Personal Column: A patient's tale

Her first novel, long-listed for the Orange Prize, is set in a psychiatric hospital, where Clare Allan spent a year and a half - but it's no autobiography, she says

In life, unlike in a novel, it is hard to know where the beginning is. The things that caused my breakdown are very hard to pinpoint. But in my mid-twenties, I basically stopped working.

My friends started to move into careers, relationships and families and I sort of didn't. I couldn't find who I was going to be and how I was going to fit into the world. It became very acute, and then it came to a head one day in Tottenham Court Road when suddenly the future completely vanished. It felt as though the doors had shut and I was on the outside. I just kept walking: all that day and all night. I wasn't heading anywhere, but I felt that if I stopped, everything would stop.

I didn't see this as a breakdown or a mental health issue at all. I had never had any contact with psychiatric services and, as far as I knew then, nor did my immediate family. Perhaps if I had been more aware of mental health issues I might have known what was going on. It is still painful to talk about this, but I feel it is important - so others in that position might become more aware.

I had no money so I stopped eating and my weight went very low. When I walked I could feel the bones in my feet against the pavement. By that point I was really paranoid: I had this idea that I was being followed.

I'm laughing now, because it is quite funny. Well, it isn't. But it is. It is quite painful. It wasn't at all funny at the time; it was so lonely and isolated.

Eventually I had some irrelevant physical problem and I went to a medical drop-in centre. The doctor immediately picked up that I had a problem and insisted I see a counsellor. I was very resistant, but he walked me in there. I ended up in day hospital five days a week, and once I had handed myself over it was an enormous relief. I was more scared that they would think they couldn't help me and I shouldn't be there.

The novel is set in a day hospital, but it is not autobiographical at all. I am not anyone in the novel, and I'm everyone. But like in the novel, everyone's concern there was that they'd be kicked out. It's not surprising when you think of the isolation: the outside world had become so frightening. The day hospital didn't do much to address that. I very quickly became extremely dependent and institutionalised. I'd be there when it opened and we'd sit there until they kicked us out.

The novel isn't primarily political but certainly there's a campaigning drive behind it. There is always politics involved with mental illness and things happened in the hospital that I feel very strongly about. I'd love people to read it who don't read many books - which is a lot of people in the psychiatric system. But I'd also like people outside the system to read it. I'm really pleased that Channel 4 is making it into a film, because that will let people see it who ordinarily wouldn't.

What concerns me is that when I was there, I ceased to exist as a person and became an illness. Nobody ever talked about what I was going to do with the rest of my life. I had written two unpublished novels, but to them the idea that I would ever achieve anything apart from a diagnosis was just part of my delusions. I once read the first page of my notes upside down across the doctor's desk. They began, "Clare is a tall, slim young woman, well-kempt, who describes herself as a writer". I think that pretty much sums up their attitude towards my writing ambitions.

What was helpful and comforting was the other patients. I learnt a great deal from them. It is an incredible leveller. I don't mean to glamorise them but they were great people, prepared to face up to things. And there's such a hierarchy. It's true in any institution, and that common room could be anywhere: a school, an office. But it's so obvious there.

I was there for about a year and a half, during which I got worse and worse. My medication went up and up. The things that people associate with mental illness - shuffling, being overweight, shaking - that's medication. I couldn't feel anything at all. I would pour kettles of boiling water over my arms - I think for something to do. I felt very profoundly that I just didn't exist. I was admitted to the wards quite a few times, and I was sectioned.

The ward was filthy, people were sitting on floor in the corridor taking drugs, there was violence, the girl opposite kept slashing herself to pieces. It was utter misery and nothing was being done to help anyone. One nurse was an absolute heroine for trying, but many of the staff would tell us we were there because we had sinned.

In the end, I was expelled from the day hospital for not getting better. It doesn't exist now, thank God. It shut on the Friday and my novel came out on the Monday. I ended up in a crisis centre called Drayton Park. It's more geared to talking, and it was superb. I've been very lucky because the borough I live in is probably the best-provided in the country.

When I left hospital I was given a social worker. She was my lucky break, she was fantastic. She was interested in all of me. I still see her every week and the book is dedicated to her. She was the one who said I should apply to the Creative Writing Course at the University of East Anglia. She always saw a future for me outside psychiatric system, even when I didn't. I rang UEA from a payphone on a ward.

It was a huge step to go there - going from being totally in one world to being in another that had nothing whatever to do with the system. I hadn't even discussed reading with anyone for several years!

I was taught by such people as Paul Magrs, Lorna Sage and Andrew Motion. We were not a match made in heaven, me and him: I felt that Motion couldn't see beyond the mental health thing. I may be wrong, but I felt that other people could. Lorna Sage was absolutely wonderful. She died the following year and I felt incredibly lucky to be taught by her.

It was at UEA that the book really started. I worked on it for the next five or six years. I had entered a story, the basis for the book, for the first Orange short story competition, and it won. Part of the prize was lunch with Clare Alexander, the agent, who took me on. It was a stamp of encouragement. I thought, "Maybe people will really want to read a book set on a psychiatric ward."

When the book was published last year it got great reviews, which was lovely. I was shocked to be long-listed for the Orange Prize. I do feel that the Orange is really important. And I'm already working on another novel, which has nothing to do with the psychiatric system.

Now I've moved out of the system, it's a struggle having a foot in both camps. I've got friends in the psychiatric system who don't know about the other side of my life now, and people in the outside world who don't know about the psychiatric side. It's very hard to deal with people's assumptions and, to be fair, what I feel their assumptions are going to be.

There have been quite a few points where I've thought, "I am better now", and then I have been back into the psychiatric system again. I don't really see it in those terms any more: that dividing line between well and ill. The difference now is that isn't my life. I have a full life now. I have horizons now that go beyond the psychiatric system and that's the way I hope it will stay.

Katy Guest