We cannot build a society on poverty and ignorance

Panorama: Poor America

Everyone should watch this. It's on iPlayer so anyone in the UK can watch it for free, and they must. When watching it you must remember that this is the richest country in the world. I saw scenes like this on my Health Sciences course DVD, showing people in India and China and rural South Africa queueing for trains that come round twice a year to perform cataract operations. I would not expect to see those sort of scenes in the richest country in the world, the gleaming example of the developed world that the rest of the world seems to want to emulate.

Every time I see things like this I am thankful that I don't live in America. With all our problems, I still feel that I am lucky to be British. We must not try to emulate America, because this is what America is like.

Newt Gringard offering child labour as a solution to poverty made me feel sick. I don't think David Cameron would ever dare to suggest that - with all our demonisation of the poor, the unemployed and the sick I think it is fairly safe to say the people in this country would not tolerate those sort of opinions being aired in public as if they were serious economic suggestions. Child labour is a serious problem in much of the developing world, because children who are working have no opportunity to go to school and so have no chance of improving their lives. I know and have always known that having an education does not guarantee you a good job, but having no education pretty much guarantees you won't. Alan Sugar left school with no qualifications, and he's done well for himself. Good for him - but presumably he still went to school at least for a bit, so even if he didn't bother to turn up to the exams at age 16 it was probably at school that he learned how to read and write and I doubt he'd have got so far if he couldn't. Bill Gates and Mark Zuckerberg dropped out of college - again, they dropped out of Harvard, so they must have done pretty well in school in order to get in there in the first place (presumably they didn't spell Harvard with a 6, and last I checked Harvard doesn't have an international airport).

I read a DWP report a couple of years ago on claimants of both DLA and IB which said that 61% of people claiming both DLA and IB and 60% claiming IB had no qualifications at all, and only 2% of either group had a degree. I suspect the figures for people who are unemployed are similar. We know that 16% of schoolchildren go to secondary school without having achieved Level 4 in reading and 25% in writing, which basically means they are functionally (if not entirely) illiterate. Is it any surprise that children who start secondary school unable to read and write don't miraculously catch up over the next 5 years and go on to fail their GCSEs, if they can even be bothered to take them in the first place? I love languages, and think all children should learn another language, but even a languages nut like me can see that trying to start teaching children French in secondary school when they can barely read and write English is a waste of time. That time could be better spent on remedial tutoring in basic literacy. I'm aware I'm entirely overlooking numeracy here, which I do believe is important, but perhaps I'm blinkered by the fact that I learned to read before the age of my earliest memories, so I cannot ever remember not being able to read. My two-room flat contains over 500 books (we counted), not including e-books and PDF copies and my OU materials. Being illiterate feels almost unimaginable, and I have no idea how someone who cannot read can function in the UK, let alone get a job.

The problem is that education is not an overnight solution, and we really need some interim measures right now. I don't have the short-term solutions, and I wish I did. Here's a starter for ten: rather than using JSA claimants as free labour in Tesco we could say that in order to claim JSA you have to have GCSE English and Maths or an equivalent qualification in basic literacy and numeracy. If you don't, you have to enrol on a course - part of the Jobcentre's remit is to help you find one - and if you don't show up you lose your benefits (attendance can be taken quite easily). Being able to read and write will improve someone's job prospects far more than a few weeks stacking shelves at a company that obviously has no intention of employing you on a paid basis at the end of it, even if they are made to give you an interview - why would they do that if they can just ring up the Jobcentre and get sent more free workers when your 8 weeks are up?

There you go, I thought of that in 15 minutes. Apparently jobseekers are only good for 8 weeks of work, whereas disabled people can work for free forever - it says this work could include "public bodies", so how about I apply for a position helping Michael Gove sort out the education system? I'll work for ESA plus coffee. I suppose there is a time limit really, as contribution-based ESA is time-limited to one year, so after that Dorothy's minimum wage job will mean I get squat, but then I guess if you're booted off ESA you can't be made to work for free - unless you then sign on, but then only for 8 weeks at a time. Swings and roundabouts.

12% of adults with HFA/Aspergers are in full-time employment. Only 20% of people with a severe mental illness (e.g. bipolar disorder, schizophrenia, psychotic depression) are employed at all. Let's face it, who the fuck is going to employ me? And to bring us back to the original topic...in the USA, no job = no healthcare. I could never afford to move to America even if I wanted to because my medications would cost me thousands of dollars a month and I would stand no chance of ever getting health insurance because of my pre-existing conditions. In the UK I can at least get the medications that go a considerable way to keeping me alive.

Clinging on with both hands

Goldberg back up to 54. Almost feels like an achievement in as much as I've managed to get this far without doing any serious damage, or even starting smoking again.

To be honest it doesn't feel like it's fucking worth it. I know giving up smoking can trigger a depressive episode even if you don't have a chronic mental illness, but I thought after 5 weeks I'd be coming over the worst of it and instead it's got significantly worse over the past couple of weeks. I haven't been actively suicidal for so long I'd almost forgotten what it was like, and it scared the shit out of me. I tried to put it down to being drunk, that it would go away in the morning, and I don't have any intent right now (I don't think I really did at the time a couple of days ago) but the self-talk really scared me.

When I get suicidal I get the internal voice that's not quite a hallucination because I (mostly) know it's coming from inside my own head but mimicks an outside voice very convincingly and cannot be 'tuned out' as easily as ordinary thoughts - a sort of halfway point between common bad thoughts and florid psychosis. The best example I can really give is Rik's conscience in The Young Ones (S2 E5, 6:29 in the clip) - it's scathing and critical and scary, except when you're suicidal the guilt can be about anything and nothing. It can be very persuasive; what I really found distasteful this time was its implication that were I to make a serious attempt on my life, Dorothy would not intervene. This semi-hallucination preyed on the memory of when I was left unattended in a coma. Logically of course there is no way that would happen again, as Dorothy would certainly not leave me to potentially die, but the combination of that memory with near-psychosis was terrifying. I did formulate a method (I won't discuss specifics here) which was possibly fatal but became frankly bizarre as my delirious mind kept trying to cover possible avenues of rescue. From a more balanced mental position it sounds like the ravings of a madman - then I remember that's essentially what it was, and that scares me.

I don't feel suicidal right now, but I don't feel much further away from that point either. I was actually supposed to have a psych appointment today but it got cancelled and pushed back a couple of weeks, so I'm going to have to wait. I wonder if perhaps I should ring them anyway but I fear that all they'd do is send the crisis team out and (certainly in this area) they're the last people you want to have to deal with when you're seriously ill. Right now any study or music is like crawling through barbed wire and I'll be impressed if I pass Grade 8 piano - lately I've been looking forward to the exam as a point after which I'll never have to play the piano again. This is a clear sign of severe depression - when I'm well music is my life, when I'm ill I want to shut it out completely and never have to think about it again, just because it takes too much energy. I'm out of bed and I made it to the computer, what more do you want?

I don't want to throw away the 5 weeks I've managed to get through without smoking, and I really can't be arsed with my mum and/or sister whingeing at me if I do start again. I also don't much want to end up locked up because I go completely batshit. Maybe when I do see my psych he'll up my meds or something and that will help, and I've just got to try and hang on until then. I consider the possibility that starting smoking again won't help anyway, or maybe I just need to wean myself off the nicotine patches more slowly. All I can do in the meantime is keep dragging myself through each day, trying to exert as little effort as possible in the process so as not to push me over my limit. Spending last weekend at my mum's probably didn't help much in that department, but what can you do.

Triggers include: pasta

I feel pretty pathetic today. This isn't helped by the fact that as I had to be awake this afternoon I didn't take my meds last night; this usually means I can get 4-5 hours of sleep and be awake, but last night I got none. I've been awake for 31 hours at this point and just before I left for my piano lesson I discovered I couldn't find my keys. Thankfully Dorothy had left her key to the flat so I could lock the flat and the guy in the flat upstairs told me to take out his spare set that he leaves with us so I could sort the front door to the house. That really jolted me when I was already knackered, having tried and failed to sleep for about 8 hours and I was very close to going and buying some lovely fags. I haven't smoked for a month and I just managed to resist...just. I still really want a fag but I figure I'll probably feel a lot better tomorrow so I'll leave thinking about breaking until I've had some sleep. The end result of all this is that I feel extremely fragile today and ended up sobbing into the pasta I made for lunch.

I sometimes make myself pasta with cheese and ketchup for a meal as it's fairly easy, relatively nourishing and filling. We are nearly out of ketchup so today I made the pasta with the Thai sweet chilli sauce I got from the 99p shop. I love sweet chilli sauce, as I love sweet and sour sauce. The reason I ended up sobbing into my pasta was that the colour and the tiny specks of chilli in the sauce reminded me of the pasta I ate at home, the dinner my dad prepared for me every day. Every day was an enormous serving of pasta, covered with Sainsburys sweet and sour sauce with extra pineapple. He insisted I wouldn't eat anything else, and that's partly true - I didn't eat anything else he prepared because it was frankly dangerous. My mum finally had enough when he served her undercooked fish and seafood and then got angry when she pointed out it wasn't cooked. She, understandably, got rather irate and said he was trying to poison her. I put that down to (what he always told me were) her insane ramblings, and also I thought he was too lazy to actively try to poison her. I know more about my father and about their relationship than I did then, and while I don't deny my mum does suffer from some fairly erratic paranoia I think it wasn't beyond the realms of reason that he would be deliberately making her ill. The pasta wasn't always cooked properly, and I often got stomach pains from trying to digest semi-raw pasta, but I knew eating undercooked pasta was unlikely to kill me so I went with the safe option.

I remember being upset that my dad used to call me, my mum and my sister fat, especially as he insisted on cooking all the food. It took me years to understand; to be honest it's something I'm really only just fully understanding that food was another way of controlling us. My dad was unquestionably anorexic, and I always put that down to why he would shout at me and my sister if we tried to make our own food. I remember my friends at school being perplexed as to why the hell I didn't just make my own food, when I came to school with beard hairs in my sandwiches and mentioned my rather restricted diet. To be honest, I was perplexed too, but at that time I was understandably pretty scared of my dad and I knew pissing him off wasn't a great idea. I accepted the food to keep the peace, and I honestly didn't understand how feeding me in that way was a way of exercising control over me and my sister. He knew we didn't respect him or see him as any sort of real authority figure, even if we were unnerved by his seemingly random outbursts. He didn't believe in hitting children, though apparently hitting his wife was perfectly acceptable, so we weren't on the receiving end of physical violence ourselves but we got the backwash from the violence that did go on, not least in the form of my mum's slap-happy hands and kick-happy feet. He knew that my mum completely ignored everything he ever said in relation to parenting, arguing that frankly he had no right to speak on any matters relating to the children he had done nothing to raise. His contributions to parenting include making my sister cry on Christmas Day and trying to guilt me out of staying at my private school for sixth form so he could siphon that tuition money off for himself. Food was the only thing in our lives that he could solely control, and he grasped that opportunity with both hands.

I never put two and two together until I was an adult, until other adults who knew a bit more about abusive households started pointing things out to me. I remember as a kid watching the NSPCC adverts, the black and white images of silent children with voiceovers in a solemn voice which urged people to donate money to help change the lives of these poor children. One that I always remembered was a child searching through a bin, with the words, "Tonight, Rex will have to find his own dinner again." Children going hungry is something that gets me teary-eyed, and I was always grateful that I wasn't in that situation. I somehow failed to realise that I had been. I remembered from a young age being so happy when Mummy came home from work, so proud that I had made my own lunch and behaved and entertained myself all day. Daddy was upstairs in bed - the second those words came out of my mouth Mummy erupted in rage, quite understandably. I always thought I was about 6 when this happened; when I mentioned this to my mum she said I was more like 3. People might be shocked to think of a 3 year old child being left to feed himself all day because Mummy was at work to buy the food and Daddy was upstairs sleeping off a colossal hangover. It didn't shock me because it was just something that happened, like knowing that he was thrown out of betting shops for taking me in there as a baby. I've never been in one as an adult, but I'm assured they're no place for a baby and I also hear it's rather difficult to get oneself thrown out of the bookies, so that behaviour must be fairly shocking to others. Maybe it was just because I kept cheering after the races had finished and put people off, I don't know and I never will, but I like to think it was maybe because someone in there had a shred of human decency left.

I don't want this to seem like I'm looking for sympathy for my sob story. This is just catharsis; sometimes I need to let this shit out or it eats me up. I know I am lucky that I at least had one worthwhile parent, so there was actually food in the house that I could scavenge, when so many other children put in that position have no food for them to even find for themselves. Sometimes, like when I'm looking at my bowl of pasta and it all comes flooding back, it makes me sad. More often, it makes me really fucking angry. I remember the night when my dinner was a plate of curry sauce - no rice, no pasta, just a plate of curry sauce with three or four small chunks of chicken floating in it. I was about 18 at this point, I must have been because I didn't eat meat between the ages of 12 and 18. What really incensed me about this was that I was given a fork to eat a plate of sauce with, and got a mouthful of verbal when I asked (probably fairly sarcastically to be fair) if I could please have a spoon. I may have added that he could at least have put it in a bowl - this to me was the final insult. That was the point at which I stopped feeling confused and even sorry for the poor man ravaged by an eating disorder and decided he was just taking the piss. Admittedly this revelation should have come a few years before, when my then young sister (somewhere between 7 and 9 I think) asked Daddy for some lunch and he presented her with a bag of crisps. Unopened. On a plastic picnic plate.

It is one thing to give a child a bag of crisps for lunch. That I can almost let slide. Maybe putting the crisps on a plate might be a constructive way to avoid crumbs everywhere, so I can even see some sense in that. But presenting a child with an unopened bag of crisps, on a plate, handing it to her like some lovingly prepared meal with a fucking smile on your face, that just made me sick. I was so disgusted that I snatched it away and went and made her a sandwich, brought back on the same plate - I think I unbagged the crisps and put them on the plate next to the slightly more substantial meal. Did my dad thank me for feeding his child for him? Did he fuck. I got a mouthful for implying that he was at fault in some way by making a child some lunch with malice aforethought. I now understand he was pissed off because I had taken back some of that control. I may not have understood the logic, but I knew that someone had to do the second parent thing because my mum worked 12 hours a day (8 paid and 4 travelling) to provide for us and put a roof over our head. The least I could do was help out with my sister. This may have caused me problems later on, like when I had to go into school in the holidays to do coursework and ask my ICT teacher nicely if I could bring my sister because I couldn't leave her at home - well, not exactly alone, but without me - and thankfully my teacher agreed. I did have to leave her behind when doing the same thing in Spanish and got a bollocking for it.

It's hard for me to transition from a sort-of-dad role to just a normal older brother role, now my sister is old enough to not need me to meet her daily needs like bathing and eating. I know how parents feel when their precious little angel is no longer an adorable little child but a grown woman or man, with thoughts and feelings and priorities that have nothing to do with you. Every good parent aims to make their children self-sufficient; I think raising children who can successfully live independently is one of the hallmarks of a good parent, even though being able to do that doesn't necessarily mean you had good parents and you may just have had to figure it out by yourself. It's still hard, when you're sitting alone with a bowl of pasta and that forces you to remember. And you really, really want a fag.

'Normal' is not a compliment

Since I've been diagnosed I've had a few people say to me that I don't seem that autistic, or I don't come across as 'noticeably' autistic online. This gets on my tits a bit, mostly because I think it's supposed to be a compliment. Congratulations are in order because I can seem normal, at least on the surface, but the undertone is "you are lucky because if I could tell I would consider you less mentally capable/less valuable as a person/unsuitable to be in contact with.". It's the same way that if a cis person - often a virtual stranger, probably because most of the people I know well wouldn't be so rude as to comment on it in public - says, "You pass so well", I generally hear "and I feel distaste or hostility towards people who don't" following it in my head.

What also annoys me is that most of these people who make these comments know bugger all about autism and probably have never met someone (they knew to be) autistic, or maybe they know one or two autistic people so they feel able to make comments. This is because people who do have a wider knowledge base about autism tend to pick up on my traits, though they'd probably not be so rude as to point it out. It's probably also true to some degree that some of the people who say I don't seem autistic have noticed my traits but they don't know enough about autism to recognise that those are autistic traits. Equally, other trans people are more likely to be able to read you as trans because they're almost invariably going to have had a lot of contact with other trans people (and of course everyone knows everyone so they've been to a conference with your best mate or shagged your ex). I've had cis guys insist I'm a lesbian but I don't think I've ever had a stranger identify me as a trans guy, probably because a lot of people don't even know that FTMs exist.

Generally passing is expressed in (linguistically) negative terms - you pass because you don't do X rather than because you do Y. I generally use positive terms because the list seems to be a lot shorter. I generally reckon I pass as male because I have a beard and a voice in an appropriate register, and I bind my chest - that seems to do it for at least 90% of everyday situations. I pass as neurotypical (I think) because I speak in sentences, I can generally express empathy and have delayed echolalia rather than immediate. I also can't multiply six-digit numbers in my head or instantly know the day of the week of any date in the last 400 years. People who find that I communicate well in internet forums probably wouldn't expect that writing this post of about 500 words has taken me nearly an hour, and writing a comment of a few lines on a forum thread may well take me just as long because it has to be part of a wider discussion rather than just rambling off in whatever direction I choose as I can do here. They've also never accidentally gotten me onto the subject of North Korea or video games. :)

If you praise me for passing as (what you see as) normal, I won't take it as a compliment and will probably feel uncomfortable around you because I worry about how you judge the people who don't pass as normal (as you see it). I know so many people who are visibly outside those boxes that I can't feel good about being sneaked under a blanket into the 'normal' world - obviously on the understanding that I never reveal to anyone that I'm not really one of them - because that pulls me away from my community where 'passing' is not a virtue; it may be an aspiration for many, generally because it makes you safer in the wider world, but it is not the sole entry criterion and it is not all you are judged on.

Probably the only thing I really do love about passing, apart from increased physical safety, is not having to answer 20 million questions every fucking day and wanting to respond to at least 19.9 million of them by punching the enquirer in the face. I can advocate and educate because I want to, not just because I am forced to.

Naturally nocturnal

I am nocturnal. I know a few people who have had insomnia from a very early age, who probably have what is called Delayed Sleep Phase Syndrome rather than classic insomnia. This is where your body clock readjusts itself so that you generally go to sleep between 2am and 6am and sleep fine - if you are permitted to do so. Obviously this can cause great difficulty functioning in the 9-5 world, and is a particular problem for children who need to conform to a school schedule. I spent most of my A-levels getting four hours or less of sleep a night, and I'm certain the chronic sleep deprivation contributed to my most dramatic mental breakdown at the age of 19.

There are treatments for sleep phase disorders, but they are very involved, expensive and require constant maintanence treatment to avoid 'relapse'. For some people the benefit may outweigh the cost, if their sleep pattern is causing them distress and creating major problems in their lives. However, not everyone wants to take this route, preferring to adapt their lives to their sleep pattern rather than the other way around. If so, they may experience pressure to conform - I have frequently had my doctors treat a maintained diurnal sleep pattern as a measure of success in my mental health treatment. The fact that I can function well at night does not seem to come into it.

Being diagnosed with autism as an adult, I avoided any of the practices inflicted upon children in order to mask their typically autistic behaviours. There is no cure for autism - the 'treatments' such as Applied Behaviour Analysis can only make an autistic person act in a certain way based on what the professionals and parents consider socially acceptable. Some people - mostly autistic adults rather than parents of autistic children or many professionals - argue that autism is not a disorder which needs intense, extensive and often unethical treatment in order to eliminate many benign behaviours just to make the autistic individual appear more 'normal'. A lot of people comment that I don't 'sound' or 'seem' overtly autistic, yet my psych describes my autistic traits as "blindingly obvious". Most people don't know a lot about autism, their mental image consisting either of Rain Man-type savants or mute children who flap their hands constantly and 'live in a world of their own'. I can speak and I don't flap my hands constantly, therefore I can't be that autistic.  I suppose I don't seem that mad on a day-to-day basis either, due to being heavily medicated, but I still am and if I were to stop taking the medications then the symptoms would return and scare the shit out of people like they used to. As I am I cannot really pass for normal, but I can pass for eccentric and while that caused me great difficulty as a child it doesn't seem too bothersome as an adult, probably because I can freely choose who I associate with rather than being locked in a building with a bunch of people the same age who I have to get on with or face total social isolation.

Basically, I can't be arsed to go to great lengths to make sure my sleep pattern conforms to 'normal'. I've tried it and it gets on my tits and generally makes me feel unwell if I try to do it for any longer than a few days. Some people might call that lazy, and maybe they're right, but right now I am not suffering any detriment due to my sleep pattern. Dorothy pointed out that I have no pressing need to have a strictly diurnal sleep pattern, so why not just go with the flow if that's what makes me feel better?

My sedative medications allow me to alter my sleep pattern on a short-term basis, as they can knock me the fuck out if I take them at the right time. If I need to be up early for some reason, I take my bedtime meds at about 7.30pm. This allows me to get up at around 7am - I call it the 12-hour window, wherein I do not have to sleep for 12 hours but I need 12 hours between taking the meds and being functional. Intriguingly the 12-hour window does not seem to apply if I allow myself to work with my natural nocturnal sleep pattern, and I wake up feeling pleasantly refreshed rather than like some form of zombie. The major adaptation I have already made to make my life easier in this respect is studying for my degree with the Open University - I do not have to go to 9am lectures every day and I am generally thriving academically as a result of the simple change which allows me to study in an appropriate way. An OU degree is by no means easier in terms of work or academic standards than a degree at a brick uni - in some ways it may be more difficult, given the high number of assessed assignments and the unusual non-averaged final marking scheme - but the method of delivery makes it accessible for people who would otherwise be unable to study. I see no point in making my life difficult for the sake of it, it is difficult enough already. I have felt so much better for the past couple of days when I have gone with the flow of my natural sleep pattern, so I think I'll stick to this for a while.

Echolalia and accents

I always wondered how I managed to develop a flawless American accent as a pre-school child. My accent was so perfect that people asked my parents if we'd spent a lot of time in America - or alternatively just looked utterly cabbaged when they heard that accent from a child living in the West Country, surrounded by British English speakers and never having even met a real-life American. My parents put it down to the amount of TV I watched, but I have never heard of another child developing an American accent from watching pre-school cartoons.

Sandy at Aspie Teacher wrote this post about how her perfect Korean accent convinced other parents at Korean school that she must have been born in Korea, which she wasn't. This perfect accent was the result of echolalia. This revalation made me want to jump with joy! That's why none of the other kids had an American accent even though they watched TV too - they weren't autistic, they didn't repeat the same phrases over and over again until they could parrot them perfectly, right down to the authentic accent. I wasn't some kind of weird space alien uniquely susceptible to the dulcet tones of the American accent from the television despite being firmly immersed in interaction with British humans. Obviously I didn't know what echolalia was when I was 4, and neither did my parents. Mum and I used to (and still do) watch shows like Blackadder and Bottom over and over again, and even though I can repeat the script of pretty much every episode word for word I still love watching them. I can mimic the tones of voice and the exact length of each comic pause, and I swear the only time I can roll my Rs properly is when saying, "Put a bit of sellotape on the fridge!" Comedy shows to me are what standards are to jazz musicians; a source of material to pick from and use at an appropriate time in an exchange, in this case of words rather than music. When I was very little my attention - and endless vocal repetition - focused almost solely on children's entertainment, which as we had Sky was primarily cartoons from the USA, as in those days CBBC and CITV were on for about two hours a day whereas the cartoon channels were on for 12 hours, and some even continued into the night (I had a 2am-10am sleep pattern as a toddler). Not quite the 24-hour schedule may of the cartoon channels have now, but a damn sight more than the British channels had to offer.

The accent waned once I started school, because I was in contact with more British English speakers and by the time I started high school I had a clearly identifiable West Country accent. After not living there for five years people around here can generally tell I'm not from here but can't always place it immediately, though it always clicks when I tell them. I giggled earlier at my sister describing Stephen Merchant as sounding 'posh' - I pointed out that this was posh for Bristolian, which is a bit like 'normal for Norfolk'. The Bristolian accent is not usually regarded as sexy or sophisticated, and you have to spend your life listening to people mispronouncing the word 'trac-der' as 'tra-er', but it's better than sounding American.

Excrement-covered glasses

I've felt like absolute shit for about the past week. Not consistently, not all the time - it's one of those episodes where you can't see any point in getting up, start feeling semi-alright in the late afternoon/early evening and then feel crappy again in the early hours of the next morning when you realise that you have to go to bed and then get up and do it all again tomorrow.

Just did my Goldberg score, came out at 32. Last year around this exact time (before I started on Seroquel) I peaked at 58, so there's a significant improvement which I don't deny, but 'mild/moderate depression' is still unpleasant and has an effect on functioning. I think part of this is due to giving up smoking as that can apparently trigger depressive episodes, especially in those with pre-existing mental health problems. Another part of it is the typical December/January dip - I managed to avoid the August/September paranoia this year, was almost starting to think I was going to be stable for a sustained period. I'm more stable, I might actually be down to one episode a year, but still not completely stable and I wonder if I ever will be.

I also don't know how much of my day-to-day issues at the moment is because of my bipolar depression and how much is because of my autism. A lot of people point out that autism isn't something you can separate from the individual, you wouldn't be the same person without it. Some people say the same thing about mental illness; Stephen Fry wouldn't push the button, I probably would. There are a lot of good things in my life that have come about as a result of me going absolutely batshit crazy for a few years, but I'm not entirely convinced by any argument that claims 'whatever doesn't kill you makes you stronger'. This is blatantly false, but it's one of those empty platitudes people like to offer to those who are suffering, as if there is some cosmic justification for their pain. This is of course total bollocks - it would require the presence of cosmic forces for which there is no evidence of existence - but it sounds better than 'life just sucks', however irritating the empty platitudes are.

While it is true that most people will probably survive a depressive episode, at times you quite frankly can't be doing with the effort of doing so. I am definitely not suicidal right now, but I am having quite a bit of the 'my future seems hopeless' bit. I have completely lost all interest in music, which is rather risky when my Grade 8 piano exam looms in a couple of months. I know I will have to drag myself to the piano stool eventually, but it's such a strain to try to concentrate and to coordinate your limbs and digits which are sluggish and unresponsive. I did briefly consider starting smoking again and then giving up once I've finished my Grade 8 exam but if I'm in an episode anyway that won't help a great deal and I'm really trying to give it a go. I said I'd give up smoking once I stopped self-harming, and only having done that twice in the past couple of years I'd say that demon is pretty conclusively exorcised - at least for the moment, providing there isn't some kind of horrifying relapse, which is unlikely based on empirical mood patterns and the vast quantity of meds I take but is still possible.

I want to give up smoking in part because I do know it will eventually kill me if I continue to do so. Almost every member of my family who smoked died of a smoking-related illness, usually combined with alcoholism on an almost impressive scale. The combination of the two is what led to my aunt dying at 50 (yes, fifty), my grandad at 61 and my dad at 70. The family members who smoke but aren't alcoholics are still alive (with the exception of my gran but she was 75 or thereabouts when she died, only a couple of years short of the national average at the time) all have varying degrees of respiratory problems which affect their quality of life and I don't want that to happen to me. Admittedly most of them smoke at least four times as much as I did up until January 2nd, but that doesn't mean it won't happen to me. Giving up smoking doesn't guarantee a long and healthy life, but best not to take chances really.

I have often felt conflicted between the idea that my mental illness creates a rather precarious position regarding my mortality and the fact that I almost seem to be invincible. I was told when I was 18 that I should have died at least twice by that point. When I was about 20/21 (I can't remember exactly) I overdosed on nitrazapam and was in a coma for five days. That's scary enough as it is; what makes it worse is that Gary did not call an ambulance, or my GP or CPN or even tell anyone else what was happening. He left me in our bed, without any medical assistance, for nearly five whole days (I ODd on Sunday night and woke up Friday afternoon). I could so easily have died it's terrifying, and it makes my blood boil thinking about it. What's really depressing is that it didn't even occur to me at the time that that was what he should have done, it only occurred to me a couple of years later. I think this is where the autism comes in - I have never been a particularly good self-advocate, I tend not to be sufficiently critical of the motives of people I know and when people are hurtful towards me I generally can't understand why. I may figure it out logically, over a period of anything from days to years, but I don't notice things in the same way other people do. It's always easier to see reality when you're outside the situation, and I know that many people would recognise something like a friend's toxic relationship long before they would notice their own, and my neurology increases this problem. To this day I can say, "well Gary did this because of XYZ" in a purely objective and logical way but I still can't answer the 'why' question in an emotionally satisfying way.

Obviously I'm not invincible, but it seems I have survived against the odds on a number of occasions with little or no support. I still sometimes get annoyed that nobody clocked that I was autistic or had bipolar disorder, even though both have been described by psychiatrists as "blindingly obvious" once the facts were presented to them in a clear and comprehensive manner. I think on the whole Darren Hayes was right when he sang, "I believe your parents did the best job they knew how to do", and I know full well that at the time I really started losing it neither of my parents were in a position to make a positive contribution to my emotional wellbeing. My mum comes from such a neglected and abusive background - as well as having autistic traits herself - that she simply didn't know for many years that my, or indeed her, behaviour was in any way abnormal. She simply did not know that things in my early childhood which a psychiatrist picked up on immediately as being clear autistic traits were something to worry about, or how to get help if she was concerned. My dad's attitude to parenting, to quote Neil Morrisey in Men Behaving Badly, was not that he wanted us to be unhappy but just thought that his own happiness was more important. That doesn't excuse his behaviour, but an alcoholic with vague mental health issues (what exactly I have and probably will never get a proper answer to) and rapidly failing physical health is not someone well placed to be making a cup of coffee, let alone dealing with a transsexual aspie teenager who is dangerously mentally ill. As a result I was not diagnosed with ASD until 23 - I was 19 when I was diagnosed with bipolar disorder but in fairness that diagnosis isn't generally made until adulthood anyway.

Going to an all-girls school also forced me to pick up on at least enough rules of social etiquette to survive, if not thrive, in such a socially-orientated environment as a group of 500 teenage girls shut in a building together for 8 hours a day. I suspect things would have been picked up a lot earlier if I was a cis guy who'd gone to an all-boys school as the level of detailed social rules needed to function in that environment is considerably lower. It is well-known that girls with ASD are generally diagnosed later than boys, probably in part because the social world is so much more complex that they have to learn to cover it up better. Hanging around with the music crowd also helped; eccentricities among musicans are generally well tolerated and even expected up to a point. This is part of the reason I plan to go into music teaching; it is well acknowledged that you have to be at least a bit mad to do so, and if not you soon will be. I feel this is something I can realistically succeed in professionally - private rather than classroom teaching, obviously. Classroom teaching for someone who experiences sensory overload, cannot follow multiple forms of sensory input at a time and does not cope well with purely verbal instructions (plus about 50 other reasons I can't be arsed to list) would be torturous. One-on-one I can cope with, 30 I cannot.

What concerns me, especially in these sorts of episodes, is whether I will be able to both work and take care of myself. I struggle with remembering and consistently doing things like showering and brushing my teeth. Trying to keep up with basic chores - laundry, washing up, cleaning the fish tank - and study at the same time is very challenging. Getting up in the morning can be damn near impossible sometimes. My opportunities for volunteer work are limited by the fact that I simply cannot deal with groups of people. I am slightly nervous about the Sword of Damocles that is the IB/ESA migration, less so now Dorothy has a job so we won't be without any income if I lose it but it's still worrying that I have no idea when it's going to happen and what the outcome will be when it does. I would love to be able to set up my teaching practice before that happens in order to spare myself the stress but I don't know if that will be possible, especially as the transfer could begin any time between tomorrow and March 2014. That's a very long time to be waiting nervously. Whether I will be able to sustain the logistics of a teaching practice, whether I will be able to acquire and maintain enough pupils to create a sufficient income to live on without going mental again, where exactly the 'too much' boundary lies and whether I can take care of myself and my future family while I do are questions that it is impossible to answer before I try. I'm terrified that it'll all go tits up and that I'll be worse off than before. I don't particularly want to be a houseperson forever, but that may be what I have to do and quite frankly that is depressing in itself.

At the moment I just don't know. I don't know what's going to happen, I have no idea what is feasible and I fear I will become really ill again or be unable to look after myself. I generally try to avoid this train of thought by focusing on the present, but at the moment the present is pretty shit so my mind wanders. Unfortunately the future is also being viewed through shit-tinted glasses, and I know this and know that my decision-making ability is affected when I am ill. This generally leaves me in a complete daze where I feel totally detached from reality and all I can do is try to distract my brain long enough that I don't feel too hopeless or think too much. Come on, let's do a Sudoku.