No holidays. None. Ever.

I originally wrote this piece for a minor publication and, having just re-read it and then tried to stiffen my upper lip, I thought it worthy of a wider and more enlightened audience. Luckily, with Elitistreview I have an organ of enormous proportions and great appreciation at my very fingertips. It is not about food or wine, but that’s fine – as you know, dear reader, diversity is the helping of San Marzano tomatoes in the mozzarella caprese. Tonight’s topic is mental health.

I have paranoid schizophrenia and it pretty much dominates my life. It’s not my chosen occupation; indeed, I developed it just after I’d finished my doctorate in epidemiology and so atomised my childhood dream career of being a biologist. It’s a shame as, back then, before my mind was filled with voices, delusions, paranoia, hallucinations and thoughts of killing or hurting myself, I used to be quite brilliant and startlingly good at epidemiology. Now I’m a nutcase and the longest job I’ve managed to hold down since going insane has been a few weeks. These were always followed by suicide attempts and stays in the loony bin.

Hell isn't other people, it's my mindWell, I say I hardly held down a job but that’s not true – paranoid schizophrenia is serious work that occupies me always and will do forever. No holidays, no quick breaks for a crafty pint, it’s always there. The voices always shout horrible abuse at my and tell me, in luridly unpleasant terms, that the whole world hates me me and wants me to die in painful ways. I always see nasty, hairy rat like things running around and I know one day they’ll eat me alive from the inside. I know that you, kind reader who has made it this far, are reading my thoughts in order to construct some fiendish method for my demise. And so it goes on. This may all sound fanciful and you may think “Well, you can tell that’s not real, right?” but looking through my eyes and experiencing in my mind it’s as real as the screen in front of you.

I’ve had a particularly rotten time of it over the past few weeks. Last night a horribly be-fanged demon was sitting at the end of my bed and the voices screamed if I called my partner in from the next room to comfort me it would spring at me and eat my face. That presented quite a dilemma; I’m glad after only half an hour of lying there sweating in silent fear my partner came it to see how I was doing. There’s been a lot more of that and a lot worse recently.

I don’t suppose anyone has made it down this far, and if you have you probably want me eviscerated with machetes. However, if you have please remember this: if someone tells you they have a serious mental illness they are not layabouts, they work much harder at what occupations have been unwantedly forced upon them and they never, ever get a holiday from it.

  • Jonathan Kalman

    Thank you for this starkly clear commentary on your illness. Members of my family have suffered from mental illness and it is extremely difficult to convey with what they have to contend. The more real information available the better.

  • Thank you for dropping by and commenting, Jonathan. I could say that I had to get my partner to read your comment and repeatedly reassure me it wasn’t some deviously constructed attack on my character, but that would probably be churlish based on what he said. I’m really sorry if the article (or this comment) didn’t work for you, or anyone else for that matter, I’m really psychotic at the moment and even saying coherent sentences is a challenge right now. Sorry everyone.

  • Jonathan Kalman

    David, nothing to be sorry for. Perhaps I was not clear enough. I thought the article was very good and I much appreciated your writing.
    Best wishes,

  • Don’t worry, I’m just very confused. Thank you for your kind words about my article. Now I read it again it’s quite good, if a bit… erm… harrowing. But then, that’s the experience…

  • bags

    Dear David,

    All your readers are in awe of your extraordinary courage.

  • I’m not sure they are, bags old bean. If they were I might get sent more pickled onions, German Riesling and, who knows, maybe on one happy day a lucrative advertising contract!

    Anyway, I hope this article did something positive for you and you continue to make your kind visits to and comments on my carefully developed organ. Thank you.

  • Very great post. I simply stumbled upon your blog and wanted to mention that I’ve really loved browsing your blog posts. After all I’ll be subscribing in your feed and I am hoping you write again soon!

  • There are many frightening things about being a paranoid schizophrenic. The voices I hear inside my head are the most constant, but there are other, non- psychiatric parts of my life that scare me just as much.

  • My therapist today told me they were thinking of changing my diagnosis from schizoaffective to Paranoid Schizophrenia. I’ve always been “bipolar”. I don’t really know what to think about this change, and when asked I said that. I get the paranoid part, I’m still paranoid a bit after leaving the hospital on Wednesday, and I’m still hearing a little bit of the voices. I just don’t know what they would do with the bipolar part. The bipolar hasn’t really acted up lately, I’m crediting my current med load of 3 antipsychotics with keeping me at an even keel. I just don’t know what to think. How do you handle this change, it seems like a huge leap that i’m encountering and i’m a bit afraid of what it really means in terms of my long term mental health.

  • Stephan, I’m sorry to hear you have these problems and that you have been in hospital. I wouldn’t worry about the diagnosis change, I’ve had several – largely dependent on the degree of ineptitude displayed by the quack psychiatrists the NHS managed to get to work in shitty areas of London. The most common and current is paranoid schizophrenia, but schizoaffective has been frequent too. Anyway…

    A diagnosis change like that will not change how you are treated to any major extent. They are both psychotic illnesses that are treated in more or less the same way.

    I could be cynical and say that both are diagnoses that medical professionals will view as ‘problem patient’ labels. These mean you’ll get treated like a third class person and every illness you have will be put down to you being delusional even when it gets to the extent that it will have a deleterious effect on your lifespan. But hopefully you don’t live in South East London, you’ll get taken seriously and, unlike me, you won’t end up dying early.

    Anyway, as I said both diagnoses are treated pretty much identically by medics – thing won’t change for you because of the different diagnosis and you are still the same person whatever label some people decide to give you. What I would suggest is you push strongly to get a decent period of Cognitive Behavioural Therapy; several months would probably be required if you are a hospital visitor who hears voices. CBT has helped me immensely, I’m going to be talking about it on the BBC next month, and if you really commit to trying your hardest at it’ll most likely improve your life no end. It would probably be a more wise thing to do than be on three antipsychotics at the same. Treatment like that is novel at best and seriously ill advised at worst. Mutli-neuroleptic treatment is an emerging science, by which I mean no one knows what the hell they are doing and it’s probably terrifyingly dangerous.

    Really push for a course of CBT or Dialectical Behavioural Therapy, they’ll help. If you are interested, here’s the talk I gave in the Houses of Parliament on talking therapies.

    Good fortune to you.

  • Orla@orlatweets


    I made it to the end, my only complaint? I could have read more.

  • I’m sorry you’ve been having such a time of it but you must know your bravery and honesty does give hope to others, or at least a reassurance that they are not terribly alone. I have recurring dreams that I am being bitten by rats and I shudder to think how terrifying this must be in waking moments. I do wish you will have some relief very soon, it’s painful to read this and know that you are suffering so. Stay strong. S.

  • Your bravery and honesty are sterling, Davy