are drugs driving you mad

"I'm convinced people taking ecstasy every week will be more liable to mental illness in the long term."

Mad For It
Everyone feels the comedown after a heavy night out. But when do the Tuesday blues become what psychiatrists would diagnose as neurosis, depression or even psychotic paranoia? If drugs don't drive you mad today, say some doctors, they may do in ten or 20 years time. Are we really playing Russian roulette with our sanity?
Writer: Jaimie Richardson

THE first time you have a panic attack, you are gripped by a fatalistic certainty of two things. Firstly, you cannot breathe. Almost as though a slab of concrete had been dropped on your ribcage and was gradually compressing the last gasp of air from your flattened lungs. Secondly, as a result of this, you are convinced you are going to die. And no amount of reasoning, comforting or reassurance is going to convince you any different. I had my first panic attack around two years ago now. It came at the end of a period when, in my early 20s I was experiencing a kind of second adolescence. Hanging out with a younger crowd. Going to house and techno clubs every weekend. Feeling excited about nightclubs again for the first time since I was 17 or 18. Taking some combination of ecstasy, speed, acid, cocaine and cannabis each weekend. The panic attack - around two days of accelerated existence, of desperate shallow breaths, valium shots at the doctors, urgent phone calls to friends and painfully long taxi rides to casualty - marked the beginning of 18 months of anxiety, paranoia and near nervous collapse. At worst I was unable to leave the house through fear of the people and things which lay outside. Simple, everyday events like catching a train or bus or even sitting in a cafe became instruments of exquisite torture. Surrounded by strangers in an enclosed space (even if with friends) anxious thoughts would set in. The people surrounding me hated me and found me repellent, and with good reason. I had no right to be there. I had to get out before they said something or came up and attacked me. My breathing would become shallow, my behaviour erratic and eye contact difficult. Luckily for me, I had friends (friends other than the people I went clubbing with) who cared about me. As a result I went to the doctor and got professional help, in the form of therapy and the anti-depressant Prozac. These days, things are slowly moving back to normal. One thing did stay with me though, from those bleak Winter days sitting in the psychiatric unit with its small, high windows and sparse, institutional furnishings. And it was something my therapist, Alan, said to me, after he'd asked me about my recreational drug use. "Ah," he nodded like my story wasn't a surprise, "give it a few years and there's gonna be a hell of a lot more people like you getting psychiatric help."

OF course, mine isn't the sort of story you bring up in polite conversation or to impress a prospective partner. And in clubland, it's pretty much a taboo subject. If someone can't take their drugs, can't cope with a comedown "they're just a bloody lightweight," aren't they? Clubs are about enjoyment, hedonism, living for the moment, losing the plot. The more drugs you take, the more of a laugh you are, you're a wild man, a lad, a hero: like Liam from Oasis or Shaun Ryder from Black Grape. If you can't take your drugs you're a wussy, a saddo or a bore. If you can't take your drugs then get out. Alan Haughton, from Manchester drugs education agency, Lifeline, has seen plenty of evidence of this attitude over the years.

"We did a lot of work with a group of 80 football fans a few years ago," he relates, "they were long term ecstasy users, straight from the beginning. They had three casualties altogether: one young lad that died and two that were real messed up. They could cope with the one that died, because he was no longer there. They could rationalise it, say: 'Well yeah, he should have drunk some water 'cos he was sweating and then he stopped sweating.' But the two that had severe problems psychologically they couldn't rationalise at all, because they were still there. They'd say things like: 'Oh no, so and so's back in the pub - don't go near him or he's gonna start crying again.' And I really think it's quite a common occurrence. "We get inundated with Monday morning calls from young lads who've taken trips and pills and for whom it's gone wrong. They can't tell anybody. They're too scared to - and they're more scared of admitting it to their mates than anyone because their mates will dog them for it. I always say to them, 'Well, I can guarantee that if you get your mates on their own and ask them sensibly at least half of them will say, 'Fucking hell, I've had a bad one and all.'"

THE irony is that, despite the fact we all come down, we all get worried, paranoid, anxious, depressed, we're supposed to be able to lose it and not lose it. To neck and snort and puff 'til we drop and not panic or pass out, not even to sweat, gurn or display too much emotion these days. We're supposed to metabolise as many potent, mind bending and even mildly toxic substances as possible and stay cool, calm, together. Now if that isn't madness, God knows what is.

Sometimes dance culture in general and house music in particular is predicated on a kind of tyranny of positivism. In other words it's primarily about happiness, enjoyment, togetherness and euphoria. Like an all-pervasive subtext to the experience of clubbing. Think of the track titles, 'Passion', 'Where Love Lives', 'Promised Land', and indeed the lyrics. Feelings of loneliness and alienation simply don't come into it. It's about collective euphoria not solitary introspection. If you're lost, stay off the dancefloor, no one's gonna help you there. If you want depth and insight then go and listen to Radiohead or something. In your bedroom. Thing is, come the Monday or Tuesday or Wednesday after the weekend and that's exactly what you're gonna wanna do. Somehow the impossibly glib, optimistic 'Ooh I'm rushin' rushin' or 'I luv you baybee' just doesn't have the resonance it did on Saturday night. While mainstream house remains in a fantasy realm where optimism reigns supreme, the reality is we all come down. We all know that intractable Sunday feeling of impending doom. Those kind of nagging thoughts that escalate wildly in your mind. You're girlfriend/boyfriend is leaving you/cheating on you. You're overdrawn at the bank. Everyone hates you. Your whole family has died in a car crash. The world is gonna end tomorrow. And somehow, inexplicably, it's all your fault. Put simply, there's a very fine line between coming down and what psychiatrists would diagnose as neurosis, depression or even psychotic paranoia. Think you're immune? Think you can handle it? Think again. It could quite easily happen to you. Mike, a 19 year old Cream regular from Edgbaston in Birmingham should know. He started taking E and speed two years ago. He had no previous record of psychiatric problems.

"I'd been doing one or two pills every week for about five or six months when it happened. I'd been to Renaissance one night with a load of mates and I can't really describe it, but everything went a bit strange. At first I thought, 'Well, this must be what they mean by a dodgy pill.' I was shivering and sweating like a bastard. On the way home I threw up in the car. My comedown seemed endless, the shivering and sweating didn't stop and then my heart would start racing and I wouldn't be able to breathe. A couple of times I really thought it was all over for me. Then, about a week later I started to get really, really para. I thought people were bugging my room, that strangers were watching me through the window, that my friends were all evil, that even my Mum was spiking my food. I had hallucinations - kept seeing balloons floating above my head, people coming into my bedroom who weren't actually there. I didn't trust anyone. Even the TV, I though they were putting coded messages into the programmes to try and fuck with my mind. Basically I just completely lost it." Mike's mum took him to their GP who referred him to the local psychiatric hospital where he ended up staying a week. "It was a nightmare, they put me on loads of drugs. It stopped all the crap going through my mind but I wouldn't exactly say it was, like, enjoyable by any means."

ECSTASY isn't the only drug that can cause serious psychological problems. We all know about acid and its potential to inflict major mental damage, but what about the supposedly 'sane' drugs like speed and coke. The ones that work on your adrenaline system rather than your perceptions. Rev up your metabolism rather than fuck up your senses? "At Rezerection's Event in Edinburgh last Summer, there seemed to be a kind of mass paranoia," says Liz Skelton of Scottish drugs agency Crew 2000. "The main drug people were using was speed. And using an awful lot of it. Like ten grams for the night. The main problem was this paranoia, a fear of violence. People thinking that other people might think they were the drugs squad and beat them up because of it. Or the other way round - people thinking everyone else was grassing them up to the drugs squad. We had people climbing into cupboards and refusing to get out totally convinced that people were after them and trying to kill them. And it was mostly young guys we'd see in this state as well." "If you take a high dose of amphetamines, then it elevates dopamine levels in your brain and elevated dopamine levels are associated with schizophrenia," explains Chris Bell, a PhD research student in Neuroscience & Pharmacology at the University College Of London and also a regular clubber. "If you take too much amphetamines, there's actually something called amphetamine psychosis that can occur. It lasts for anything between three months and three years and is completely indistinguishable from schizophrenia." As with speed, popular misconception has it that cocaine is less psychologically damaging than psychedelics like acid and mushrooms and empathogens which affect the emotions like ecstasy.

"Cocaine is a very pure form of amphetamine," continues Chris Bell, "so like speed it raises the heart rate and releases neuradrenaline in the cortex. It causes that 'fight or flight' response. However it also causes a hypertensive state which can lead to anxiety attacks and because it has a very short course of action - a 'half life' (the time it takes the body to metabolise half the amount of drug taken) of around an hour - you're going to get a below bassline depression immediately after that." "Of all the insidious mental effects of drugs that are used recreationally, I'd say one of the worst is cocaine," affirms Lifeline's Alan Haughton, "you've only gotta look at the way it fucks up a lot of people in the music industry as evidence of that. Cocaine's a classic, there's lots of DJs and semi-famous people we know who've lost it on cocaine. Individuals we know as clients who can't get out of bed in the morning without a line of charlie. Cocaine separates you from your soul. If you see people who've done lots and lots of cocaine you'll know what I mean, it fucks with your judgement big style. They're paranoid, aggressive and often violent too." Alan also points out how DJs, club promoters, producers and dance music celebs are just as, if not more so, susceptible to mental breakdowns precipitated by drug use as the rest of us. "A famous DJ's first manager came to us because he felt he was losing the plot because he caned it on E so much. He got to the point where he just wanted out of the whole scene so he went to work for Oxfam and went away to India. I remember a case about 12 months ago when really quite a famous DJ came to us. He'd got so mentally fucked up on drugs that he had to get out as well. So he sold all his records, he just couldn't stand to be part of the scene any more." Although there are resident counsellors and associated psychiatrists who help out at Lifeline, Alan himself feels there's a grave lack of specialised advice available for the average clubber experiencing mental distress.

"There's not a great deal of help we can offer people with psychiatric problems caused by recreational drug use. If they end up going to psychiatric services they get one of two options - they either get drugs - some type of anti depressant, and if you've had severe problems with one drug, you're gonna be reluctant to put your faith in another. Similarly many people are sceptical about being therapied to fuck - that's another arduous tunnel. And neither of them fit in with the lifestyle your average clubber is likely to have had before."

HELEN, a 23 year old bank clerk from Sheffield admits she didn't have a clue what to do when, after three years of regularly taking ecstasy, speed, cannabis and occasionally acid at clubs, things started going wrong with her mental state.

"I was always a really strong, independent person. Totally together. When other girls couldn't keep up with the lads on a night out I'd be necking pills and 'aving it as long as any bloke. About a year ago I began to feel nervous and light-headed all the time and I was panicking about everything. I don't think it was related to any one particular pill, the feeling just crept up on me gradually. Before long, I'd lost all my confidence, I couldn't go anywhere without my boyfriend. I couldn't sleep and when I did I'd have these horrific nightmares. My appetite went and I was down to eight stone within a few weeks. Basically I felt I was losing my mind and I was never gonna get it back." According to Alan Haughton, it's also a common feeling acid users experience, that they've crossed the line, travelled to a place in their minds and they just can't get back to the place they were before. Maybe that's the gamble we take with all drugs. They rocket us up somewhere higher, somewhere exciting, liberating, far from humdrum reality. But equally, they also sink us lower, to depths and anxieties, into paranoias and depressions, that we'd be better off having never experienced. And what if we can't get back? What if, as Jarvis says, all of us E heads and coke heads and weed smokers and speed nutters and acid freaks have left a part of our brains, somewhere, in a field/club/bar in Hampshire/Ayrshire/Staffordshire/Yorkshire. A little bit of innocence or sensitivity or individuality that we're never, ever gonna recover?

MAYBE we've got a lot more to lose than innocence, too. Research into the long term mental health effects of taking ecstasy is still in its infancy. However, the prognosis isn't good. A recent study published by Dr Morgan in Cardiff which compared regular ecstasy users to people who'd never taken recreational drugs found higher levels of depression amongst the ecstasy users. Ironically enough one of the original uses of ecstasy was as an adjunct to psychotherapy - to help facilitate communication skills in the patient. "Ecstasy increases the levels of seratonin in the brain," confirms Tony Richardson, Professor of Neuropharmacology at University College Of London and world leading expert on the chemical effects of ecstasy on the brain. "It goes up and then it appears to bring it down again. The point is if the seratonin levels stay down then you can argue that people who have used the drug and got their brain into that situation may well be more susceptible to psychiatric disorders in the future. But the only thing that will tell us for sure is long term studies." Research on rats and monkeys fed with low but frequent doses of ecstasy has shown the drug to cause permanent depletion in both seratonin levels and the cells which create seratonin.

"If humans react in the same way as rats and monkeys to ecstasy then this decrease would almost certainly lead to depression," verifies Chris Bell. "In some cases it will also lead to what is called an 'amotivational state'. I know one doctor who is predicting it's possible in 20 years time the generation who are now taking ecstasy every week will all be suffering from depression and in amotivational states. What we mean by an amotivational state in the psychiatric profession is that you no longer have a desire to care for yourself, you no longer have a desire to care for your children, you no longer worry about hygiene, you can't work, you have reduced motor function. So we'll basically have one and a half million or however many total cripples." Dr John Henry from the National Poisons Unit at London's Guy's Hospital sees the effects of ecstasy in animal experimentation as conclusive proof of its long term toxicity on the human brain. "I'm convinced people taking ecstasy every week will be more liable to mental illness in the long term. I'm convinced because ecstasy damages seratonin terminals in the brain in every animal species tested and almost certainly the same applies to man. I mean four doses in animals causes permanent damage and people take it time and time again. So every time they do they're damaging their brain." Dr Henry predicts huge problems in the next 30 years for ecstasy users and a massive demographic of ecstasy users who will eventually experience pyschological abnormalities.
"The main problem will be depression and suicide as a result of that depression. The normal incidence of depression in the population is about five per cent. If that turns out to be ten or 20 per cent in people who've used ecstasy it would be a massive tragedy and there would be an accompanying increase in suicides too." Dr Sophie Zeman, Scientific Research Officer at The Mental Health Council is also pessimistic about the long term effects of ecstasy on the brain. She also points out the potential mental heath dangers of cannabis too. Tests on the Swedish Army in the late 80s proved people who smoke cannabis just once are 2.4 times as prone as the normal population to develop schitzophrenia and those who've used it 50 times or more are six times as likely to develop it. "There's certainly evidence to suggest that people who have schizophrenia and smoke cannabis are likely to have their symptoms worsened," says Dr Zeman. "As for ecstasy, we know some of the short term effects because we see people ending up in hospital after taking one tablet. We aren't sure of the long term effects but we can predict them because we know what these drugs do chemically. And the long term effects are therefore likely to be pretty gruesome. In the long term, probably, most people are going to be alright but there are going to be some who are not. If ecstasy does destroy the seratonin levels in the brain then these people are likely to have problems reflecting low seratonin levels - things like depression. Serious and possibly quite intractable depression. And saying, 'Well it's OK we can just give them Prozac or anti-depressants' won't help because if they've actually destroyed their seratonin producing cells, they may not have anything there for Prozac to increase the levels of." So in effect they may never be happy again? "Well yeah, I think in the long term that's absolutely right."

Give your mind a break
Remember, your mind needs proper time to recover from a heavy weekend too. There's no point getting fucked again to alleviate that Wednesday night depression, you're simply gonna make yourself more depressed and anxious the next time you come down. Take a week or two out to recover your mental balance.

Problems to look out for Depression
If you're comedown seems never ending, if you have suicidal thoughts or feel permanently sad or demotivated, are lethargic, crying more then usual or have problems sleeping, it's likely you are suffering from depression.

Anxiety and panic attacks
If you're short of breath, continually worrying about the smallest details, have a paralysing fear (say of social situations, leaving the house etc.), are losing sleep, experiencing trembling, shaking or sweating attacks, having palpitations (racing pulse, fluttering pains in the chest) then you need help for anxiety and panic. Try visiting your GP or phoning the MIND helpline below. Remember taking ecstasy, LSD, amphetamines, cocaine and cannabis may well have precipitated your condition.

Paranoia
Hearing voices, feeling watched, mistrusting your mates or family, feeling followed or under surveillance and a crippling fear are all symptoms of an overly paranoid state of mind. Feelings of paranoia are particularly associated with the consumption of speed and cocaine.

Mood swings
Feeling suicidally depressed one minute then euphorically happy the next? Unless you've won the lottery, this could well be a sign of mental imbalance. If you or anyone you know tends to fluctuate dramatically between feeling full of the joys of life and down in the pits there could be a problem. As above, talk to someone professional.

Don't be afraid to talk about it
If you or anyone you know is experiencing any of the following problems: depression, paranoia, hallucinations, extreme mood swings, anxiety, panic attacks then you need to talk to someone about it. Try the MIND (The National Association for Mental Health) 24 hr helpline on 0345 678000. You can phone from anywhere in the UK for the cost of a local call. Alternatively, drugs agencies like Lifeline and Crew 2000 will be able to put you in touch with counsellors and psychiatrists, experienced in dealing with recreational drug users.