Edward - Interview 10

Age at interview: 59

Age at diagnosis: 20

Brief Outline: Edward, 59, was born in Australia and diagnosed with schizophrenia aged 20. A former head teacher, he took early retirement for health reasons and now stacks supermarket shelves. He believes his condition is caused by genetic and environmental factors.

Background: Shelf stacker in retail, divorced with 1 adult child. Ethnic background/nationality: White Welsh Australian (born in Australia, Welsh father).

More about me...

Edward, 59, is a former head teacher who has worked as a shelf stacker in a supermarket since taking early retirement due to ill-health. He was diagnosed with schizophrenia aged 20, and has experienced depression. 

Edward describes schizophrenia as a chemical imbalance related to the fight or flight mechanism which affects emotions and perceptions. Edward believes his schizophrenia arose as a result of genetic and environmental factors' Edward's mother had schizophrenia and he was raised by his grandparents. Edward first met his father when he was sent to the UK aged 7. When he was sent to boarding school, Edward felt isolated and like he was being punished. 

He returned to Australia aged 20, where he experienced his first episode of psychosis which he believes was triggered by the shock of meeting his mother for the first time combined with the shock of migration. Edward began to doubt his capacity to stay well, leading him to seek help. He voluntarily went into hospital and had electro convulsive therapy which helped, but led to some insignificant memory loss such as his pre-migration farewell party in England. He took medication (Stelazine and Kemadrin) but believes tablets only offer “temporary relief”, unlike talking therapies which move you forward. Edward identifies more with British culture than Australian, and describes finding it difficult to explain his culture to his (Australian) psychiatrist. 

Edward took early retirement for health reasons because he was feeling depressed and suicidal. Edward says losing his career and professional identity made him ask “what am I now?” and it has taken him 7 years to re-establish himself. He says his identity was also affected by his migration back to the UK, and this added to his feelings of isolation. Edward has had a very positive experience of mental health services in the UK - feeling understood and believed was crucial. He advises professionals to let people talk and make it clear that they're believed.

Edward urges people to not feel afraid and recommends that they find a psychiatrist they empathise with and can explain things to, listen to their doctors and nurses, exercise, eat a balanced diet, keep in touch with friends, avoid alcohol and perception altering drugs (e.g. cannabis) - Edward does so in order to safeguard his sense of reality. Warning signs for Edward include excessive paranoia, depression, persistent general anxiety, excessive thirst, mixing up words and loss of function. His self-awareness (aided by monitoring his thoughts and progress in a diary) has enabled Edward to avoid another episode of psychosis. However, Edward recognises that when depressed, it's difficult to have enough self-esteem to undertake this “repair job”. 

Edward now sees schizophrenia as a kind of gift or “enabling disability” that gives him insight into other people's feelings and situations that others don't have. Although it's taken many years and has been difficult to achieve self-acceptance, Edward is happy and proud to be who he is.

Edward feels people need time to talk and says challenging the patient's delusions may undermine the psychiatrist's authority.

I'd say to the psychiatrists when you're dealing with someone like me, don't argue with the main delusion or the main prevailing delusion talk about something else until the patient has calmed down about that main delusion okay because the people out there in the public, you know, the ones who haven't had the training they'll always confront the main delusion say looks that's not right, you know. Like my son was deluded that you could get online without plugging in the phone and all this sort of thing, you know, because he was looked at the saved images from the, I forget what it's called that file that saves the images of the last website you went to. So you mustn't confront his or mine or anybody else's main delusion, you must steer away from that main delusion and concentrate on other things and let the person talk, okay? That's the first thing I would say and then the second thing is make it clear that you believe what they say, very clearly that you believe what they say because if you show or hint that you don't believe what they say then that's, then you've undermined your own authority in their eyes and therefore that makes the repair process a lot, a lot more difficult and a lot more long term. that's all really.
 

Edward calls his recovery a "major project"; he says recovery takes a long time but it's worth it.

I think it's fallacious to think you know something has gone and it will never come back. I don't mind accepting it. You see this is another thing, the self acceptance takes a long time because of all the stigma out in the community and in your own head space, you gain from your relatives and so forth, inadvertently when you're little. So, you know, it takes quite a long time to accept yourself as, because you can't see it with a camera, you can't measure it with the thermometer, you can't measure it with a ruler, that's what I'm saying. But the important things are the things you can't measure, okay? And well I'm happy and proud that I am what I am actually, quite honestly and but it hasn't been, it doesn't, that doesn't happen automatically you've got to really say look after yourself and work on yourself. And, of course, I've lived alone for years you know, that's what I said in my little spiel there, the talktative hermit, you know, you wouldn't perhaps think I live on my own to talk to me but I do, I've lived alone since my separation. I've lived alone since the 11th November 1990 more or less. Now that's quite a long time, hey? So you're looking at a lot of, a product here of a lot of soul searching, a lot of, a person who's spent a lot of time weighing these things up and trying to get the difference between reality and delusion and waiting and waiting and waiting and writing in the diary and all this kind of stuff as well as trying to eat the right kind of food and exercise a reasonable amount and so forth. there's been quite a lot of work, you know, so, so I'm talking to you at the end of a kind of a major project that's lasted about 17 years, you know. 

And I won't say I regret the project, I'm very happy with the outcome but there were times when I wonder whether it would ever end, you know, whether I'd ever get to the fog sort of clearing and the cycle of, you know, okay one week and not so good the next, whether the cycle would ever end and I don't ever sort of get a chance to look at the view. But anyway, I'm looking at the view and it's alright so it was a project and it did last a long time. I wouldn't want, I don't want anyone to think it was easy but then again I don't want anyone to think that it was [intake of breath] too difficult to do. I mean it's a pleasure to do something like that because whoever I, whoever you are, whoever you are. Is that alright?

Yes

Whoever you are you are the beneficiary of your own strategy, you're the beneficiary of your own self help and therefore when you get to the outcome you feel much more edified by it than if it was imposed upon you by your parents or your teachers or somebody else, it's something you've done for yourself and therefore you feel really happy and proud that you've succeeded in well, breaking the code or whatever it is. It's like the enigma code, you know, fiddling around, this way and that way, and yeah it's good I feel glad that I'm able to tell you about it.

Edward says he has a good GP who arranged for him to have an assessment when he told him his history of schizophrenia.

What happened was after I'd been here for a, a year or two I thought okay alright you're well but, you know, what are you going to do if you get ill, there's a three month wait to get treatment. And I thought that's not good, three months is too long. I'll say that to the camera, it's too long. so what are you going do to about it? I thought to myself okay I'll go and see my GP who is, luckily, the coolest dude in the galaxy, he's just an ace you know he really is, wonderful man. Very bright, great sense of humour, good at his job, you know, what else can you say? And as soon as I mentioned the word schizophrenia to him he said, 'Okay well we can arrange for you to go and have an assessment.' And so I did, I went and had the assessment. Took a little while to get it organised. I had the assessment it took, lasted about an hour and I think there were two social workers that interviewed me and they sort of asked me my story, you know, the story I've told you here more or less and they took it all down long hand and then send me a copy. And what they did was they put that story on file and if I want to ring, if I feel sick and I want to ring a certain number, I just ring that number and a duty psychiatrist can call my story up onto the screen and I won't have to repeat myself and feel disbelieved, you see, because one of the key things when you're not very well is you mustn't get a sense that the person is disbelieving you, okay. And I found that a lot of people disbelieve me when I say I've had schizophrenia, they disbelieve me, they don't believe it. They don't believe it because my behaviour doesn't match their stereotype and if there's one thing that makes me upset more than anything else is when people start to question my integrity. You see, when I'm disbelieved that upsets me even more. So I was believed by these people and they wrote the thing down and I don't have to go through it again. If I don't feel well or I get depressed for more than five days in a row or whatever I ring the number, the story's on his screen, it's there. And it's not only that it's been signed by me because they sent me a copy to see if I agree with it, how about that? 

Now that is value, that is, that is state of the art mental health care in my view because my rights were always considered the whole time, no secrets were kept from me about what I diagnosed or what was said about me or anything. I was able to look at it, change it, just the same as I am here now. And that was a big change from Australia where everything is kept in a file secret, you know, you've got to ask for the doctor to go to the hospital, get it out with the hospital's permission, sign to say you've asked for it, sign to say you've seen it, as well as him seeing it, he's got to be allowed to see it too, not that I understand it anyway.
 

Edward says life does get better because having a mental health problem is a 'gift' or an 'enabling disability'.

So yes it's a gift as well, so it's an enabling disability. I don't know if I said that in my little, I don't know, but I have written to someone about it describing it as an enabling disability. And really the reason I'm here talking to you now is that I'd like other people whose relatives and friends, or they themselves are very anxious and worried about how it's going to pan out, I'd like them to hear me say this and tell them about this story because life does get better and it is an enabling disability. It never leaves you, it's a sort of a perceptual thing that never leaves you. But it is actually a gift if you can learn about it and manage it and get the best out of yourself. I mean it's no different from what anybody else is trying to do is get the best out of ourselves aren't we so, you know, it's pretty good.
 

Edward had ECT while he was in hospital and says it was very helpful and the effect on his memory was not too bad.

And from then on in after I'd, after I was an in-patient for three months and I had electro convulsive therapy, or shock treatment, whatever you want to call it. That seemed to help me greatly, I had three, three treatments a week for three weeks, I had nine treatments altogether and that was a, that was a great gift because all that did was it , it calmed down whatever was bothering me and sort of put it to one side. And at the same time all I, all I forgot, because it does affect your memory, it does affect some parts of your memory, all I forgot was my life in England for the final year before I left back to Australia. So I forgot about all the movies I'd seen and I knew I'd seen them but I couldn't remember the plot and I couldn't remember my farewell party or anything like that. So now I'm back in England, it's wonderful, how everything is sort of vaguely familiar, it's, you know, it's new, at the same time it's new, it's a delight, you know. But anyway so the shock treatment or the ECT was very helpful to me and so I spent three months as an in-patient and then about six months as an out-patient where I used to go back and see the psychiatrist every fortnight and he'd have a look at my medication and there'd be a bit of a chat and there might be some group therapy with some of the other patients, other out-patients. And that seemed to work really well.
 

Edward would like to see more research into the nature of the chemical make up of cells in the brain - although he believes environmental factors are important too.

Well I mean I think that probably what could be researched a little bit better, but of course they're making big advances all the time and so I could be out of date when I'm saying this, is the nature of the chemical, the chemical make up of certain cells in the brain and, and the make up of certain receptors that take the chemicals, the chemicals out of the brain to the various organs, you know, there's receptors, halfway houses, like the adrenal gland and so forth. I think that if those genetic factors in the cells are studied more, I think they are actually, they can identify schizophrenia now by looking at your cellular structure but I'm not sure whether they can. then that would be a big help but, but we must be very careful not to prejudice our behaviour by such an analysis because it is an analysis of measurement and this illness, or whatever it is has a genetic component and environmental component, and there is nothing to say that there will be an outbreak just because of the genetic component, nothing to say and so therefore these tests and investigations need to be done without prejudice when the results are printed there should be that declaimer at the bottom, you know, be careful it's not a one size fits all experiment that's going to solve everything because unfortunately I have difficulty in explaining this to people as to what schizophrenia is and I'm still not quite clear. I mean I know it is, it is a perceptual thing and there are different extremes of feeling in, in the same circumstances as the rest of the population that can be identified as different in me to the rest of the population.
 

Edward experienced "delusions about world domination" and uses hindsight to distinguish between delusions and reality.

And I remember reading in a Beautiful Mind that John Nash Junior had these delusions about world domination which I confess I've had a little bit myself, you know, that, that somebody is trying to dominate, this is when I was much younger by the way I haven't had them lately, I couldn't care less about that sort of thing any more but I noticed that people who are in my age group now, that I was at the time I had these delusions they've actually come out and admitted to me that they've got this world domination stuff happening there. And John Nash Junior went back to Paris and did nothing because he was trying to hook up something to do with mathematics and the game theory or something in connection with world, some world conspiracy or other.

You know, I mean he had that sort of, he had that kind of scheme going on in his head by the look of it so, yeah it can happen' it can happen. and the person is not aware of it, they think that's okay, everybody knows, you know, everybody knows the CIA have bugged my toilet sort of thing. And they bug your toilet too but you're not, just have a look around and make sure will you, you know. Yeah they're surprised, they're surprised that they're deluded. That's why I'm saying, I'm careful to wait for hindsight before I decide whether anything really definitely, you know, because I am susceptible to those things but I'm aware of it. Some people aren't, you know, that's going to happen, they're waiting for that to happen.
 

Edward describes his symptoms, including anxiety, shallow breathing, negative thoughts, feeling sad, powerless, empty and not caring for himself.

There's some other, there's some other physical signs, there's shallow breathing, you know, that shows the anxiety level up there with the thirst, the shallow breathing and the, and the sentence mixing up, those are the three things that stick, that spring to mind as being danger signals, time to do something.

And what are the symptoms of the depression, can you tell me what, how do you know'?

There's a sort of empty feeling, a very sad empty feeling that won't go away and keeps generating negative thoughts about yourself and the things you've done and the things you might have said and you should have said or you couldn't say and all this sort of thing. So it's a kind of, it's a sad feeling, an intensely sad feeling with regret put in there somewhere and with a powerlessness put in there as well, a disempowerment to change anything for the better, those three ingredients, sadness, disempowerment, what was the other thing I said?

'emptiness.

Emptiness, thank you. Okay, see I can never remember what I said, okay, so emptiness, disempowerment, regret, okay? That's what it's like' Intensely, an intensity too, so that actually it actually gets to the stage where you can't think outside of your head space into the outside world, you know, you can't help anyone else, you can't do anything else, it sort of paralyses you and into lying on the couch all day or shutting the door and not going anywhere all day, and all night and all of the next day. It develops into a paralysis. And a sure sign when someone is getting better is when they start to think about other people and how they're going to fit into the rest of the world and how they're going to help them. another sign of depression from, you know, just looking at people to see that they're feeling depressed is when their self-care skills deteriorate, you know, they don't bother to comb their hair and they don't bothered to shave and the next thing you know they've got a, they've had the same shirt on for a week and all these things suddenly change and deteriorate so their appearance and, and their thought of others, you know, their sense of self in relation to others seems to' Mmm.
 

Edward had his first experience of psychosis after the "shock" of migrating to Australia and meeting his mother for the first time aged 20.

And when I got out there I got to meet my mother didn't I, for the first time, and that was a terrible shock. She wasn't well and we just, there was some kind of toxic communication system where she frightened the living daylights out of me and I frightened the living daylights out of her. Once when she had one of her more lucid moments she said to me, you know, 'What happened to the baby on the boat, I don't even remember, what happened to the baby?' You know, this is on the journey coming out. 

I said, 'Look the baby is here, you're talking to the baby, the baby's okay.' You know, but it's just one of those tragic things where she couldn't even remember what was going on. She was conscious of the fact she had a child, that the child had been taken away or whatever, you know, and she'd lost it, so couldn't look after herself or the child. And I, I don't know but the, the, the shock of migration there, because when you're there the first year I didn't understand what people meant when they said what they said, it was a, just because they drive on the left and speak English doesn't mean a thing, you know, it's a huge culture over there to get used to and often people failed to get used to it have to come back here don't they? But of course I had to stay for two years because otherwise I'd have to pay the fare back and I couldn't afford that. 

 and anyway I had connections there so after a year it was okay but in the first few months after I met my mother that's when I had the first psychosis, after about five months I was not well, just after Christmas, between Christmas and New Year in 1968 I was in, I volunteered, I signed myself in because I know that I wasn't, I was having hallucinations and a terrible anxiety 24/7. I felt anxious the whole time and I didn't know what it was about and I knew that wasn't right. And I'd seen my mother, how sick she was and seen the effect it had on her where you couldn't sort of determine the difference between personality and illness you know so the boundary line was very vague and it was quite scary because I was closely related to her you see and that made me doubt my own capacity to stay well. And as soon as that self doubt seeped into my conscious state of where I was going and where I was headed, where I was headed, I became anxious on the basis of my mother's, you know, outcome.
 

Edward felt suicidal but changed his mind when he began to feel "neutral" - he believes this was "a miracle".

I back peddle on this spirituality thing because I think it is actually, it's up to the individual to find their own way through it or around it or whatever and I feel lucky that the first time I felt suicidal and was going to drive my car off a cliff top in Sydney, I had it planned, I stopped the car at the base of the cliff and walked along the beach, don't know why, I just parked the car. And after I'd walked one length, 1' lengths, it's about, it's about a 3 mile beach I suppose I felt this, there I felt the size of a 50p piece a neutrality. You know, I tell you about anxiety and all these other feelings you get when you're depressed? It was a neutral bit and it got there, and with every pace the neutral bit sort of started to expand and spread all over me and I thought I've never felt neutral in my life before at all now so that was my version of a miracle. You know, I know officially the Catholic church will say that's not a miracle it has to be, it has to be approved by, it has to follow certain guidelines, they've even got a miracle committee in the Vatican somewhere there as far as I know, or that I heard. So yes that's my version of a miracle to me and there have been a few since then and I feel it's helped me understand that there are certain things beyond my control and I've got to let those things be dealt with by whatever, not by me. I can only change the things I can change, you know, like in the AlAnon self-help prayer, you know.

So yeah, so it's important to me but I would say I don't like to talk about it on the basis of it being the same for everybody because I don't think it is. And I would never want to impose my belief system or faith on somebody else, that's not the way I don't see it like that, I don't see it like that. I don't see it as a tribal thing like joining a group and you've got to believe in this and that, you know, and some kind of indoctrination scheme, which is often what they are. You know, if they're not arrived at spontaneously by yourself well then it, it does seem to be an indoctrination thing, which fair enough some people really need that or they like that or they, they want that but that's not the way I can operate. So I really do think it's up to the individual to find their letting go mechanism the best way they can because you've got to be able to let go of some things you can't change, you must be able to do that. So if you call that spirituality alright but that's all it is, you start at that point and then find out what the rest of it means to you.

And is that, that's what it does for you then, it's your point of letting go?

It is, it has to be, otherwise I'd feel disempowered about the things I couldn't change. It's a trap if I can't learn to let go and whatever the method I use, is a spiritual method.

And do you have a particular religion that you believe in?

No I haven't been able to do that, I haven't been able to do that. Look I've spent quite a lot of time [four second pause] as an attender at Quaker meetings, I've been to two or three or their enquiries weekends, they've got a special sort of what do you call it a retreat for people who are enquiring about Quakerism, they conduct those in, up in Oxfordshire, I've been to three of those. Last one was in 2001 and, 2002 I think and I've been to various Meeting Houses to try and find out which group suits me, I haven't found one. I haven't found one so now I'm not going to bother with that any more because it. They don't quite suit my belief system, I'm just a little bit, most of what they, most of, most of their the Friends they call themselves appeals to me, the way they go about things but there's, there's also that little bit of tribalism in there and that group joining and one grou

Edward believes that his mental health problems have a genetic component and an environmental trigger - in his case migration and meeting his mother for the first time.

Yeah I would after seeing my mother, that's, 'til I actually met my mother I wasn't really aware of it at all. I knew that she'd been ill and she'd been, you know, she'd been in a mental hospital but I didn't really, didn't have that sort of , you know, in your face feeling that it gives you when you, when you're related to somebody who's not well. You know, you wonder where the boundaries are going to be and whether you're going to lose your grip straight away, you know, or whether you're going to lose your grip in a week's time or in a year's time. You really do because it's got a genetic component you can see yourself in the other person obviously, if it's your mother or your father you can see yourself in there in their reactions to certain things and thinking oh hang on a minute, you know, I'm sure I've had that, not only that look but the feeling behind the look before now and I didn't realise what it was and I didn't realise how serious it could get, you know. So that's sort of, yeah the genetic component is a very strong governor of the lack of confidence you free about the future that's it. 

 but the environmental component, I mean I think lots of kids have had a hard time, you know, one way or the other or they've had their parents go to hospital, leave them on their own for longer than they would if they knew about today's findings and, you know, it hasn't caused them to, it hasn't caused them to have schizophrenia so the genetic thing is the main determinant and the environmental things are incidental triggers if you, if you're in that category.

And what have been the environmental triggers for you do you think?

Well I think, I think' the forced migration at an early age, away from the people I considered to be my surrogate parents to people that I'd never met before and not only that it's not just down the road, I could never go back again so I was stuck on another planet, you know. When you're a little child coming to the UK from Australia is like being on Mars and not only that without a friend, without anyone you know. So that environmental trigger was a big one and then after that the migration back to Australia and in meeting your, your mother for the first time. Wow you know that can be, that can go either way can't it? It can be hugs and kisses and tears or it can be, ooh, you know, sort of terribly the opposite, you know, the antithesis of that. And that's what happened in my case so that was a big shock, you know. I'd say environmental factors need to be shocks, they need to be big lifestyle shocks like [intake of breath] losing your job or something, or losing your partner after a long illness or, you know, something like that where you're, it's pretty stressful and, and, and emotionally charging, those would be the sort of typical environmental triggers.
 

Edward describes his own individual spirituality which helped him to overcome suicidal feelings.

I back peddle on this spirituality thing because I think it is actually, it's up to the individual to find their own way through it or around it or whatever and I feel lucky that the first time I felt suicidal and was going to drive my car off a cliff top in Sydney, I had it planned, I stopped the car at the base of the cliff and walked along the beach, don't know why, I just parked the car. And after I'd walked one length, 1' lengths, it's about, it's about a 3 mile beach I suppose I felt this, there I felt the size of a 50p piece a neutrality. You know, I tell you about anxiety and all these other feelings you get when you're depressed? It was a neutral bit and it got there, and with every pace the neutral bit sort of started to expand and spread all over me and I thought I've never felt neutral in my life before at all now so that was my version of a miracle. You know, I know officially the Catholic church will say that's not a miracle it has to be, it has to be approved by, it has to follow certain guidelines, they've even got a miracle committee in the Vatican somewhere there as far as I know, or that I heard. So yes that's my version of a miracle to me and there have been a few since then and I feel it's helped me understand that there are certain things beyond my control and I've got to let those things be dealt with by whatever, not by me. I can only change the things I can change, you know, like in the AlAnon self-help prayer, you know. So yeah, so it's important to me but I would say I don't like to talk about it on the basis of it being the same for everybody because I don't think it is. And I would never want to impose my belief system or faith on somebody else, that's not the way I don't see it like that. I don't see it as a tribal thing like joining a group and you've got to believe in this and that, you know, and some kind of indoctrination scheme, which is often what they are. You know, if they're not arrived at spontaneously by yourself well then it, it does seem to be an indoctrination thing, which fair enough some people really need that or they like that or they, they want that but that's not the way I can operate. So I really do think it's up to the individual to find their letting go mechanism the best way they can because you've got to be able to let go of some things you can't change, you must be able to do that. So if you call that spirituality alright but that's all it is, you start at that point and then find out what the rest of it means to you.

And is that, that's what it does for you then, it's your point of letting go?

It is, it is, it has to be, it has to be, otherwise I'd feel disempowered about the things I couldn't change. It's a, it's a trap if I can't learn to let go and whatever the method I use, is a spiritual method.

And do you have a particular religion that you believe in?

No I haven't been able to do that, I haven't been able to do that. Look I've spent quite a lot of time [four second pause] as an attender at Quaker meetings, I've been to two or three or their enquiries weekends, they've got a special sort of what do you call it a retreat for people who are enquiring about Quakerism, they conduct those in, up in Oxfordshire, I've been to three of those. last one was in 2001 and, 2002 I think and I've been to various Meeting Houses to try and find out which group suits me, I haven't found one. I haven't found one so now I'm not going to bother with that any more because it. They don't quite suit my belief system, I'm just a little bit, most of what they, most of, most of their the Friends they call themselves appeals to me, the way they go about things but there's, there's also that little bit of tribalism in there and that group joining and one group doesn't talk to the other and so

Edward describes the things that help him cope' keeping a diary, avoiding drugs and alcohol, and recognising warning signs.

So after that I decided okay I spoke to the psychiatrist and he said, 'Well look if you don't have another, a relapse before the age of 25 or so, 24 or 25 you'll be okay because history tell us these psychoses affect people between 16 and 24 mostly. So I was quite confident once I reached, you know, in fact I was waiting for that, you know, day to come and then I thought well okay I'll be alright now. And I just carried on making sure that I didn't take any tablets of any kind or any perception altering drugs like cannabis sativa okay? And there were friends who liked that sort of thing but I kind of shied away from it because I didn't want to lose my sense of reality. It's very important, you know, when you're having these delusions that when you get better you guard your sense of reality as strongly as you can. 

Well that's the way that I see it anyway. So, you know, I didn't drink too much alcohol either because when you can, even though I didn't have a relapse as such the illness would, or the condition would tend to result in sort of mild depression and so forth. And I had all the signals, I had all the signals to be avoided in a list, I hadn't written the list down and the signals, the warning signs that I was looking for in myself were excessive paranoia, depression' anxiety state that goes on for too long, non-specific anxiety state. Obviously if you're anxious about an oncoming bus and you're stuck in the middle of a pedestrian crossing that's understandable but, you know, any kind of anxiety state that doesn't have a, an obvious explanation. And the physical things are excessive thirst and mixing up words at the end of sentences and having to repeat them, that's very embarrassing. That's the most demeaning symptom that I can think of, especially being a professional communicator, you know, the thought of going in front of a class and just not being able to say anything properly, you know, but feel that they notice everything. Well they do, but they don't notice it as much as I feel they did, you see. So that was something, so those are the excessive thirst, anxiety state, paranoia and delusions.

(The following section is written only)

And so the diary has helped me calm down in so far as if I've had, say last year I had on 29th June I summarised the previous seven and said, 'Look I've had four bad, four bad days in a row this year.' I go to the diary, look at the same time the previous year and read it and hey, I had five bad days in a row last year at this time of year and it's worked like that all along the line so that I'm able to monitor, prove to myself that life gets better and it does. I know it does because I've just got to read my diary if I'm in any doubt it gets better. And somehow we have to, all of us, it doesn't matter whether we've been ill or not have to try and get this perceptual integrity about living in the present, you know. And hopefully I've at least mastered that by now, you know, or some days perhaps not but, you know, most of the time.

Now I once said to my shrink in Australia, I said, 'Look [my psychiatrist], I know the difference between delusions and reality.' And he said, 'Oh do you,' he said 'what's that?' I said, 'Hindsight' [Laughs] so' [laughs]. I tend to wait for a lot of hindsight to make sure that these delusions are in fact what they are. So I go to a lot more trouble than most people do to examine their delusions, okay? And that takes up quite a lot of time and effort. I keep a diary every day and I have done since, oh 1991, I think when I first separated, before divorce. I keep a diary every day and it's a page to an opening A4 and in it, when I've got the time I usually fill it in you know it's pretty full by the end of the year because even if there are gaps I can come back to the gaps and fill them in with an

Edward was so afraid and anxious he felt relieved when he was admitted to hospital.

When I had the first psychosis, after about five months I was not well, just after Christmas, between Christmas and New Year in 1968 I was in, I volunteered, I signed myself in because I know that I wasn't, I was having hallucinations and a terrible anxiety 24/7. I felt anxious the whole time and I didn't know what it was about and I knew that wasn't right'

And I signed myself in because I thought no I'm not going to live in denial, I'm going to get well here, I'm going to get someone to help me improve because this can't be what life is going to be like for me for the next 50 years you know or whatever, next ten years, who knows'

So yeah the anxiety state is a huge thing, that's something I remember. I was afraid of what, I don't know, 24/7 I was relieved to get into hospital and have that door shut behind me, you know, that's how frightened I was.