My trip to mad world Horatio Clare

When Horatio Clare went psychotic, he was prescribed pills. In fact, he needed therapy – and to give up smoking dope

‘I had thrown booze and cannabis into the mix and gone up in a whoosh of delusions’

Irelish English terms for madness. We’re loopy, bonkers, potty, bananas, crackers and cuckoo. The merry imagery suggests that being batty is part of us. The acute personal version of madness, which I experienced two years ago, is terrifyingly dramatic. It is also rooted in language.

In medical parlance, I experienced ‘hypomania’, ‘mania’ and a ‘psychotic episode’. For weeks, I felt high, brimming with energy. Publishing two books, lecturing and supporting my family, I criss-crossed the country until my feet bled, my voice failed and my thoughts raced.

Scarcely sleeping, I came to believe that the radio could hear me, and aliens and security services were on my side. I made a hole in the ceiling of my flat, aiming to convert the whole block into a university of peace and international understanding. Convinced that world peace required me to appear to end my life, I set my car to roll down a hill and walked away from it, naked but for my boots. So attired, I informed an alarmed farmer I thought I needed help.

A thoughtful and sympathetic social worker ‘detained’ me, as she preferred to call it, under Section 2 of the Mental Health Act. I became one of about 50,000 people who are ‘sectioned’ annually.

In an acute care ward in a psychiatric hospital in Wakefield, two anti-psychotic pills, none of the booze and cannabis I had been guzzling and an enforced break from work and family led me to ‘present as sane’ (in the jargon) in two days.

I was allowed into town after nine days – thank God for the sculpture in the Hepworth Wakefield art gallery, more healing than any pill – and soon afterwards discharged.

Now came a turmoil of contradictory languages and ways of seeing. An NHS psychiatrist believed my ‘longitudinal history’ (I had been up and down before) indicated ‘bipolar disorder’, for which he advised lithium or another ‘mood-stabiliser’.

Although I understood and appreciated that medication helps a great many people, I was wary of side effects, polypharmacy (widespread overprescription, whereby you take pills to counteract pills) and a sense that the pharmaceutical road would be dangerous. Coming off lithium, for example, can leave you worse than you were.

I turned to psychology instead. My therapist, like many others, does not regard ‘bipolar’ as a useful word and has little truck with ‘disorder’.

Rather than treat symptoms, as medication does, she went for causes. It became clear that my breakdown was no mystery. I had taken from childhood deep self-doubt and a desperation to please, added years of lies, evasions and thrill-seeking to resultant shame and guilt, piled them inside me like a bonfire, thrown booze like fuel and cannabis as a detonator into the mix and gone up in a whoosh of delusions.

We used Eye Movement Desensitisation and Reprocessing – you follow your therapist’s moving finger while recalling traumatic memories, entering them on a subconscious level, addressing them afresh. It was astonishingly cathartic.

Effective talking therapies, such as the Open Dialogue approach, treat delusions as language for a crisis that you have no other way of explaining.

It would have taken me years, sane, to account for myself when mad (indeed it has – two). But, mid-breakdown, the idea of omnipotent forces who knew and understood me was a blessed short cut to a comprehensible universe.

Delusions relieved me of responsibility for the chaos I had brought on myself and my family. Spooks and aliens are ever popular delusions.

‘Once upon a time, it was probably the King or the Bishop or whoever people felt had power over them,’ a progressive consultant psychiatrist told me. ‘Now it tends to be spies and celebrities.’

Perhaps because he was not legally responsible for me, this consultant judged that my understanding – that cannabis had triggered my highs, which brought lows – sounded ‘a fair shout’.

One striking moment in hospital came when someone said that cannabis had messed him up. An adamant chorus of us agreed. Ironically, I had written a book about the effects of cannabis, 12 years earlier – which makes me an idiot who ignored his own warnings, but also an idiot who documented his own ‘longitudinal history’.

The consultant’s approach helped refute the NHS psychiatrist’s insistence: that, because I was ‘bipolar’, I ‘self-medicated’ with cannabis; that the highs must therefore precede use; and that I should therefore take pills.

Two years later, I hope my position is not a loony insistence on my being right but a quiet conviction, widely shared, that the individual matters more than the system, and that ours is failing to cope. Bipolar diagnoses have increased 4,000 per cent in a decade, while around a fifth of our adult population are on antidepressants.

I have been undramatically up and down since the breakdown, remaining dope-free, functional and as happy as the times allow.

An epiphany came in conversation with a psychologist. ‘It’s not about cure,’ she said. ‘It’s all about healing.’

And so I see myself as someone who had a breakdown, and remains in recovery. Choosing language is, for me, a way of choosing hope.

Heavy Light: A Journey through Madness, Mania and Healing by Horatio Clare (Chatto & Windus) is out now