Saturday, 31 January 2009

Picture by Eldest Boy (6)

Gloucester Cathedral, Boxing Day.

The Problem With Kraepelin

His model... you all know his model. Lillian Gith. Only joking. Ok, if you don't know it, Kraepelin's model for mixed states is a combination of mood, flight/inhibition of thought, and psychomotor agitation/retardation. Those three in different combinations give eight different flavours between and including manic and depressed. Off the top of my head: Mania, Dysphoric Mania, Manic Stupor, Inhibited Mania, Agitated Depression, Depression with Flight of Thought (which I prefer to call Anguished Torpor, because I do, ok?), and Melancholic Depression.

Right, that's that out of the way.

Back around 10 or 11 months ago I described how I felt these things interact: I remember trying to describe to the psychiatrist and the CPN in a very garbled and excited manner my idea of three snakes writhing up and down connected by bungee cords at regular intervals, like a dna molecule with an extra strand: when one coil loops too hard against its restraints, it pulls the others after it, and is then pulled back in turn. Another bee in my bonnet I had was dopamine, noradrenaline and seratonin being in some way connected to these three snakes of flight-of-ideas, agitation and mood, and their agonistic/antagonistic effect on each other being the bungee cords. (They blinked and carried on trying to persuade me to take the pills.)

Well, fair enough, but perhaps not.

Anyway the PROBLEM.

The problem is this. I find that at my age, experience, years, infinite wisdom... call it what you will, I have snipped the bungee cords that connect mood. I know when I should be happy. I know when I should be sad. When I am either inappropriately, I know that there is no reason, and that's grand. I wish I could control the other two.

Off the pills, on a rating of +3 to -3, I find I'm normally (in my normal state around 2 for flight of ideas and agitation, and between 2 and -2 for mood). That is what I call my day to day stuff. I like being in that state. It's productive, it's good, it's fucking super.

On the pills I am about -1 for thought, -3 for agitation, and -2 for mood. Oh what supershit remedies these quacks offer.

The problem again, since I made it the title, and yes I've rambled (again). The problem is, when you have learned to curb 'mood', and even though you want to vanish from the face of the earth, you know that it's irrational - when say, CBT has been self-administered to the point where it is unconscious - then you present an irritating and contradictory case to the shrinks.

S: "Do you feel like killing yourself."

P: "Of course I don't." (Even if you do.) [Because you know you wouldn't, if you didn't happen to be thinking so at the time] {and you certainly wouldn't admit it to that priest manque}...

Oh balls bum and bollocks. This is all nonsense and ranting.

Have some Bach.

Friday, 30 January 2009

If I Could Feel, I Would Feel Shit

As my darling said: "I don't what to say, I feel I am always missing the point."

Me: "There is no point to miss."

Old memories of the pottery being thrown when there was no telly to fill the schedules... watch this Japanese potter - craftmanship to put a smile on anyone's face - simply superb.

Tuesday, 27 January 2009

Post-Manic Shame Reflected Using a Kierkegaard Mirror

Apologies for the cat song earlier. It made me laugh, so... anyway.

"The most dreadful thing that can happen to a man is to become ridiculous in his own eyes in a matter of essential importance, to discover, for example, that the sum and substance of his sentiment is rubbish." Søren Kierkegaard

There is nothing quite like the appalled embarrassment and self-loathing that can follow mania. The partial amnesia that often accompanies it is a gentle blessing at times. Forgetting is a self-defense mechanism. Who would ever summon up an ounce of confidence in themselves if every ghastly failure and misconception of their being was permanently fresh in their mind?

Since madness is primarily defined in practice within the terms of what is socially acceptable behaviour, it casts a shadow over all independent thought, all rebellion, revolutionary ideas, sheer eccentricity, oddball notions. It makes you doubt everything about your intelligence. The only defense is to declare yourself not-mad, merely different.

I have held some strange notions in my time. But what if they were not, in fact, actually that strange? What if they were just inconvenient, dangerous and difficult? What if they were in some way a route forward in my life, my self?

The trick is not to stop dancing, but to learn to dance better.

This all has the dangerous whiff of self-delusion. But it's cheering me up no end.

The bizarre synthethesis the mind can achieve when in an 'interesting' state, is quite remarkable. Even more remarkable is the way that shortly afterwards, one can remember the essence of it, but not how the unearthly logic worked, and a little later, one can barely recall the nature of the disparate elements that somehow one had welded into a new (dangerously new) thing (a bit like copper porridge, or rubber glass - oh hang, that's perspex isn't it - how about a scalding verdigris snowflake perpetual motion aubergine?). Later still, one has blanked all recollection apart from the memory of having had the experience.

I don't believe every bout of mania is a deep-seated learning process but I wouldn't be surprised if a few were. As with all thoughts and ideas, some prove shoddy, others gold. Unfortunately/fortunately it seems the only way to continue living with the more alien concepts is to remain 'mad' - an impossibility.

Abysmal Language School Part One

o, ie a i er ee o,
u ee e er u i ie o
u i er ie ear ee,
u o i a ue oe,
u ay ow a ie,
ue i u oe e a ee.
u a i ar ie o
u o a i er ue ee
ar o u a ue o
ee ie o u ue ae
ar o a ie u ae
e oe u o ee ow i
u ee ow u o u i
u i e u ar ee
oe i i a i er i
ue ee e er e i i er

bloody cats

Sunday, 25 January 2009

Fencing With 3000 Mile Foils

The nature of communication over the internet, or any text based form, even the old standby the 'letter' - remember them? - is a particularly thin form of communication. It stabs and breaks the skin over a small area, but often plunges quite deep, and bypasses most of the fluff and prevarication of the real world. We may flatter ourselves that we are being 'anonymous', playing a part, a persona, editing our personalities to be more entertaining or educational, or simply putting our best cheek forward to be slapped before turning the other, but we cannot help but reveal ourselves through not just what we say, but also what we omit.

To bolster this argument, everyone I've met who I first knew online for a good while were just how I imagined them - when I met them face to face as people. Of course all the irrelevancies were different - appearance, mannerisms, tics, what have you - but in essence the personality was familiar, and made the friendship aspect very easy.

I've had various arguments about the pros and cons of making friends using such a newfangled and dubious medium. But I think that one of the advantages of it is that like-minded people tend to congregate. I don't just mean mental health. It cuts out a lot of the pub bores who one would avoid like the plague.

In fact, we had some parents of a child at eldest boy's school around for supper the other day. Talk about wanting to slit your wrists with despair, boredom and irritation. Nothing in common except we had all managed to get sperm to talk to eggs. Pass me the shotgun.

So, to finish, and to stop winding up, and to wind up, here's a toast to the self-selecting memelogical great-minds-think-alike-a-pologicaticistical modern communications.

Shame to think it will probably all go kaput within our lifetimes!

Take care all, David

Saturday, 24 January 2009

Plagued by Scattiness

So here are a few pictures from a walk this afternoon.

The Bipolar Schizophrenic Overlap

Mo's blog linked to this Lancet article.

Interest in the much-debated possibility of genetic overlap between schizophrenia and bipolar disorder has been restimulated by molecular genetic studies, which have led to reappraisal of previous evidence from genetic epidemiology. Most previous genetic epidemiological studies have been underpowered to investigate the question of diagnostic overlap. This study, however, included more than 2 million nuclear families; the researchers merged data from the Swedish multigeneration population register and the Swedish hospital discharge register. The results clearly show increased risks of both schizophrenia and bipolar disorder for first-degree relatives of probands with either disorder. Furthermore, evidence from half-siblings and offspring adopted away shows that this is due substantially to genetic factors.

The Kraepelinesque Dichotomy is dead! (I've always wanted to say that.) Kraepelin, as you all know, differentiated what he called Manic-Depressive Insanity from Dementia Praecox (what we now call schizophrenia). In fact, though, Kraepelin later said:

No experienced psychiatrist will deny that there is an alarmingly large number of cases in which it seems impossible, in spite of the most careful observation to make a firm diagnosis... it is becoming increasingly clear that we cannot distinguish satisfactorily between these two illnesses and this raises the suspicion that our formulation of the problem may be incorrect. (1920)

Seriously, it has been on the cards for a while. The overlap has been highlighted recently (to my certain knowledge) since at least 1995 (Eysenck: Genius, the Natural History of Creativity - you can read some of the book here - quite interesting, and refreshingly straightforward (why are psychologists more readable than psychiatrists?) though I may have been feeling mildly grandiose when I ordered it from Amazon).

Various studies comparing people with schizophrenia and manic depression with the likelihood of their children inheriting either condition: Rosenthal (1970), Penrose (1968), Powell et al (1973), Elsasser (1952), Schulz (1940), Pollock and Maltzberg (1940), Slater (1953), etc, etc, etc... all of these show that one type of illness may beget the other to a significantly higher degree than would be expected by chance (eg, Rosenthal found that the children of manic depressives had a 2.3% chance of being schizophrenic, compared to 0.8% in the general population).

On the other hand - there is evidence that there is a difference between the two conditions. I commented on Mo's blog: "if there were five genes, and four of them (say ABCD) made you schizophrenic and another four (say BCDE) made you bipolar" then it would be easy to see how the shared likelihood of transmission could occur, but still differentiate the two conditions. Some studies, Kant (1942), Weingberg and Lobstein (1943), Vaillant (1962) found that relatives of schizophrenics who didn't recover showed a greater ratio in first degree relatives of schizophrenia to manic depression, compared to relatives of recovered schizophrenics, where the ratio was reversed. The ratios varied between 5:1/1:5 and 7:1/1:7.

Studies have been carried out seeing how often different psychiatrists' diagnoses accord with each other. The figures for agreement are generally around 59%. Or on the other hand, 41% of the time, someone gets it wrong. This obviously (?) cannot purely be down to incompetence (thus he prays).

However, this Swedish study seems very large, and hopefully should make more of a splash in the murky waters of the pond.

I've rambled on long enough to little purpose. I'll finish with a quote from Eysenck:

As regards the generality of 'psychosis', it seems clear that there are definite genetic links between different diagnostic categories (schizophrenia, manic-depressive disorder, schizo-affective disorder, unipolar disorder) which make it impossible to regard them as entirely separate disease entities. Some specificity there undoubtedly is, but there is also a generality of disorder which links all these disorders and their sub-classifications and diagnoses together to form one end of the psychoticism continuum, with a severity gradient placing schizophrenia at the extreme end, followed by schizo-affective disorder, manic-depressive disorder and finally unipolar illness.

Back to the schizoaffective spectrum, eh? Or since that was written in the mid 90s, that should be towards the schizoaffective spectrum.

P.S. On a brighter note, I hope this will reduce the stigma that gets shoved at schizophrenia. I find it irritates me when I read someone with (say) manic depression 'writing off' people with something 'worse'. Our 'shared heritage' he said, raising an eyebrow in sympathetic amusement, should give us pause.


Update. 4.15. It's hard and crunchy and very frosty outside. No less than five cockerels are competing. The stars are malevolent in their gleam. I feel calm, relaxed, but utterly untricked of sleepiness. Nothing unpleasant, just... just... oh well... you all know I'm sure what follows on from "just..."... But already?

Friday, 23 January 2009

Question - The Café

The Café

some days
he spoke quietly
I feel homesick for
homes I never had
dreams I never dreamed
are all things
that undefine
my definition
blur is a comfort

I sit in mind
regarding a sun
a shaken eye
a searing circle
on oily black
within my coffee cup
upon a table
again never seen

A friend wants to make a short film using stop motion text using this poem. She's been asking me for ideas, and I've been keeping schtum generally because I want to see her ideas, not mine. And also the poem is supposed to be as open as possible, so I certainly don't have any desire to fix the meaning. Any ideas, anyone?

In the mood for writing tonight: first post here.

Thursday, 22 January 2009

Been Lethargic and Hyper of Late

And the two states have been riffled together like a pack of cards over the last few days.

I have been meaning to write a long post on the history of mixed-states over the last 100 or so years, but keep finding the prospect exceedingly dull. I will get round to it, because during my brooding over the last year I've got myself firstly some decent texts on the subject which deserve paraphrasing (someone might find it useful), and secondly I've developed my own jaundiced ideas and criticisms of the whole subject area. Anyway, that is in the pipeline, but can't be arsed at the moment.

Sleep has been either too much or hardly any. Nothing I do to try to influence it seems to make any difference. Mood has been up and down. My brain seems to be in a permanent state of thinking of three things at any one time (no change there) but with very few focused windows of opportunity to achieve anything useful.

Went out on Tuesday to do a morning of voluntary work with my old friend to see how well my patience and concentration and temper held out in the old work environment. No, not dangling in the clouds, just conserving a Norman font. Of course it felt as if I hadn't been away, nor mad, or if I was mad, then I was always mad. Anyway, just like old times. I was pretty low the day after though. Still, gives me hope, assuming the driving license turns up soon. I also realised that those four hours if I had been paid would have been the same money as two weeks incapacity. Now there's a spur.

Damn it. If the bastards hadn't been called out a year ago, I'd probably have calmed down by February and have been back at work as if nothing had happened. What a fucking mess. It's like tightrope walking. One slip and you've had it.

"Life is being on the wire, everything else is just waiting." Karl Wallenda.

Mouse Drowned in Bucket

Meniscus memory, you hold your shape,
A perfect cloud of you in the bucket:
Six cold months, or less perhaps, you've sailed
A miniscule ocean in interior winter nights.

A rhythmic gymnast, looped and coiled about
With freeze-frame squirls of ribbon; not so agile
To escape, no easy spring to bold applause, just
The end, occluded in the soft vignette of a pail.

I tip you out; your space dissolves. Your tiny
Bones crumble, splattered to mush across the compost,
Broken needle-tips specking a grey sludge.

A sullen will kept your integrity intact
In the clockless silence of that dead house.
We bore distasteful witness to it at last.

Monday, 19 January 2009

Newer Anti-Psychotics Linked to Increased Risk of Heart Attack

[The researchers] found that users of the newer drugs were 2.26 times more likely to suffer from sudden cardiac death than those not on the medications.

Patients who took the highest doses were at the highest risk. Overall, the patients had a three-in-1,000 risk of sudden cardiac death a year [...]

The drugs appear to cause problems by disrupting potassium in the heart, causing its electrical rhythm to fail [...]

Dr. Sebastian Schneeweiss, an associate professor of medicine and epidemiology at the Harvard School of Public Health, co-wrote an accompanying commentary in the journal. He said that, considering the risk and lack of evidence that the drugs are useful beyond limited cases, doctors should "sharply" reduce their use to treat conditions other than acute psychosis and schizophrenia.

Hmm, it just gets better and better for these drugs, doesn't it? Original study is published in the Jan. 15 issue of the New England Journal of Medicine.

Sunday, 18 January 2009

A Tale From My Erstwhile Career

A tentacle of god, suckered
With marian mouths,
Twisting like a high sail.

Marian flowers, three petalled,
Enclosing the godseed.

Just one arm of the octopus
Visible, the other seven,
Spectral, lashing round
The stone spike, all four winds
And their brothers.

Sense of beast breathing,
The perceptible rise and fall,
The pulse in viagra-bonded
Stone - medieval pornography.

There is the Oscillation, the Sway
And worst of all the Corkscrew.

What would you know of life
At the tip of a living stalagmite?

Marian vaginas, three lobed,
Mons veneris, labia majoris,
Inside, the ball of the head
Of the sacred child.

Seven tentacles of wind,
One for each planetary
Influence were seating the rails
And trundle of my fate.

Half a long kilometer
Of rope I hauled, snaring-in
The winds, force-ten, eleven.

Recovered with coffee, gateaux,
Kirsch cherries, shaking and snarling.

Those ornaments are called ballflowers - I've never heard a satisfactory explanation for them. Some prelates mumble about the Trinity, but if so, the ball of Christ's head in the centre makes Four... Personally, I think it is a stylised womb with a trinity symbol incorporated, and the head of christ visible within, either as homunculus, or as child being born. (I have been within inches of a trinity of children born over the last six years, so humour me!)

When I took the photo at the top I was stood on the top of the tower 220 feet up. The spire carries on for another 184. And yes, I was at the top in force 11 once. And yes, it is horrible, sincerely horrible from the depth of hell to the top of your spirit, wrong, utterly wrong. And I'm not scared of heights. But the gateaux and cherries were remarkably pleasant.


This is to illustrate what I was just talking about here.

This part of the post might vanish. I'll leave it for a few days, but here is a video from the top of that damned spire.

Running a business is stressful enough. I started mine in the same month I started my MA and my family! Having employees who have just started families and who rely on you for the work is stressful too. When the day at work is in places like this, then there really isn't any respite. After seven years, looking back after a year out, I'm really not that surprised I got ill.

p.s. That's my best friend filming.

Friday, 16 January 2009

Ok, Over A Year

Yeah, yeah, yestreen a year ago they came clumping up to the house with their burly faces and concerned looks. (I was sure they had restraints in the boots of their cars.)

Following that, they banged me on the head with quetiapine until I felt rather 'not-quite-with-it'. But thank goodness they let me stay at home. Funnily though, my wife today mentioned off the cuff that I should really have gone into hospital, in retrospect... (we'd been talking about banging heads on the wall and other grisly stuff).

To try and keep some sense and to fight against the feeling of being steam-rollered I would go out for walks in the rain everyday. See? I was better then than I've been lately. Ridiculous.

Oh well. A self-portrait from around that time:

And yes I was as zombified as I look. I could have sat there for hours. I might well have sat there for hours. I can't remember.

Take care all.

Valproate, Lithium and Placebo.

Following on from the link from last night's post.

There has only been one long-term study on valproate (divalproex, Depakote, etc) versus placebo (A Randomized, Placebo-Controlled 12-Month Trial of Divalproex and Lithium in Treatment of Outpatients With Bipolar I Disorder - Charles L. Bowden, et al - Arch Gen Psychiatry. 2000;57:481-489.).

Here is the study: full text, or pdf (I personally found the pdf much easier to read, as the graphs etc are all in their proper places).

Here is the abstract (bear with me, I'll talk about it in a moment):

Background Long-term outcomes are often poor in patients with bipolar disorder despite treatment; more effective treatments are needed to reduce recurrences and morbidity. This study compared the efficacy of divalproex, lithium, and placebo as prophylactic therapy.

Methods A randomized, double-blind, parallel-group multicenter study of treatment outcomes was conducted over a 52-week maintenance period. Patients who met the recovery criteria within 3 months of the onset of an index manic episode (n=372) were randomized to maintenance treatment with divalproex, lithium, or placebo in a 2:1:1 ratio. Psychotropic medications were discontinued before randomization, except for open-label divalproex or lithium, which were gradually tapered over the first 2 weeks of maintenance treatment. The primary outcome measure was time to recurrence of any mood episode. Secondary measures were time to a manic episode, time to a depressive episode, average change from baseline in Schedule for Affective Disorders and Schizophrenia–Change Version subscale scores for depression and mania, and Global Assessment of Function scores.

Results The divalproex group did not differ significantly from the placebo group in time to any mood episode. Divalproex was superior to placebo in terms of lower rates of discontinuation for either a recurrent mood episode or depressive episode. Divalproex was superior to lithium in longer duration of successful prophylaxis in the study and less deterioration in depressive symptoms and Global Assessment Scale scores.

Conclusions The treatments did not differ significantly on time to recurrence of any mood episode during maintenance therapy. Patients treated with divalproex had better outcomes than those treated with placebo or lithium on several secondary outcome measures.

(Proportion of patients to relapse against time)

What is this actually saying in English?

There was no demonstrable benefit shown by taking divalproex or lithium for maintenance treatment over taking a placebo.

Less people taking the divalproex stopped taking it during a relapse than those on the placebo.

The side effects of divalproex were not as unpleasant as those of lithium, reflected in the lower drop out rate. In other words, the drug that is not doing anything effective has fewer unpleasant side-effects than the other drug that is not doing anything effective either.

If you read the main study, they explain the results by saying that due to ethical reasons they 'probably' had managed to screen out the really bad cases, and if they had been included, they 'probably' would have shown a better result in comparison to placebo:

Several factors may have contributed to the surprisingly good outcomes in the placebo group. Patients with mild forms of bipolar disorder may have been selected for the study because of the enrollment requirement that 2 consecutive GAS scores had to be above 60. Bias may also have been introduced by the requirement that remission of mania had to be achieved within 3 months of the manic episode, as failure to meet this criterion was a major reason for exclusion from randomization. Also, some patients were randomized whose manic episodes resolved without specific treatment. In addition, a number of study candidates with histories of severe illness were reluctant to enroll in the study because of the chance of receiving placebo for up to 1 year, with minimal use of rescue medications. Moreover, the index episodes of mania seemed to be more severe in patients who failed to qualify for randomization than in those randomized. Drug-placebo differences are known to be greater when patients with more severe forms of illness are studied.

But what does that mean, when we look beyond the self-deprecation of the study? If, instead of reading that as "oh, that's ok, the study's flawed anyway, therefore we can ignore the results", we look at the implication of those caveats?

It is saying that if the above is true, then the drugs do not prevent relapse apart from perhaps in the more severe or refractory cases.

What conclusions can be drawn? Valproate is definitely an effective anti-manic treatment. I can vouch for its efficacy. However, there is no decent evidence for it being of any use at all in maintenance treatment. Which begs the question, for me, personally, why put up with the damn side effects? Why not take it when needed, to knock down a high that is going too high, and when down again, come off sensibly.

I shall be taking these issues up with my psychiatrist with a voice of tumult and thunder next month, and yea! I shall smite his desk!

Thursday, 15 January 2009

Down in the Hole

And the cover slides off, and a weary hand tremulously shoves out a couple of second-hand morsels for the stray dogs in lieu of anything worthwhile to give.

Cover slides back on. Night.

Wednesday, 14 January 2009

Screening and Genetics

Article here by Marcel Berlins in the Guardian: It is the autism screening debate, but is relevant to any spectrum disorder and the pros and cons of gassing us all in the womb. I might try writing a post about it later if my concentration permits.

Monday, 12 January 2009

Bits and Pieces

It's three days short of a year since the docs and nurses arrived at the house. I don't feel like celebrating. Hence me saying it now rather than in three days.

Had appointment with gp today... hopefully last leg of the dvla shenanigans. He's a good man.

I realised Depakote is an anagram of Take Dope. I'm sure I'm the last person in la-la land to have noticed, but thought I'd mention it anyway.

And a picture.

Take care everyone, Dx

Sunday, 11 January 2009

Negative Capability.

"I had not a dispute but a disquisition with Dilke, on various subjects; several things dovetailed in my mind, & at once it struck me, what quality went to form a Man of Achievement especially in literature & which Shakespeare possessed so enormously - I mean Negative Capability, that is when man is capable of being in uncertainties, Mysteries, doubts without any irritable reaching after fact & reason." John Keats.

A classic example is the way in which Shakespeare manages to interweave entertainment for the masses and the few in such a way that improves the whole - the inherent self-contradictions of plot in Hamlet, for instance. Hamlet is both mad and pretending to be mad. The ghost is but a figment of his mind, but the guards and Horatio see him too. We can read/experience on two (or more) contradictory levels simultaneously.

The sooner we all realise that we are all simultaneously both mad and sane, the better for us all. After all, the definition depends on the framing, and in society the framing of the definition depends all too often on the utility of the individual to society. The bastards!

Well, now I've got that off my chest, to more personal matters.

The Depakote is still making me feel crap, but the sleeplessness has returned. Full moon? One of the aspects I hate most about it and any of these sedating drugs is the way they rob you of love. I look at my children and don't feel that special father's fondness - they are like 'other people's kids' - they lose their cuteness. It is a side-effect that makes me feel extremely angry, and makes me want to take my psychiatrist by the ears and shake him until his brain falls out his left nostril. My wife can never bear me when I'm on the pills either for the same reason. It is not that I am cold: I'm just not alive to the degree I have always been. Medical compliance is rather difficult in this house for that reason. Perhaps she is wiser than me? The last dose of hypos over xmas were getting thoroughly out of control though. No life-reasons for it. What to do? What to do?

On that blunting of love, I'm reminded by this from Coleridge, from his Ode To Dejection:

And still I gaze -- and with how blank an eye!
And those thin clouds above, in flakes and bars,
That give away their motion to the stars;
Those stars, that glide behind them or between,
Now sparkling, now bedimmed, but always seen:
Yon crescent Moon, as fixed as if it grew
In its own cloudless, starless lake of blue;
I see them all so excellently fair,
I see, not feel, how beautiful they are!

I see, not feel, how beautiful they are... That says it all. Logic dictates I love; logic dictates I find them beautiful; but the heart is dead. Quality of life, eh?

New Year's Resolutions... not too bad. One glass of wine last night. Kept the cigarettes within the limit, and the early teens once or twice. Been taking the foul brain poison like a good boy. Even managed to do the cards* once a day. The most recent reading told me that at the moment I was Ordered and Disciplined (woohoo), and if I carry on I will have Confidence, Security, Honour, Good Faith, etc. If I change tack, then I get Pleasure, Gaiety, Enjoyment and Satisfaction. Hmmm. Seeing as how I can't avoid Mourning, Sadness and Affliction (apparently), I'm in a quandary (he said, preparing the ropes and tiller and stilling the cry of Gybe-ho! in his throat).

* Lest any of you think I believe in this mumbo-jumbo, I don't. Not in the slightest. However, I enjoy the way the random meanings make you examine your life and motives in a vain hope of making them fit the lie of the cards. (Good pun on Lie of the Cards there, if I may say so myself).

Oh well, enough. I've been rambling to little purpose. Have a good week everybody.

p.s. Boring housekeeping notice: just re-merged last year's posts back in here. I'd stopped feeling paranoid about it.

p.p.s. It's been cold up here. This was yesterday. It's just thawed out after god knows how long.

Saturday, 10 January 2009

Used Labels Going Cheap

μελαγχολία, μανία, μαίνομαι, malikhuliya, melancolia, melancholia, mania, melancholia phrontis, melancholia moria, melancholia saltans, melancholia errabunda, melancholia silvestris, melancholia furens, melancholia enthusiastica, melancholia, ecstasis melancholia, mania melancholia, athymia melancholico-maniaca, melancholia agitans, melancholia activa, angstmelancholie, mania melancholia, melancholique maniaque, melancholia mixta catholica, folie circulaire, tristimania, lypemania, vecordia melaena, melancholia periodica, melancholia of circular insanity, melancholia of the age of involution, involutional melancholia, manic-depressive insanity, manic-depressive illness, bipolar disorder... you get the idea...

Friday, 9 January 2009

Drained and Empty

Just feeling old, rickety, empty, bleak, no desire for the future, no relish for the past, grim, anxious, blank and wide-awake. I guess the depakote is working again properly (the sight of incomprehension on people's faces when you explain, "Actually, these drugs are meant to make you depressed," always irritates me). Enough moaning and groaning. Have a cheery picture. Night.

Thursday, 8 January 2009


I was feeling rather fed up with the whole new-years resolution rubbish - after all, what's the point? I'm only going to forget I made them, or decide in a completely different state of mind that they weren't worth making. So I decided to make a completely useless resolution just to irritate people: to read the Tarot once a day. Thankfully I can't find them tonight, so heigh ho, there we go!

I did make another resolution, to wit: to make some more useful resolutions. Anyway, first couple on the list:

i) Give the pills a go without starting and stopping and fucking around with the dosages for three months and see if they actually do some good.

ii) Give up drink for three months. After the last eighteen months my body could do with the rest I imagine.

iii) Get to bed at a sensible hour - ha ha ha ha ha.

iv) Cut down the smokes to ten a day (actually already done that).

Well, they'll do for starters. I've been feeling quite crappy the last few days. Nothing like Depakote for making you feel about twenty years older overnight.

What else is new? Read Dr Jekyll and Mr Hyde this evening. I'd never read it before. Better than I imagined it would be. I especially liked this:

"The most racking pangs succeeded: a grinding in the bones, deadly nausea, and a horror of the spirit that cannot be exceeded at the hour of birth or death. Then these agonies began swiftly to subside, and I came to myself as if out of a great sickness. There was something strange in my sensations, something indescribably new and, from its very novelty, incredibly sweet. I felt younger, lighter, happier in body; within I was conscious of a heady recklessness, a current of disordered sensual images running like a millrace in my fancy, a solution of the bonds of obligation, an unknown but not an innocent freedom of the soul. I knew myself, at the first breath of this new life, to be more wicked, tenfold more wicked, sold a slave to my original evil; and the thought, in that moment, braced and delighted me like wine."

Oh well, enough. Keep safe all.

Wednesday, 7 January 2009

Piano Revisited and Session

Ah, got the damn thing in the house up the ice-sheathed path and steps... When the boys had had their fill making modern elbow-music I tried to get the brain tentatively working with the rh part for the prelude in f minor from the first book... That has to be one of the most heartbreaking pieces of music ever, especially taken slow, which is the only way I'll ever play it... especially with the finger I broke this summer... :-(

Then went out to Bristol for our fortnightly tunes. Really didn't want to go. I guess the pills are working then! But told K that if I start wanting to be a hibernating hermit then make an extra effort to persuade me. It's been my only social lifeline over the last year, and a lifeline it has been. Anyway, a good night was had. In fact, apart from the fact that your average pub punter thinks you're mad for playing in public in a strictly non-performing fashion - and apart from the fact that most of our compatriots are probably half-unhinged - and apart from the fact it was bloody brass monkeys to get there and back from the Cotswolds - well, I probably came over quite sane.

Tuesday, 6 January 2009

Just Vague and Withered.

I'm afraid we went out for a Cotswold Sunday lunch yesterday, which ended up finishing about six this morning. I've had lions and tigers fighting in my head over the right to which particular hangover savaging I deserve to endure.

Oh, Happy Days
Oh, Happy Days.

Hope all are well.

p.s. We've been given a piano! Time to dig out the 48 Preludes and Fugues! (Looking on the bright side of a wiped-out day...)

Sunday, 4 January 2009


Cool space. As soon as achieved
assaults redouble, and again.
Bluebeard, his smug key thigh-hanging.

The tide comes in, leaves beach bare,
when out should be in, when in, out;
gull's eye gleams from climbless roost.

The figures come and pass the window.
Seagreen shutters the house fold-blind;
inside what half-heard laughter means?

A dim hall obscures mysteries,
bulbs have been torn from sockets,
the lamp-click in dark could be teeth.

Cool space is a pinnacle rising out of hell.
It is not found in womb or casket.
There must be air to stretch in.

Pandora's Box

I keep having imaginary conversations with people. I assume most people do. But mine are visceral. I end up mouthing my replies, and can see in my mind's eye the other person, in their setting, as if it's real. I've always had a knack for that. It makes me very tense. It's as if you have all the arguments you could potentially have in a lifetime or twenty.

I wish I could channel it to some purpose, but these days, it's generally a dead-end.

Anyway, this evening it was the smooth young youth of a psychiatrist I was arguing with. I won't bore you with the details, but it involved how the human race can turn a theory as simple and as self-evident as Malthus' into a 'disproved' theory.

Well, in my argument I realised I was going to cry, thinking how the human-race-salesman-par-excellence had sold me the same golden story, and now I had three children, and hence the urge to weep, and I wasn't going to have that, not in front of that bastard, so I changed the subject and asked him if he knew the Pandora story.

"Yes, of course," he replied, frowning slightly.

"Well, the last thing that came out of the box, can you remember what that was?"


"Hope. Does that ring a bell?"

"Ah yes! Hope."

"And was it a good or bad thing?"

I gave up the mental games there. Most bullshitty versions of the story have Hope as the gift of solace from the gods after all of the evils have been unleashed upon humankind. The original story, from the Ancient Greek, has Hope as the ultimate evil, because it keeps us being ignorant, it keeps us lying to ourselves, it keeps us from making the world better.

Hopelessness is a greater spur to action than Hope. After all, what have we got to lose?

Sorry. Just had to get that off my chest.

Edit: and while I'm being grotty, some music (warning, it's the Ballad of Hollis Brown):

It won't be me down that road though.

Saturday, 3 January 2009

Common Theme

The pills might be working. I can take a dig at the early C19th. Something I have a bad habit for. But the theme seems constant enough.

TO THE NEW MOON - Here, Dec/Jan 2009

I used to welcome you as my true friend -
  A toenail waving in the evening sky:
    You'd put the zing back in my run-down volts,
    But now your merciless appeal jolts
       My soul's unkempt exhaustion. Your command
Pricks sore; your charms I reprehend:
  I curse for peace as round your track you fly
       Once more, my shaking service to demand.
Such is my plea, that in this monthly trend,
  That I, at peace, my conscience freshly preened,
     Does not deserve the mud in your white hand,
    Nor taste of your addictive contraband.
       I speak quite nervous of your reprimand:
  Be merciful; don't play the spiteful fiend.

(cf. MARCH MOON - Exeter, Mar 1994/5?

As I walked haste-bound on, ignoring the city,
At best attempting to, and it was early night;-

Sudden the full moon reared-up over a roof,
A pale-primrose dancing, frenzied and silent
From island-cloud to cloud, apocalypso jade.
I stopped, stared silently, third-lusting,
Love-hurting, aghast finally; the city gone.

'With your easy roll-eyed reel,' I muttered,
'You have destroyed that I fail nightly to')

(cf. THE TRUE-HEARTED LOVER - Cheltenham, 1991

As field-elder whistles in the rain,
  And floods rise up to drown the river-shore,
The worshipper of water laughs again,
  To see his words washed past his heels once more;
Though bare, his feet clench in the crumbling earth,-
  Shiver as lapping grey-topped waves unseat
     His stance and plunge him in the surging lake;
Drowning in sodden glory, shouts his mirth
  For loving rain, the mist and frost, that meet
    In massive floody strength when waters break.

Then every hedgerow makes a sombre strand,
  Between the moon-grey waters of the night;
And owls fly white above the sunken land,
  Hooting their dismal song in mist-cracked light;
The votary entwined within that tune,
  Twists round his sorrowful eyes and expects
    The silence of her old remorseless trawl;
But flinches at the belly of the moon,
  Who pulls the mists up to her, and rejects
    His plea for entrance with her lustrous shawl.)

It's ok, you're allowed to laugh. I am.

Friday, 2 January 2009

Life Is Shit vs Mood Disorder

How to live through terminal hopelessness. I'm not even talking depression per se. I'm talking being aware of what it is in our human condition that any 'sane' person would get depressed by.

I'm not going to list the glooms. They are far too many. Be reassured Guardianistas, you'll starve if the shit hits the fan, as will we all. It is amplified when you have children (so spake the Guardian reader who feels the need to have a bath these days afterwards...)...

Ok, off the track already.

I have felt hopeless since I was at junior school - the playground was the setting for the scene where the brain clicked and god vanished. And the full Beckettian (Beckettish?) horror filled the gap. Nuit et Broiullard did for me the year or so after.

Since then, as a small child, the age of my eldest, who to me is just a babe, I was not-fully (how could I be at that age?) but definitely cognizant of the dreadful banality of life. I think it was fourteen or thirteen I wanted to stab a knife up behind my ear, and my parents clucked and interrogated when I mentioned it some while later (before forgetting it ever happened).

Fast forward.

It didn't get better. In many ways it got far worse. But always it felt (feels) like a race, a competition of myself against my knowledge. Sometimes I want to flop down at the edge of the road and say yes, enough. Other times I'm so far ahead of the rest of the tramping file they can't hear what I'm telling them about the lie of the road ahead.

When I flop, I remember that I can run to the front. When I'm too far in front, I flop, so I can catch up with people again, real communication, not garbled gabble.

It is too simplistic to relate a mood-disorder to a jaundiced view of the human species. The former only complicates. And perhaps facilitates survival.

I have known what it is like to flop and get left so far behind there is only the blizzard for speech, and the wind for touch. Then I eventually get up and start sprinting to catch up.

Life is a meaningless pile of dung. But it's all we have. And whatever we do with it is our own prerogative. Peggy Lee said it best, among many others:

And of course, perhaps the emergence of the disorder is simply a symptom of the life we are forced to live.

Keep safe everyone.

A Fresh Start, Perhaps a Changed Voice.

New year and all that, and when I can make up my mind, perhaps a new look, perhaps not. But everything from last year is preserved at the blindingly obvious address in the blogroll. Too many links that people I know (in real life) could track back to me. Just wanted to take those posts out of 'easy' circulation. If they want to be nosey, that's their lookout.

This will still always be my main blog. I may just 'archive' stuff occasionally. So if you're a comment freak, then bookmark the other place. I'll keep looking in.

A belated happy new year to all. D x

UPDATE Jan 11th: Put it all back again... sigh. No fucking consistency eh?

Its a new dawn,
its a new day,
its a new life for me
yeah, its a new dawn
its a new day
its a new life for me

And I hope to be feeling good.

Damn wish there was the full track on youtube...