drop in one or two at a time rather than give you page after page of, say, anger management techniques. We don’t want to break the flow of Michael’s story too much now we’ve got underway. Nor do we want to turn this into a text book.

The self-help exercises we’re suggesting for anger, stress, anxiety and so on are all easy to do. Clearly, though, these are low-level, especially in Part One of our story, and you are not going to turn severe anxiety or clinical depression around by, as we’ll see in a moment, something like snapping a cane or breathing deeply. But we need to start somewhere and the beginning is always a good place, and we will look at more heavy-duty things later in the book.

Cane snapping, and variations of it, is an anger management exercise that’s been around for a good while. You stand up and hold a cane or a thin piece of wood in your hands (not too thick, and you’ll see why in a minute).

Hold this out in front of you. At the same time, bring your knee up and the cane down sharply so that it snaps. You may wish to shout out, as loudly as you can, whilst you do this. Repeat until you feel the anger ease.

Variations include using an imaginary cane – often easier, unless you have a constant supply of canes – and holding your fists in front of your face, bringing them down quickly to your sides as you shout or grunt or make some other noise. The key point is that you make some sudden, almost violent, gesture and that this, with loud shouting, can blow that anger away. It’s a quick fix that’s effective for some people.

Monday 3 December 2012

It feels like I’m in prison as we get marched single file through locked corridors, escorted by members of staff with walkie-talkies. The others seem extremely thin to me and I feel normal, but I know deep down I’m probably the most mental of all of them. I know I’m thin too really, but I look at the others and to me they look way worse than me, but I know it’s hard for me to see what I’m really like.

My head is always playing games with me, telling me I’m a worthless person but also that I shouldn’t be here. It’s hard to know what to think any more. I think about Niamh a lot. Today is the anniversary of when we met and we don’t get to see each other because Dr Webster said she couldn’t come today because I need to focus, whatever the hell that means. What am I supposed to be focusing on exactly?

My meal plan has been stepped up. I’m now eating way more than I would at home and I feel awful. I’m spending most of my day feeling stuffed and at the point of vomiting. I also have a constant headache. The days drag so slowly.

You start to realise what you’re missing from real life – even the smallest things like going for walks, lying in my own bed, seeing my family or going to the cinema. The only thing keeping me going at the moment is knowing that I get to see Niamh most evenings.

Tomorrow I’m having a proper lunch, not cold stodgy custard with soggy fruit. I also know that my meal plan is stepping up again soon as my weight is so low. I think I weigh less than most of the girls here and I’m about six foot.

Tuesday 4 December 2012

I’ve just had a meeting with the head nurse who said I’m lucky to be here and by all accounts I could very easily have died. That’s nice, isn’t it? She said that I’m one of the most shocking cases she has seen and she is surprised I’ve made it this far. So much for the pep talk.

I’m really starting to panic now as the food is being increased again. It’s getting to the point where it’s becoming unmanageable, but they keep telling me that I need to do it or my body could shut down. I have something for breakfast, lunch and dinner along with a snack. The amounts of puddings and number and sizes of snacks are increasing.

It’s relentless!!!

The atmosphere here is so claustrophobic and unsettling. The addicts are in the next corridor and I have talked to a couple when I’ve passed them in the dining hall. I have already spoken to staff and said I want to leave. I have no option but to stay, though. I could make a run for it but I know that wouldn’t end well.

Another group session: bloody yoga. I felt like a complete idiot and being the only man there made things even worse. Even though I felt awkward, I did actually feel slightly more relaxed. It didn’t take long, though, before I returned to my room and fell back into hell. I hate being here. I feel so lonely and lost. Sitting alone in my room makes me realise how far I’ve fallen. I’m in prison, really.

Wednesday 5 December 2012

Today, I’d had enough and refused to get up. I was set on staying in bed all day, but the nurses came in and forced me up. I got angry and said stuff I shouldn’t have. I don’t normally swear or lose my temper, but when I’m pushed I can snap sometimes. Being treated like a child for so long pushed me too far. The nurses tried to talk me down and told me to relax. It’s easy enough saying that but when you’re in this place, living like this, it’s too easy to crack.

Eventually, when I had got up and dressed, they left me alone and I pulled back the curtains and saw it was snowing. It made me realise how trapped I am in here.

* * *

This morning I got weighed and came in at 44.1 kilos, whatever that is. The snow is getting pretty heavy outside and I’m starting to realise Niamh might not be able to make it here tonight. It’s hard to write stuff down sometimes as the days all merge into one big black mess where you sit around thinking about how crap everything is.

I have chosen the meals I will be having today. For lunch, beans on toast for what seems like the 100th time. For dinner, vegetable kebabs (again).

* * *

At this moment, lunchtime, I’m sitting on the edge of the bath with the door locked trying not to cry. Tomorrow, I get to speak to Dr Webster. He is the head guy who oversees everyone and ultimately has the final say on everything. The meetings with him are few and far between and are make or break really – basically, it’s my chance to pretend to be normal, so let’s not do anything mental or say I want to jump off the Orwell Bridge. These talks happen on a Thursday. We are called in one-by-one at any point during the day. It lasts around ten minutes.

I’m also meeting a guy called Richard this afternoon, who does CBT. Richard focuses on teaching me on how the mind works and how it can be trained to think differently – more positively. I will then have a body image class where we all sit around and talk about how we feel and why we hate ourselves – all good fun. We are a relatively small group of weirdos, so it’s a chance for us to see how each of us are suffering. I don’t really like talking about myself to others.

* * *

I just spoke to Richard (the CBT guy). He is awesome and has begun to explain to me how CBT can help change the way I think and see different situations. He told me about something called the hippocampus in the brain. This can shrink when you become depressed but can also be trained to function properly. I like him because he’s the only person that doesn’t talk to me like I’m a five-year-old. We can actually talk like mates. He also tried to help put things into perspective for me and I think he might be able to help me. Richard talks a lot about thought patterns and trying to bring back a more positive and balanced outlook on situations and life.

* * *

I’m feeling really desperate and want to speak to Dr Webster. I feel desperate because getting to talk to him is very rare and I know he’s my only way out of here at the end of the day. I have to try to seem calm and collected when I talk to him but inside I’m screaming, ‘I want to get out.’ Got to just play this game to get out. I feel like I’m in the Hunger Games. I’m starting to hate the amount of food I have to eat.

I’m worried about Niamh driving in the snow. I look forward to her getting here but it almost makes things worse once she leaves and I realise how bad it is here. I’m starting to feel like I won’t ever know what it’s like to be happy again.

If you think about it, what is happy?

All I know is I feel crap and the worst I’ve felt in a long time. Being happy, in my mind, is being comfortable with who you are, enjoying your life and feeling connected to what is around you at the present moment. I feel none of these things.

* * *

I haven’t been happy for so long. No matter what pills I take, I still end up feeling like this. I’ve tried fluoxetine and many others, but right now I’m on a high dosage of citalopram. Pills can have an effect on me – they make me numb, care a little less about anything and make me tired. If I stop taking them, I pretty much feel like killing myself, it can be that bad. I don’t want to take pills, though. I’m trapped either way.

I’m also stressed about seeing my family soon. I’m ashamed that I’m here and for them to see me in this situation. I miss my brother and sister. I don’t think my parents want Adam to see me here and to see me looking such a mess. I clearly look mental, skeletal and surrounded by some pretty shocking-looking people. I can’t even begin to explain how much I miss the outside world. I haven’t had fresh air in ages now.

Me and my meds

I wanted to write down the medications I had taken before going into the Priory:

Fluoxetine (Prozac, Sarafem)

Fluoxetine is used to treat different types of depression, obsessive compulsive disorder, some eating disorders and panic attacks.

The more common side effects of this drug can include strange dreams, decreased sexual desire, erectile dysfunction (trouble getting or keeping an erection) and decreased appetite. Side effects can also include trouble sleeping, anxiety, rash, sweating and diarrhoea.

In some cases, fluoxetine can cause serious side effects. These side effects can include serotonin syndrome, mania, low salt levels, abnormal bleeding and seizures.

Citalopram (Celexa)

This drug and other antivepressant drugs may increase suicidal thoughts or actions in some children, teenagers or young adults within the first few months of treatment or when the dose is changed.

Trazodone (Oleptro)

In some cases, trazodone can cause serious side effects. These include thoughts of suicide. This risk is higher for children, teens and young adults within the first few months of treatment.

ANGER EXERCISE 2: BREATHING IN POSITIVES

Anger was something that was almost overwhelming Michael in these early days in the Priory. It’s a common thread and an issue that many readers may relate to. One of the things that Michael did to manage it, eventually, was breathing exercises. These are so simple but often brilliantly effective in many ways. They can be a great way of managing anger.

One exercise involves breathing in a positive and/or breathing out a negative. It’s a very simple thing to do. You need to find somewhere to sit comfortably and relax, and then focus on your breathing in and out, in and out, in and out. Keep doing that over and over again; you should find it calming, especially once you start to focus on it.

As you breathe in, imagine a positive emotion such as love filling your lungs and being sent out into every part of your body. Continue this exercise – breathing in love for as long as five minutes, or whatever’s right for you.

This same exercise can be used to breathe out negative emotions – anger, most often. As you practise, you will find that you can often get into a rhythm where you breathe out a negative emotion such as resentment and breathe in a positive one: acceptance. Try it – it takes some getting used to as you’ve got to get your head round the idea but it works really well for many people.

Thursday 6 December 2012

I feel like I’ve been here for months. I am feeling down every day and it seems to be getting worse at the moment. We have ward round today, where we get our chance to speak to Dr Webster. Ward round is what I’m waiting for. It’s the only hope of making progress or hearing when things might be happening. You then go back to the endless daily cycle.

Ward round happens once a week. It’s on a Thursday and everyone is on edge because they know they could get called to Dr Webster’s office at any time. It could be any time from early in the morning and up to times like 8pm.

* * *

I know I will get nervous when I see him and make inappropriate jokes about being thin, running away and killing myself. I’m like my dad at times, always making an awful joke at exactly the wrong moment. I only say these things because it’s intimidating sitting in a room with everyone watching your every move.

It won’t last long – five minutes. I am told by the staff to take in a list of notes or things I want to ask him, because, if not, I will forget to ask things I want to find out. I only have one question and that is easy to remember – ‘When do I get out of this hellhole?’

* * *

I’ve just found out that I can’t continue with my master’s degree because I’m here. Niamh texted me saying she made the choice to call my university and say I’m not coming back. I feel everything is collapsing around me. It feels like my walls are caving in and things are getting worse. I’m told it’s for the best but I can’t see that right now. I’m starting to feel lost and beginning to lose hope. Christmas also feels like it’s fading away. I don’t have much to hold on to at the moment. I need something.

* * *

It’s now almost ‘snack time’, which is where we all sit around like we are in some weird playgroup and eat snacks. We are watched hawk-eyed to make sure we don’t throw food away or stuff it under cushions. I’ve already found chocolate bars stuffed down the sides of sofas and have seen people cramming food into their pockets. Some people here have awful OCD and prepping food takes ages. Others eat food in particular ways like cutting an orange in half and eating it with a fork. It’s agony watching them. It must be hell for them.

* * *

I still haven’t seen Dr Webster yet as, throughout the day, we are called one-by-one to see him randomly during activities. I think the activity today will be yoga. We have certain classes/activities on different days. It’s a bit like being back at school but instead of Maths and English it’s body image and let’s not kill ourselves.

I think the waiting is designed to make us try to cope with the anxiety. The fact that the meeting could spring up at any point means you are constantly on edge. Having to deal with that is actually a lot harder than it sounds, but I think he knows that.

* * *

I just spoke to Dr Webster and have been told I’m staying here until after Christmas. I’m feeling at my lowest – just want to fade away. I have felt suicidal at times and right now it’s very much at the front of my mind. Who wouldn’t, though? I’m stuck in this place with no set time frame, and when I get out, if I do, it’s back to the real world. That in itself is a scary prospect. Imagine having to tell people why you have been away for so many months. It’s hard to not give up hope.

Now, to top things off, I have to go and have dinner with all the other crazy people whilst being treated like a child. This is where we get marched through locked corridors, get checked and then after the meal we have to sit and be watched for 45 minutes. Meal times are pretty awful to have to witness let alone be a part of. We sit around in a group whilst various staff members sit and watch our every move. We’re given very specific amounts and allowances, even including salt and pepper. Most of the people in here have some sort of OCD rituals when it comes to eating. If you’re not mental before this, you soon will be.

I hate it here. It drives me mad.

ANGER EXERCISE 3: THE JUNGLE PATHWAY

There is a visualisation technique that has worked well for many people who see a hugely difficult time ahead – for Michael, at this point, getting through another week locked up. You have to imagine you are faced, all around you, with a thick, dense jungle; trees and vines and creepers all block your way. There is no path at all and it’s almost impossible to see a way through.

You sit on the ground and then focus on the jungle. Imagine a path opening up behind – behind – you. Try to see it in your mind’s eye as clearly as you can. The trees and the vines and the creepers all pulling back to leave a pathway clear for you. Focus more and see that pathway opening up wider and wider.

You then stand and turn. You can see the wide-open pathway in front of you. Walk forward on to the path and feel yourself moving, striding now, along between all the trees as you move your way through. Some people find this works for them; it gives them a sense of self-belief and strength.

Friday 7 December 2012

Today I woke up and I feel awesome – ha, ha, not bloody likely. Once again, I’m about to be patrolled to breakfast where I’m watched eagle-eyed by the staff. There’s a group of about ten of us, which can vary depending on whether someone’s tried to leg it or is on a home visit. I’m followed to the coffee machine to watch how much sugar I put in my drink and how much milk I put on my Weetabix. I’m enjoying playing games to wind up the staff. I keep swapping food about as if I can’t make my mind up and then pour my cereal and milk out as slowly as possible.

One girl here called Tia has a severe eating disorder and really bad OCD. This means she has to carry out ritualistic behaviour to feel safe. It gets to the point where she has to pour her cereal and milk in such a certain way that it’s painful to watch.

Am I really that mental? I guess I must be to be here.

Maybe they watch me doing the same sort of thing? I’ve tried to think about any weird things I do, but really what is normal? We are told how to act and be from the day we are born. If you actually sit and think about some of the everyday things we do, it’s pretty strange. Like people sitting round watching soaps on TV – pretend versions of life. We are living life and yet people still choose to watch fake stuff like that.

I know I’m weird and it’s hard to actually say what I do that’s weird. I just know I am and that’s why I’m here. I have noticed I have OCD tendencies, like having to do my hair in a certain way or having to do things at the same time every day. I don’t think I have bad OCD. I’ve been diagnosed with mild OCD, but it’s linked to my other issues. I think it’s again down to control. I know my mind and body are out of control so I have to have control over little things, like the way I brush my hair, that make me feel like I have some power.

Saturday 8 December 2012

Niamh is allowed to come and have dinner with me tonight. She isn’t allowed to have dinner every night – it depends on how many times Dr Webster says she can come in a week. It’s Sunday tomorrow and I’m allowed to go out in the car with Niamh for a drink somewhere nearby. We will be set a scheduled amount of time to go out. This could be my chance to make a getaway. I think we will get an hour to an hour and a half of time out, so it’s not much but enough.

I still have to be weighed daily, which is horrible as I’m woken at 6am, have to strip down and stand in a freezing cold room in front of someone who carefully checks me. Before being weighed you have to go to the toilet and you’re not allowed to drink – the staff think you’re trying to drink a lot of water to increase your weight which would mean you get out of here that much faster.

For me, it’s all a game. The aim is to keep my weight going up. If it does go up, I am one step closer to home; if it drops, it means my meal plan is increased. Even worse, the staff think I am skipping food, hiding it or vomiting it back up – none of which I have ever actually done.

This – the focus on getting weight up – is where I think the Priory and places like it can fail. I am very aware already that the aim is to hit a target weight, linked to BMI (body mass index), which is crazy in my opinion. I think there should be more of a focus on fixing the way people think. The weight is still very important, but without the right way of thinking nothing else matters. As it stands, as long as you’re on their good side, you are more likely to get out – even if, in your head, you are still completely mental.

I’m now reading The Hobbit because there’s not much else to do except stare at the ceiling. My antidepressants have been increased, which is never a good sign. I’m still taking citalopram – not sure of the dosage, I just know it’s a lot. Every day feels harder to get through, and to be honest I’m feeling a lot of anger. I don’t even really know what at. I think it’s a mixture of my own stupidity, the environment I’m stuck in and the staff looking down on me. I’m feeling really low and I know that the staff are noticing it. I’m failing at ‘the game’ at the moment. I feel like my life is falling apart.

ANGER EXERCISE 4: LETTING GO OF THE PAST

Anger is a natural emotion but it can also be a destructive one, both internally on your mental health and externally on your relationship with others, if it does not subside. There are many anger management exercises you can try to help control these feelings. We have talked of one or two already, involving cane snapping and breathing. Here is another that we have come across over the years that might work for you. It’s called ‘letting go of the past’.

Sit somewhere quiet and peaceful and try to imagine yourself sitting alone in the middle of a huge cathedral or other old and sacred place appropriate to your beliefs. It could be a huge dark cave, as long as it is somewhere you can feel at ease.

Now bring your earliest memories into your mind and try to see them in your head as they happened. You now want to try to imagine letting them go into the dark, faraway corners of the cave. ‘I release these memories. I have moved on. I am free.’

Now try to move on and visualise the moments in your life that have been turning points and changed your direction. Again, imagine letting these go away into the vastness of the cave. Again: ‘I release these memories. I have moved on. I am free.’

Wherever you imagine you are sitting – a cave is probably a place that suits everyone regardless of beliefs – you should see this as representing your past where all of your memories go. They stay there whilst you move on with your life. They are always there if you want to revisit the good ones. The others can stay there, hidden far away in the shadows. Let them be. When you are ready, imagine yourself leaving the cave and moving on.

Sunday 9 December 2012

Last night, Niamh came here for dinner. She seemed exhausted and we are finding it hard to talk. I think it’s starting to get very difficult between us. I can’t blame her, though. Who wants a boyfriend in a nuthouse?

* * *

I was weighed this morning and my weight hasn’t changed at all which means the food will be increased again. The body is a weird thing – the more you eat, the more your body starts to burn it off.

At mealtimes, you literally have to finish every bit of food off your plate – almost to the point where you have to lick every last crumb.

There have been points where people refuse to eat any more and we all sit there for well over an hour whilst the staff try to force that person to eat. It ends with the last person eating whilst tears roll down their cheeks.

* * *

My meal plan has increased. I think this is another flaw in the way it works here. More attention should be put into getting people’s heads right rather than just fattening them up.

My issue is about feeling low rather than trying to be skinny. If I feel depressed, I don’t feel like eating. So the focus, for me anyway, should be on the mood side really.

I’m starting to get panic attacks because I feel trapped. It’s so claustrophobic being locked in here with minimal sunlight. Everybody always feels on edge and I have snapped at people a couple of times already.

* * *

I have been getting back into my drawing, which is good. I don’t think I’ve sat down and drawn properly in a long time. My work has always been quite dark and being here is giving me plenty of inspiration.

I’ve been trying various breathing techniques which are designed to help calm me and lower my heart rate. If I’m feeling panicky, I take my focus away from the room, shut my eyes and breathe and focus on nothing but breathing.

* * *

This afternoon, Niamh came down again and we went out for an hour. We wandered around a few shops whilst people stared at me – and I really do mean stare because I look a mess. I know people look because I’m so thin, and I know it’s not just me thinking it because Niamh tends to say something back if a stranger stares too much or makes a comment.

I can’t begin to describe what it feels like to only go outside for an hour after being locked indoors for days on end. The only thing I can compare it to is like being a naughty child or being in prison. I’m an adult and I’m being told what to do at all times.

I have made a good friend here called Wilko. He is the only other man on my unit and he’s in a pretty bad way. He can barely walk without holding on to the walls and he struggles really badly with eating anything. I saw he was upset a lot today so I went into his room, which is not allowed, and we chatted a while. He has had a pretty horrific past with some awful things that have happened to him in his life.

* * *

Tonight, my mum and dad are coming to see me which is making me nervous. Niamh has always seen me like this every day for ages, but I don’t like my family to see me a mess and so thin, probably because I’m ashamed and the people here are all clearly mental. There are people who can barely walk and I know the addicts are literally in the next corridor.

I don’t know what my parents will make of all of this. I imagine they will be scared and shocked by the whole thing. There are drug and sex addicts, depressed people and people with all sorts of other problems I can’t even begin to explain. You can often hear swearing, shouting and people screaming. It’s like One Flew Over the Cuckoo’s Nest. It’s a madhouse.

I really want to see my younger brother, Adam, but I don’t think my parents will bring him tonight because of the people here and the way I look.

OUR VISIT TO THE PRIORY

One of the things to consider when reading Michael’s diary is that, however sane he might sound at times, he was in the Priory partly because of his anorexia but mostly because of his mental ill-health. That’s worth remembering, I think. He wasn’t 100 per cent clear and straight in his mind. How could he possibly be after everything that had happened to him?

Depression, anxiety and other issues can all be seen reflected in what Michael writes, but there are also moments where it is plain that he is not thinking properly about the help he was getting – with talk of all this being a game and a sense that the doctors and staff are toying with him at times and, almost but not quite, out to get him.

I guess that’s not surprising – he was mentally ill and his physical health was not good either, of course. Anorexia, and its effect on the body including blood vessels, can have a damaging effect on the workings of the brain, decision making, etc. In simple terms, anorexics don’t always ‘think straight’. It would be too much to expect that they could.

I’ll come later to my own interactions with Dr Webster – a good guy for sure – but, first, let’s look at our visit to see Michael in the Priory, ‘to compare notes’, as it were, on what it was like there. Tracey and I had wanted to visit Michael for a while, but Niamh seemed to visit every night – rattling down the A12 and back, a 100-or-so-mile round trip, in a clapped-out old banger – so we had to wait our turn. Niamh’s mother appeared to be a regular visitor too. It bothered us quite a lot that we were some way back in the queue but we kept quiet about it rather than risk a falling-out. We did not take Adam with us; we wanted to protect him from what we expected to see. And Sophie was up at Durham doing her degree.

Going into the Priory was daunting and scary; we did not know what to expect. Pulling up in the car park, the building looked like a big old Travelodge. It was quiet. The car park was fairly empty. We walked to the entrance, neither of us speaking, both of us nervous. As often happens when confronted with a locked door and a bell and various buttons, I tend to press all of them in turn repeatedly and hope something happens soon.

Eventually, a no-nonsense female member of staff – a nurse in manner – opened the door and, after introductions and bag checks, led us through a maze of corridors and security systems. She seemed pleasant enough, although I would not have wanted to arm-wrestle her.

We entered reception and we were struck by the number of young girls – all elbows, knees and sunken eyes – sitting awkwardly in a semi-circle of chairs. We waited for a moment or two – I think we were being signed in – not knowing where to look. My default reaction when faced with something out of my comfort zone is to make a joke, usually out of place and with those around me stunned into silence.

There were no jokes tonight. It was all too awful to see – these anorexic girls just sitting there like zombies. We hurried through, along a neat and tidy corridor, to Michael’s anonymous room. We were shown in and, other than a nurse putting his head round the door once or twice, were left alone for the next half hour or so.

It looked like a nice and clean budget-hotel room: a simple bed, a chair, shelf, TV, mirror, en-suite bathroom – and Michael, stick boy himself, sitting up in bed. Tracey hugged him. She’s quite good at that sort of thing. I couldn’t really look at him. Struggling with my emotions, I turned away and looked instead at Michael’s bits and pieces on the side, straightening them, fiddling about, moving to the wash basin, composing myself as best I could. If I’d had a duster and polish, I would have had more of a tidy. Anything to avoid facing this. Aware that if I spoke now, my heartbreak emotions would be heard in my voice.

We settled and then talked, albeit fairly superficially, as if we were visiting someone in hospital who had had some sort of embarrassing operation – what my mother would have mouthed ‘down there’. I felt awkward, not sure what to say. This was not the moment for questions and explanations and recriminations and apologies; I knew that. We needed to keep it light and pleasant.

Michael looked thin and tired but he talked comfortably enough with us. We talked as normally as we could: of what was happening at home, with Sophie and with Adam, and then what Michael was doing, whether he was watching anything on the television, whether he needed anything; underwear and socks formed the basis of a lengthy conversation with Tracey. I had an equally long conversation about buying him a DVD or two that he could watch to keep himself busy. Dexter seemed to be one series he liked and Michael had seen this season and not that season and half of another one, so I said I would get him one or two he had not seen. And I did.

And then we left, Tracey hugging him again, me avoiding all that sort of stuff with a ‘Look after yourself, see you soon.’ We made our way out, shown to the door by the same member of staff who brought us in and took us through to Michael. For us, the place seemed quiet and organised, and the staff we saw and spoke to seemed friendly and professional. Other than the young girls at reception and the fact that we were checked in and out carefully, we would not have been aware what this place actually was. Michael, being there all the time, would have seen another side.

I cried – that it had all come to this, our son locked away – in the car on the way home. Then we stopped at Burger King and ate burgers and drank Cokes in the car park. We felt relief that Michael was where he was and thought it was the best place for him. The meeting went okay and I think we all felt better for it.

Monday 10 December 2012

Last night, my mum and dad came up to see me. I think they were pleased to have a chance to come in, but I could see they were both really upset by it all. I think they were also a little nervous to be in this sort of environment.

* * *

Today was an interesting day. We were at breakfast when the staff suddenly noticed that Liv was missing. Members of staff were panicking and I could see that something could kick off. You never really see the staff flustered and today I could see panic on their faces.

I looked out of the window from the food hall and saw Liv legging it down the front driveway in her pyjamas pursued by two women running at full speed. I presume they caught her because I saw her sitting in the communal area later in the day.

* * *

I would like to run. I think I probably could get out. But I don’t know where I’d go. I can’t run all the way back up the A12 to home. They’d catch me. It would make things worse if that were possible. I’d be here longer anyway.

Tuesday 11 December 2012

Last night, I saw Niamh and her mum. That went okay, but sometimes it can get too much talking about all of this all of the time. People always want to talk to try to make sense of it and to help in some way. But none of it really makes sense and I don’t want to talk about it anyway.

* * *

Making choices is a really big issue for me. It always has been and the last few years have been a nightmare. It’s all linked to anxiety. Anxiety plays with your head and makes it very difficult to come to a rational decision. Having severe anxiety makes it very hard to commit to something, and even the daily meal choices are testing. It would take a normal person probably seconds to decide what to have; it can take me as long as an hour.

Everything here seems to be a test. I think they are seeing what makes us tick – once again, it’s clear to me that we are playing a game. I often feel like I’m in Big Brother or some kind of reality TV show. I always thought the people on those TV shows were crazy, but us lot in here are straight-up mental. Like people not being able to pour milk on to their cereal without crying about it.

* * *

I’ve just had scrambled eggs on toast and then went to yoga. I feel like some sort of hipster but I feel relaxed about it.

Wednesday 12 December 2012

I’ve just been told I have something called a CPA (care plan assessment) meeting on the third of January which is a much more serious version of ward round, where they discuss how I’m doing and what sort of mental state I’m in. They give you a chance to talk briefly, but it will probably be them talking at me. It’s like the bonus round in this weird game and the aim is to act normal in front of them all. If I don’t say anything too mental or start crying, that will be a big help.

* * *

Today, we had a group trip out. Basically, the people who are thought to be doing okay get to go out for the morning on a walk about town together – it must look like some kind of freak show. Wilko doesn’t do well as he has social anxiety. This basically means he doesn’t like being around people, especially strangers in a public place. It’s something I struggle with too, although my issues are less extreme than Wilko’s. I don’t think anyone would know I was struggling, but it’s obvious with Wilko.

He had a really bad panic attack and I didn’t know what to do and, to be honest, it was pretty scary to watch. He basically either starts to hyperventilate, get angry or go into shock. If this happens, we have to try to help him breathe, or if it gets too bad, we all just have to leave wherever we are. Getting out and about is good practice for him, though.

* * *

Niamh came for dinner this evening. I had bought her some presents from my trip out. I didn’t get much – just a candle and flowers. She always tells me that I need to treat myself as I don’t know how to be good to myself. I don’t think I’ve got anything in months. I think it’s again to do with me punishing myself as I feel guilty for being this way and I have no self-worth, so why would I look after myself?

I’m trying to get to sleep but am feeling anxious. Quite a few things are troubling me. Tomorrow, we are having our Christmas lunch which I’m feeling anxious about. I don’t like eating in front of people. Wilko and others have said I’m looking better, which basically means bigger. I don’t want to be bigger, i.e. fatter. I have ward round tomorrow, so I will hopefully find out what’s happening at the weekend. I am worried about that a lot.

ANXIETY EXERCISE 1: THE BLACK BIRDS

Michael ended up in hospital and went into the Priory essentially because he was anorexic – his weight loss had led to his body closing down on him. The hospital patched him up physically and the Priory was there to help him mentally, and to help him put on weight too.

The thing with mental illness – and I’m no expert but this is how it seems to me – is that it is rarely a simple, straightforward thing; it never seems to be one, single issue. If only it were ‘just’ anxiety or ‘just’ OCD (awful though these are in themselves). It never seems to be. Michael, like many other sufferers, had a multitude of issues, one leading to another, some overlapping, doubling back, twisting into each other, making all of them worse. Imagine an octopus-type monster with lots of tentacles, some still, other writhing. That is the intertwined, tangled, suffocating nature of mental illness that many people experience.

The heavy-duty issues really started with what might be called low-level issues, primarily anxiety. Left unchecked, as it was with Michael, this can be debilitating. The reality, of course, is that there are really no low-level issues as they are all awful for the sufferer, but we are obviously trying to untangle and separate issues into awful, really awful, life-threatening awful and so on, to try to make some sort of sense of what is often senseless.

We will look at several anxiety-related exercises as we move into the book. But Michael has written of anxiety and not wanting to be near people several times now – an example of one issue rolling into another and then back again to make matters worse. Michael felt anxious. He did not want to be with people. Knowing he had to be made him more anxious. The anxiety levels went up when he was with people, so he wanted to be with them less. Endless – around and around he went, down and down.

Let’s start looking at anxiety – as Michael has mentioned anxiety stopping him from sleeping – with an exercise to aid sleep. Sit or lie down somewhere that’s peaceful and comfortable, and close your eyes.

Now focus on your breath, listening to yourself breathing in and out and in and out, slowly and steadily. In and out. In and out. Slowly. Steadily. Tune in to your breathing until that is your only focus. In and out. In and out. Slowly. Steadily. This in itself should help you to start to relax and is something you can build into your day on an ‘as needed’ basis. Slow breathing is a brilliant way to reclaim some calm.

Now, imagine a flock of black birds circling just above your head. They’re not going to touch you or harm you or anything like that. You’re safe. One hundred per cent. They just want your attention. You can imagine them flying around you, calling out, occasionally swooping closer to make you look at them. These black birds represent whatever it is that’s making you feel anxious.

The next time one swoops close, reach out in your imagination and catch it ever so gently. You don’t want to hurt it, just hold it in your hand. Feel how light and inconsequential it really is. It’s just a small, squawky, noisy bird – that’s all. There is no weight or substance to it. Let it go! Throw it ever so gently skywards. Watch it fly away until it is just a dot in the distance.

Now catch the next bird and the next, repeating this ‘catch and let go’ process time and time again until all you can see are these little black dots far, far away. You should feel a sense of relief as you release each bird and a sense of peace when they have all flown away from you. All done? Time to sleep…

Thursday 13 December 2012

Today, there is ward round which means everyone will be on edge and ready to snap. Let’s practise being normal. On the inside, I’m screaming ‘Let me out.’

* * *

I think that there’s a chance I might get to go home for a night at the weekend which would be my first step to getting out of this hellhole.

Others who have been here longer than me come and go a lot more because they have made progress (i.e. they play the game).

* * *

I started the day as usual by being weighed. It turns out I’m 46.8 kilos. I feel like I’ve been stuffing myself now for days on end. My weight is increasing and that feels weird. I don’t like not being in control.

I’ve just had my breakfast and am getting ready for another day in paradise.

Today I have the Christmas lunch – this will be a test.

I think I will go back to my room afterwards, put on a DVD and try not to think about how crap this all is.

I hate having to sit with everyone. I know people will look at me. They will pretend to not be watching my every move, but I’m not stupid and know they will watch. I’d be the same.

I don’t like the atmosphere, and being with others who are mental makes me realise just how crazy I am.

It can be a laugh, though, at times. Well, not really a laugh to a normal person. To a normal person it’s probably quite concerning.

* * *

I get to go home for one night at the weekend!

ANXIETY EXERCISE 2: BREATHING THROUGH ALTERNATE NOSTRILS

Taking control of your breathing patterns can be effective at all sorts of times when you’re not feeling so good. When you’re stressed, for example, your breathing can become fast and irregular and that can have a knock-on effect on your physical health, blood pressure, etc. The key is to be aware of this and, when it happens, to take charge by breathing in and out deeply and slowly.

Try taking a long, deep breath, holding it and then breathing slowly out until you feel you have emptied all the air from your lungs. You can do this three or four times, one after the other, each time trying to focus solely on your breathing. Some people find it helpful to imagine they are breathing in whatever is making them feel anxious and then blowing it all away as they breathe out.

Michael only dabbled a little with yoga – it’s not something he’s done long-term – but one exercise there helped him. It involved breathing deeply through alternate nostrils. It’s really simple. Close your left nostril and breathe in slowly through the right. Breathe in as deeply as you can. Next, close both nostrils and hold your breath whilst counting slowly to 20. Release the left nostril, keeping the right one closed. Breathe out as long and as slowly as you can until you’ve emptied it all out. Repeat the exercise with the right nostril and alternate up to ten times or so, until you feel calm.

Friday 14 December 2012

I woke up feeling drained. At least I’m starting to recognise I wake up depressed every day. I can sort of separate myself from it in a way. One day I hope I can wake up again in my own bed without being yelled at by a horrible member of staff. This tends to happen when they come to do the early-morning weigh-in and I don’t make things easy for them. By this I mean I simply don’t get up until they physically pull the covers off me and turn the lights on.

Today, I’m seeing Richard and I hope he helps settle my mind. Richard seems to connect with me more than anyone I’ve spoken to. I think it simply comes down to the fact that he understands mental health, but more importantly he talks to me like a friend. He doesn’t look down on me or judge me at all. He simply suggests theories, ideas and positive outlooks on situations.

* * *

We talked about ‘decatastrophising’. This is basically where you try to see things differently and attempt to stop catastrophic ways of thinking.

This can happen when you overthink a situation in a negative way, think about how awful it’s going to be and therefore panic about an event.

Decatastrophising is a way of thinking to over-come negative thoughts attached to upcoming events.

Often, the event is never as bad as you might expect, so Richard might ask me to talk about similar events in my past and how I feel about them now. It sort of helps put things in perspective. It was okay before, so it will be okay next time.

* * *

Richard was really helpful and tried to help me see things from a different perspective. He talks about what life could be like for me and also tries to reinforce that it’s not too late for me to have a good life. I just need to keep my head down and get on with it, but that’s really hard when all I want is for the ground to swallow me up.

Niamh isn’t coming over tonight because she’s got work stuff on, so that’s a real blow. It means I have nothing to look forward to at all today. It makes me feel even more empty as there is very little purpose to the day. I have to have something that keeps me going, otherwise it becomes a big struggle.

* * *

Tomorrow, I get to go home for the night. I thought I would be pleased but I’m actually very nervous about it. I feel there is a lot of pressure on me and Niamh to make sure it all goes well and that I get back on time. They judge if it went well by my weight, what I did with my time and how they perceive me to be feeling.

I feel like I have been locked in this hellhole for ever. The initial thought that I’d be in here for two weeks or so is clearly not the case. I was told I’d be here a couple of weeks by my mental health team at the hospital. I feel I’ve wasted so much of my life already and this process just feels like an ongoing nightmare.

* * *

I just spoke to Chris the dietitian about the weekend. Chris basically has the weigh-in details and then decides on a suitable meal plan that will increase my weight. It’s all pretty straightforward. If my weight’s not going up, the food piles up.

It’s a weird feeling being scared to go outside into the real world. I remember a similar feeling when I was discharged from hospital after almost dying. I felt very scared because I thought I was going to die. I remember getting home and my legs being so messed up I couldn’t walk properly and literally had to drag myself up the stairs by the banister.

I feel like I don’t have a home any more. I have been in and out of hospital, I can’t really remember much of what has happened to me and now I’m here. My head doesn’t feel settled.

* * *

I haven’t heard from anyone today, not even Niamh. I get odd letters and emails from my dad about stuff that makes him laugh, but I’ve not heard from him either for a day or two. I feel so isolated here when I’m just sitting for hours on end in my room.

I need to find a way to learn how to be happy and why I don’t allow myself to see the good things in life. I always feel the need to punish and hate myself. I think the medication has started to make me numb and to feel a little more dead inside.

I feel like I’ve let everyone down and I’m a huge disappointment. I should really be happy but I’m not. I think that’s why I punish myself. I have no self-worth and don’t feel like I deserve to have a life when I’ve hurt people so much.

ANXIETY EXERCISE 3: THE BLUE BUBBLE

Many of Michael’s issues revolved around difficulties with other people – watching him eat, seeing him in the street and engaging with him in social situations. ‘The blue bubble’ is a technique that is often suggested, in varying forms, by experts trying to help those with anxiety and, more specifically, social anxiety. It can be effective when you have to be in a crowded room or on a packed-out bus or train, or even in the street.

It’s really, really simple. You visualise a blue bubble around your body, protecting you (blue is widely regarded as a colour associated with peace and protection). As you move about, this blue bubble protects you from those around you. As an alternative, you can imagine drawing a circle around yourself on the ground. As you move around, this protective circle moves with you, its invisible walls protecting you from top to toe. It’s something that can work well once you have the idea in your head.

Saturday 15 December 2012

Today, I’m going home for the night which is both exciting and scary. Niamh will be coming soon to pick me up. I feel like I hate myself and don’t want anyone to see me. I feel ashamed.

In some ways, I think being at home is going to make me sadder because I’m going to see what I’m missing out on.

If and when I do eventually get out of this place, I need to make sure it’s for good – I’m not coming back to this hell.

Sunday 16 December 2012

Yesterday, I got to go home for the day and night. On the way back, we stopped at the big Tesco at Copdock. It seemed so busy and hectic with everyone hurrying about and no one standing still. I can’t even describe how weird it feels to walk about in public after being locked away. Imagine having every simple privilege taken away from you. Like being able to open a window or go to the toilet without being checked on.

We then went into town and I did my best to keep my head down and hope no one I know saw me. We didn’t really do anything in town apart from go for a drink and have a wander round the shops. I didn’t buy anything.

I’m reading a book called Crank, which is really bizarre but very interesting. It’s so blunt and has the text all over the place to show the character is going crazy. My diary should look like that.

I’m having to get in the right frame of mind for another long, horrible week of being watched. I don’t really even know how to think positively about being here. It feels like an endless nightmare. The only thing that gives me hope is getting out, but I literally have no idea when that could be. I think it will be months rather than weeks and that makes me sad.

POSITIVITY EXERCISE 1: TURNING NEGATIVES POSITIVE

Many of Michael’s troubles come from issues of anxiety and being negative and assuming the worst will happen. There is an exercise – and you’ll see versions of it in many self-help books – that involves replacing negative thoughts with positive ones, and it can work well if you are not too far down the path or have come out the other side and want to keep on top of things. This exercise is similar to those used in Michael’s CBT sessions.

For example, ‘I never know what to say in a conversation’ – something many of us worry about – can become ‘But I can listen to what the other person says and ask them something about that’. Experts will suggest all sorts of activities that can also help from carrying cards with positive statements to putting 10p in a jar for every positive thought and 10p in another jar for every negative thought and, as you focus on turning negatives into positives, seeing how the positive jar piles up with coins. You may start with more coins in your negative jar but that should change over time as you think more positively.

All good in their way – but we think the place to start is by being aware of negative thoughts and then monitoring them in the first place. We all know someone who sees the downside in everything. Often, they do not realise it – at best, when pressed, they see themselves as ‘honest’ or ‘realistic’ or ‘plain-speaking’. Those around them see them as a misery guts.

Many people don’t realise how negative the mind can be and how downbeat thoughts can swarm over everything. There have been times when I have said to Michael, ‘If you won five million pounds on the lottery, you’d find the negatives in that’ (and, to be fair, there are times when he would have done). It’s a matter of trying to see the upsides and focusing on them.

Here’s a simple little exercise that you may find useful. List, let’s say, 30 negative things about yourself (it doesn’t have to be bang on 30 – do what feels about right). Write each of these out, one at a time, on 30 postcards. Then try to write 30 matching but positive statements on another 30 postcards. Pair them up, one negative with its corresponding positive. For example, ‘I’m quite shy and can never begin a conversation’ may be a negative. ‘I can smile at someone and they may start a conversation’ may be a positive. Every day, take one pair and focus on repeating the positive statement at regular intervals through the day.

Monday 17 December 2012

I came back to the Priory last night and Niamh stayed and had dinner with me, which was nice. We then went back to my room and I pretty much passed out. It’s not long until Christmas now and it feels horrendous being locked up here. I still have no idea at all when I will be discharged.

I was weighed this morning and I have increased to 47.5 kilos. Weight going up always looks good when it comes to ward round.

Time is always passing, which means I’m closer to leaving, as long as I don’t go mental…well, even more mental.

I have now kind of given up on Christmas this year and realise it’s not going to happen. I haven’t got Niamh or my family any presents so I’m feeling pretty awful about that.

I have been called to see the big man (Dr Webster) and that’s making me very nervous. I might ask him if I can go home during the week to try being on my own for a while when Niamh is at work. It’s worth a try.

I’m starting to hate looking in the mirror – I hate myself so much. I hate who I am, from the way I look to the way I think. I do feel stronger and have more energy, but getting bigger very quickly is hard. I’m going to watch Where the Wild Things Are in bed and do nothing.

* * *

This afternoon I saw Dr Webster. He was pleased with how I did at the weekend. My weight had gone up and that’s really all they look for. I will see him again on Thursday. I think there might be a chance I get two nights at home next weekend. It’s getting very close to Christmas now and I still don’t know what’s happening. He always seems to be planning my next step – whether it’s good or bad news. I don’t feel I have any control over things.

Dr Webster keeps stressing that I need to be careful and repeating that I could have easily died. He says I’m one of the few people he’s met who has come so close to dying. Part of me thinks he’s trying to scare me into getting better. Another part of me is starting to think that his plan is to keep me here a lot longer.

Tuesday 18 December 2012

I only just woke up in time for breakfast so I had to throw on my clothes fast and join the other weirdos. There was a massive fuss at breakfast today because Becky refused to eat, which means we all sit around waiting whilst staff try to persuade her. She also has severe OCD and finds it difficult to even pour her milk. Being here has made me realise people suffer in such different ways. Whether it’s having OCD or a fear of leaving their homes.

It makes me think about how and why people get into these habits or ways of thinking. Some of it is genetic but some of it comes down to habit, addiction or simply not thinking straight.

I have CBT soon with Richard, and yoga if I can face embarrassing myself. I feel ugly and want a haircut. It helps a bit.

* * *

Tomorrow, I’m out with the rehab group again. It’s where we get to go into town. I’m now allowed to buy my own lunch in town and then bring it back here. I’ll probably go to M&S and get something. It’s all pretty humiliating as we are watched by staff in a public place.

Going out in the group is very embarrassing. Partly because, as a group, we are all clearly barking mad one way or the other, whether it’s Wilko going into a fit or Tia crying her eyes out, but also because, as we shuffle around the shops, the staff from the Priory keep a watchful eye on us. It makes me feel even more mental or some sort of criminal. I might pretend to leg it for a laugh.

* * *

I just had my CBT session, where we talked about why I’m a lunatic and act the way I do. Richard also met Niamh and we all got to talk. I think that helped me and Niamh understand each other a bit more and it also gave Richard a chance to see us together.

Wednesday 19 December 2012

I now hate how I look in the mirror. I feel like crap. I feel fat. I know I’m not fat, but in comparison with what I was I’m massive. I have always felt ugly and hated how I look. I can’t really change that, though. I don’t know how I wish I’d look; I think it’s more a case that I’m not comfortable in my skin.

* * *

Today is the rehab group trip. Time to parade about with the others with the public staring at us as if we are freaks in a circus.

Niamh should be coming up tonight to see me.

Time is passing so slowly. I spoke to Petra today and she has been here almost a whole year. I can’t bear the thought of being here that length of time, but I have to come to terms with the fact that it might happen. I get to speak to Dr Webster soon and find out about Christmas. I have given up on it, though.

* * *

I’ve just got back from the rehab trip. It was actually pretty cool. I got to have a chat with Richard and to walk on our own for a bit. We just talked about everyday things for a change. He was probably just trying to see what I was like in a relatively normal situation and was testing me, but I like to think he likes me and we are mates. I had some blood tests the other day and have been told it’s all looking a lot better – well, at least I’m not dying any more, so that’s something, isn’t it?

* * *

We had lunch at the lodge, a small building separate from the other patients, for a change. The better you do, the nicer things you get to do. If you eat meals properly, your weight increases and you engage with staff positively, then you’re winning the game.

* * *

This afternoon, I had a body image session with Paula who always makes me laugh. This class is about trying to recognise what it is we don’t like about ourselves and how we can learn to cope with that or possibly change how we see ourselves. I got pretty upset when we spoke about my past. Having to go over bad stuff that happened is always very draining and I don’t really like having to talk about it.

What I don’t like about myself!

I feel ugly and have felt so for a long time. I don’t know why – I just don’t like how I look.

I also feel uncomfortable because I’m getting bigger, my clothes are tighter and I feel bloated.

I also don’t like that I’m shy and quiet.

I don’t like being around people.

I just don’t like people – ha!

I probably don’t cope with these things in a very good way. I just push it all deep down inside, which makes me feel worse. I try to be around people, but at the moment I just don’t like it. Maybe in the future I will feel more confident.

* * *

Becky said I still look underweight and like a skeleton. I don’t believe her. It’s not that I think I’m fat; I just don’t feel comfortable. I’m now just waiting for Niamh to arrive.

POSITIVITY EXERCISE 2: THOUGHT STOPPING

There are various ways you can try to stop negative thoughts and, as suggested, positive self-talk is one of them. There is a technique we have come across called thought stopping which may be effective on its own or alongside positive self-talk to emphasise it.

What you do is this. Find somewhere quiet and peaceful where you can relax a little (we’ll come to some relaxation exercises soon enough). What you then do is bring that most troubling thought into your mind. Try to think it ‘out loud’ in your head – ‘I have no self-confidence’, for example.

Stop! Either think ‘Stop!’ or visualise a big red-and-black stop sign. Some experts will say you can actually say or shout ‘Stop!’ out loud. Whenever you find yourself thinking this, or any other negative thought, you can say ‘Stop!’ or, when that’s not appropriate – if you’re with people, for example – you can imagine that stop sign. Then try to replace that thought with something more positive.

Thursday 20 December 2012

My weight has dropped to 47.3 kilos. This could mean that I’m not going to get leave. It also means my meal plan will be increasing again. I’m just going to have to be open to whatever happens next. I feel gutted.

I hate Thursdays because of the early weigh-ins. Thursday is when we all get pulled out of bed at half five because that is when your weight is most accurate, apparently. I really can’t relax and I want to see Chris the dietitian now. I feel like I’m getting frustrated with having to wait around to see people.

I think I might sneak into Wilko’s room to play PlayStation games. It feels weird, two grown men having to sneak about to play games. We have only done it a couple of times, but it’s cool getting to hang out because it makes things seem a little bit more normal.

Because my weight has dropped, I feel like I’ve taken a massive step backwards. This definitely means I will be staying here longer. I’m crying now because I feel like I’m going to be stuck here for ever and it just feels like a prison to me. I have just realised I have absolutely no say in anything that happens to me any more.

* * *

I’ve just seen the doctor. My meal plan has been increased because they think I have been making cutbacks somewhere without telling them, which I haven’t. Weight is a weird thing, especially when your diet changes. Sometimes if you eat more, your body starts to have an increased metabolism, meaning you burn more calories. This process is taking so long and I’m beginning to realise the fastest way out is to eat my way out, which isn’t really the best idea. You can be fat and mental, and that’s okay. Thin, and whatever your mental state, that’s not okay.

Me and Niamh argued today, I think because she’s frustrated with this whole situation.

I have been thinking a lot about things. Mainly about what people have said to me. I think I hate myself and have for a long time. I don’t know how to be kind to myself any more. Every day is about punishing myself.

Friday 21 December 2012

Today I get to go home for a while. Niamh’s mum will be picking me up at 2pm and we will head back to Ipswich. She offered to pick me up because Niamh is at work and her mum has the day off and wanted to see me. I get two nights at home, but before I go I have to talk to the dietitian and then to Richard about things when I get back. He will just go over what I did whilst I went away and talk about my progress. I can talk most openly with Richard.

When you go on leave, you have your bags checked and you have to have a risk assessment. In the risk assessment, you get asked questions like these, in so many words:

How’s your mood?

What are you going to get up to?

Do you feel like running away?

Are you going to kill yourself?

I always say, for the last one, ‘I don’t know; I’ll see where the weekend takes me.’ They never look impressed by my joke. It makes me smile, though.

The risk assessment seems pointless to me because I wouldn’t tell them if I was planning to kill myself. If I was going to do it, I would have already done it by now.

Sunday 23 December 2012

I’m back in the Priory now after some time at home. I went into town with Niamh’s mum the other day, which was nice. We went for a drink and I bumped into a friend I had not seen for a long time and we spoke for a few minutes and that seemed okay. I finally went to see The Hobbit with Niamh and geek out. It’s weird how being locked up makes you really appreciate the smallest things in life. We take life for granted and it’s only when things get really bad that you get to enjoy life.

It’s back to reality, though, and I’m getting weighed very early in the morning before another day in hell. I hope I get to speak to Wilko soon. I know he has been struggling and I hope he’s okay.

People take so much for granted and you only realise this when it’s taken away. You don’t really ever think about how you have the freedom to walk down the street, go to the shop or see your mates. I do now that I’m locked away.

* * *

I’m crying again.

It’s good, though.

I’ve just been told I can go home for Christmas!

TALKING TO DR WEBSTER

We saw Michael once in the Priory in mid-December and since then had kept in touch with the odd silly but encouraging letter from me, parcels from Tracey and emails and texts, mostly from Sophie and Adam. As someone who has been used to organising and scheduling for much of my life, and never having had huge reserves of patience, I grew increasingly frustrated that Michael did not seem to know what was happening to him and when. It was all rather vague.

At this time, still not understanding mental health issues, I wanted to know what was being done to make him better and when he would be coming out. We wanted him to stay as long as he needed to, but were looking for some sort of timetable. (I know now, of course, that you cannot straighten and tidy and pack away and box off mental illness quite so neatly and to try to do so is generally pretty daft.)

Michael and I emailed each other about this and he seemed to want to know more too. He gave Dr Webster permission to talk to me. Although this seemed to take time to arrange – Michael did not see Dr Webster that often – it did mean I could put my concerns to Dr Webster and get some feedback from him. I could then talk to Michael about what was happening, which seemed to be what he wanted too.

For a long time, Tracey and I had had something of an issue with Niamh, although we tried our best to keep our concerns from her and Michael in case things blew up between us. Frankly, we thought this might be all her fault. When we had first met her, she was a slightly chubby girl but she had soon slimmed down. We thought for a while that Michael had followed her in dieting and had taken matters to an extreme. We also felt that Niamh was protecting and shielding Michael from us and that we were being kept at arm’s length (which, to be fair, we were, albeit with the best intentions).

Then again, she had always been cheerful and jolly with us, at least early on; as Michael descended into his hell between 2010 and 2012, things did become increasingly strained. I recall Michael and Niamh – Niamh mostly, I think – not wanting to come on holiday to Spain with us in 2011 because of some sharp words I had said to them. And, a little later, I remember being in Ipswich town centre with them and the atmosphere being so strained that we barely spoke to each other.

We did not really know if Niamh was a good influence or a bad one on Michael, and so my first contact with Dr Webster was by email and, in essence, it was:

Niamh has, in our view, exerted total control over Michael over the past five years and we are not sure that this is beneficial for Michael. Everything seems to suggest that he needs to get Niamh’s agreement to do anything. It may be that we have misjudged Niamh. It may be that, without her, Michael would not even have got this far. Positive or negative, we cannot help but feel she is a key factor in all of this and, as such, would ask you to give this your consideration.

Dr Webster’s reply was, as you’d expect, fairly non-committal, thanking me for the email and stating he would factor this into his work with Michael. Later, I spoke to Dr Webster on the telephone and he explained how close Michael had come to death and he talked a little of what they were doing with him. This seemed to be a mix of feeding him up to get his weight into the ‘normal’ BMI range and working on his mental health through a range of programmes; CBT, body image, etc. All good sensible stuff, really. He did not seem to think that Niamh was at fault at all, but indicated that they were ‘too close’ – that is, Michael was over-dependent on her which, with the benefit of hindsight, was the issue that we had misinterpreted.

The doctor’s main concern seemed to be getting the balance right between keeping Michael there and letting him out for so many days and nights. Michael did not want to be there. He wanted to go. Dr Webster was worried that if he did not let him go home now and then, Michael would become difficult and uncooperative. If he did let him go, he thought that Michael may not come back and they’d have to move to get him sectioned. I got the impression that they’d cut Michael as much slack as they could, but that they were worried about him.

We felt reassured by the conversation and relayed the gist of it back to Michael: that he was doing well and was on course to get some leave. We did not mention the doctor’s dilemma about Michael’s leave from the Priory. We felt suggestions that Michael wasn’t trusted 100 per cent and talk of not coming back and confrontations and being sectioned would possibly be something of a setback to him. I think anyone in that situation wants to hear ‘You’re doing well’ rather than ‘They don’t trust you to come back…you might get sectioned.’ We got that right: something of a first.

Monday 24 December 2012

I don’t really know how I feel about Christmas. Part of me just wants it to be over, but I feel like I should at least try to enjoy it.

I really didn’t sleep well last night. I think I’ve just got a lot on my mind. I was weighed early this morning and have gone from 47.3 to 48.0 kilos, which is very good news because it gives me a better chance of going home.

I can’t describe how I’m feeling right now. I’m just not comfortable. I can’t believe it’s Christmas Eve today – it just doesn’t seem like it. I feel really sad because I would normally do family stuff today including a panto in the morning and a cinema visit this afternoon. I miss the family Christmas routine.

When I was last out with Niamh, we went to the cinema to see The Hobbit. I saw my sister (Sophie) in the foyer and she burst into tears. She gave me a big hug – I’ve never seen her so upset.

Niamh wants to go to her sister and her sister’s boyfriend’s on Christmas day, which is fine, but I would have liked to have seen my own family at some point whilst I am out. I don’t feel like being around other people who know I’m out of the loony bin for a short time.

I’m currently waiting to see Chris the dietitian. Seeing Chris is a scheduled thing which happens once a week. It’s just about looking at what meal plan I am on and what changes need to be made.

I’ve just heard I’m going to have to move rooms which I’m annoyed about. Wilko only has a shower instead of a bath and keeps slipping over for some reason, so I’m swapping with him. It’s annoying because I’m used to my room, but I don’t mind swapping for Wilko.

THE MAITLAND CHRISTMAS

The Maitland Christmas is, I guess, like many families’ Christmas, something of a well-established routine. We – usually seven or eight of us, what with assorted boyfriends and girlfriends – all go along and see the panto at the New Wolsey Theatre on Christmas Eve morning (they’re brilliant!). We then all dash off to have lunch and get last-minute gifts and wrapping paper and sprouts and carrots and stuff. Tracey usually goes home to wrap things and talk to friends on the phone and drink. The rest of us go the cinema; this year, it was Life of Pi. In the evening, we usually have pizza and watch television.

None of us quite knew what Michael was doing on Christmas Eve, and whether he would suddenly appear at the pantomime or the film. Sophie had received a text to say he was coming out, so we knew he would be about. I think we all hoped he would appear out of the blue. He didn’t, but we kept quiet rather than contact him or Niamh and maybe cause a rift. We wanted him to do whatever he wanted to do, whatever made him most happy.

Our Christmas Day is much the same as many other people’s, I imagine. Bernard the dog usually gets a good walk first thing. We then tend to watch a DVD, something like The Day After Tomorrow. We have a huge Christmas dinner that no one can ever quite manage and a range of puddings; Tracey and I like a Christmas pudding with an orange in the middle. The children prefer chocolatey things. We do home-made crackers too with scratchcards in them and Sophie and Michael usually win something. We then open the presents, walk the dog again and watch (and nod off through) the Doctor Who Christmas special before we all slump at varying angles until it’s time for bed.

There were some text messages between Michael and Tracey and Sophie and Adam on Christmas Day; we knew he was out and all was well, and that the presents we’d left in their shed on Christmas Eve had been received. Again, I think we hoped Michael would turn up at some point but probably wouldn’t. He didn’t.

In recent years, Boxing Days have been a bit less family-orientated, with football matches, early-starting New Year sales and trips to New York for Sophie and her boyfriend shortening the family festivities. Back in 2012, we still did much as we’d always done: walks, DVDs, games, a spread of cold meats and vegetables at tea-time and then a film again in the evening.

I did not text Michael that day or any time over Christmas. It was the first Christmas we had never seen Michael at all. And, to be honest, much as he often angered and frustrated and infuriated me, I was sad about that. More than I would have imagined. It was not the best of Christmases, to be honest.

Thursday 27 December 2012

I went home on Christmas Eve and I spent some time in town for a while. Then it was Christmas Day and I wasn’t up for it at all. I spent it with Niamh’s family, but really I wanted to be with my own family. I’m hoping that Christmas will be better in the future. Christmas Day was okay but it didn’t feel like Christmas to me. I really just wanted it to be over. I just want to be on my own at the moment. I need some space. I wish I’d seen my family – it might have felt more Christmassy but I don’t like my family seeing me not well.

* * *

Today I feel pretty bad because I had to pack my stuff up to come back to the Priory. I have had a meeting with Dr Webster which went well, though. My weight is now 50.8 kilos. I also just got told that I’m going to get leave again! That was a nice boost. I get to go home again tomorrow morning, which is awesome. I feel like I’m making some sort of progress.

Wilko isn’t feeling good at all. His leave didn’t go well and I can see he’s struggling. I have spent a lot of time talking to him and he told me a little more about his horrible past and some really bad things that happened to him which I think have scarred him pretty badly.

* * *

I get to have five nights’ leave! This is a massive step forward for me, considering I have gone for huge stretches of time just sitting alone in my room here. I come back on Wednesday for my CPA (care plan assessment) on Thursday. Niamh will be picking me up tomorrow. I just want to spend as much time as I can away from here.

I have been talking to Petra this evening about the possibility of getting discharged. I’m hopeful, but I know I could get knocked down if I don’t get what I want. I also really want to see my family now because I haven’t seen them properly in ages. My weight is going up pretty fast and isn’t slowing down, which feels weird and scary and I don’t feel in control about that.

Friday 28 December 2012

Today I’m getting picked up and I get to go home for five nights, which is brilliant! I have to have breakfast first before I go, though.

I’m hoping we have a good New Year – and surely next year can’t be as awful as this year. I don’t think anything could ever be as bad as this year.

This past year has just been one massive nightmare, to be honest. I can’t even really remember parts of it – my mind is just blank. Maybe it’s been so dreadful that my brain blots out the worst of it to protect me. I don’t know – I hope that’s the case; otherwise, I am probably experiencing dementia. I almost died in hospital, I couldn’t walk and I ended up in the loony bin.

Sunday 30 December 2012

I am on leave now but am still keeping a diary. I think it’s a good thing to do, so maybe one day I will look back on it. It’s really nice to be out and at home. I came home on Friday and had dinner. We had a veggie pasta bake. I have been catching up on Game of Thrones, so I have been binge-watching that. I always think I will sit down to watch one episode, but before I know it I’ve started the sixth. It’s beginning to feel a bit more normal being back at home and I like having a little more control of my life. I could shake things up and do something mental. Or maybe not.

Tuesday 1 January 2013

A new diary – a proper one this time, not a notebook.

Yesterday I laid in and then I had lunch at home. I had couscous with tofu and I then did some gaming and generally chilled out. It’s hard knowing that I have to pack my stuff away soon to head back to rehab. I’m still bingeing on Game of Thrones. Going back to rehab will pull me back down and it makes me realise how much I want to be out now.

Hopefully, my meeting on Thursday will go well and I will get some positive feedback. I hope to hear some kind of news on when I will be leaving. Also, it’s getting hard to keep writing this diary in the Priory when all I do there is eat, sleep and cry and eat, sleep and cry and…eat, sleep and cry. I feel like there needs to be an exciting plot twist. Maybe a murder?

I hope I’m not still writing this diary by the time I get to the last page. Or at least I hope I am still not here.

Wednesday 2 January 2013

I’m now back at the Priory. I feel so lonely here, even though there are lots of people milling about. I have a weigh-in tomorrow, which I’m feeling extremely nervous about because I want it to be positive for my meeting with Dr Webster.

* * *

It feels like it’s been a while since I’ve seen the other crazies in here and it’s starting to feel odd. There’s a sense of jealously in the air towards me. I have felt it myself in the past towards people who have had the chance to go home for a while when I haven’t. I’m just about to go to dinner, so I will see how the others are there.

* * *

The others were okay with me. They were a lot quieter than usual, but it’s probably just because I’ve been away and not so much a part of the group.

Thursday 3 January 2013

Today is my sister’s birthday and it really sucks that I have to be locked up in here.

I had my weigh-in this morning which went well. When I say it went well, I mean I stuffed myself enough to please the doctors. I went up from 48.0 kilos to 49.5. I think that will please Dr Webster. I have my CPA meeting today which I’m getting very nervous about because they don’t come around very often and can determine what happens in the coming months.

I feel like I have a migraine coming on, which isn’t good. It’s probably because I’ve been stressing myself about things. I’m not good at much but I am good at stressing. If there were an Olympic sport for it, I would have a whole trophy cabinet full of gold medals. In fact, I’d probably have won bronze, silver and gold at the same time.

* * *

I’ve just had lunch with the other inmates before heading back to my room. I saw Colm earlier – he is the guy who oversees me and will check up on me when I eventually get out of here. He’s fine, but he has never had any mental health issues himself as far as I know, so I don’t really take much notice of what he says. For me, people who have experienced mental health issues understand. Those who haven’t, don’t. It’s as simple as that. I’m not being nasty; it’s just how it is. He’s a lovely guy, but I might as well be talking to some random stranger at the pub.

Niamh and her mum will be here soon for my big meeting. They will just sit in and listen to what has to be said. The meeting is basically a more serious assessment of how I am doing. I know for a fact that people only get discharged at these meetings and they don’t happen very often. I’m starting to get nervous because I don’t know what’s going to happen. I want to get discharged now – TODAY – but I know I will feel crushed if I don’t.

STRESS EXERCISE 1: THE SHRINKING WIDESCREEN TV

We’re trying to present this first part of the book in as straightforward a manner as we can, mainly by following Michael’s diary pretty much day by day so that you can see a little of what goes on inside the head of someone with mental illness.

We’re then – for parents, family and loved ones – trying to offer the Maitland family’s views at key points in Michael’s story. If you have a loved one somewhere along the path to mental illness, it may help you to know you’re not alone. Maybe we can also offer you some ideas that may shorten the journey or perhaps take it along another, nicer path.

We’re also trying to drop in some how-to suggestions for exercises that can be done for those experiencing mental health issues – basic at this stage, more detailed later on – so that there are practical benefits for you. We tend to include these as and when Michael raises relevant points in his diary, so we may jump about a little depending on what’s happening to him and his mood at the time.

Stress, as such, is something we’ve not written about, but clearly this is now an issue for Michael (and in reality has been for some time). So we will offer some suggestions over the next few pages. The first, long-used exercise, which works for many, can be called ‘the TV trick’.

Start by imagining you have a big, widescreen TV in front of you, with a top-of-the-range, cutting-edge picture. Whatever it is that is causing stress can be seen on that TV in big, bold colours.

What you then need to do is to imagine you are draining all the colour out of that picture until it is black and white. Now shrink that picture, smaller and smaller, until you can barely see it at all. Hold it there, so small and insignificant.

You are controlling your stress. That’s good. If you can, now see if you can slowly make that picture bigger again, going through black and white and into colour, with a more positive, upbeat picture that makes you feel good. This is such a simple trick and it works well as a quick fix for many sufferers.