Sixteen months ago, I somehow found myself standing bewildered in the dock of a magistrates court, at my own bail hearing for attempted armed robbery, wondering if I was really there or not. I had inexplicably gone into a shop with a toy gun at 7.30am, pointed it at the cashier and screamed at him for money while in a psychotic, delusional state. In my mind, I hadn’t committed a crime at all; I was merely acting out a scene from a film. Legally I had committed a Schedule 15 offence – a list that includes kidnapping, sex offences, manslaughter and soliciting murder, grave crimes that can result in a maximum of 14 years’ custody. Bail wasn’t even considered, as the magistrate believed I underestimated the seriousness of my crime, didn’t think I’d surrender to my bail conditions and saw me as a flight risk. I don’t know if he banged a gavel or not – I like to imagine he did – but he told me I’d be held on remand in prison awaiting trial at crown court. My solicitor told me in a vaguely panicked way that this was a “two-strike life offence”, meaning that if I commit a second offence of similar severity, I have to be given a maximum sentence. All the while I was half-there and half-not, observing it all happening, kind of bemused.
The magistrate made the right call, I see that now. I was manic, I would have done it again, I would have run, I would have died of misadventure (there was a time I was so manic I thought I could outrun trains, and if it hadn’t been Christmas Day when I made this discovery about myself, I would have died there and then on the tracks). I truly believe if the universe wanted to destroy me, then bail would have been granted that day. Me being placed on remand was an act of loving kindness from a power far greater than me: to remove me from society, to save me from myself, to get better for my two beautiful young sons back at home. I had been living mostly alone after my marriage broke down, and while the parenting situation between us is shared care, I had not been capable of this for two years. When I wasn’t committing major offences, I was under section in hospital, or trying to kick my constantly resurfacing addictions to alcohol and drugs in rehab. For two years, I spent more time in institutions than not, and it looked as if this year would be no different.
I’ve been having bouts of psychosis since I was 18. I have schizoaffective disorder, which is like being the divorce-child of schizophrenia and bipolar. They both battle for centre stage when it comes to my attention, and I am the unwilling product of their toxic and bloody union. Usually when I recover from a psychotic break, I do so in a hospital bed, or safely at home, eventually floating downstairs on a high dose of sedatives, greeted with kisses and cuddles from my boys who are glad their mama is back on Earth with them. This time, it was in a jail cell, with no clue why I ended up there or what would happen next. Before, my illness only ever made me a danger to myself. Now I was a danger to public safety.
I don’t remember committing my crime, something the prosecution understandably thought was a bit too convenient. When I pleaded guilty at my first hearing, the judge ordered a psychiatric report to establish fitness to plead, and to see if I was lying about not remembering, but the psychiatrist concluded: “It is not uncommon for patients to have complete amnesia of events during a manic episode … this is termed ‘bipolar blackout’,” which was great for my case, but existentially terrifying. I kind of remember being hauled into a police van in a white nightgown and handcuffs; that part felt cinematic and beautiful. In truth I looked like the portrait in the attic. I hadn’t had any meaningful sleep in weeks, and I had gone back to abusing drugs and alcohol due to the adrenaline-chasing, inhibitionless world of mania. I was bloated from liver damage, yellow in complexion. I had wild, blue, knotted hair and a wide, feral stare. I had heard voices for weeks giving neutral instructions, and it made sense to me that the voices were the production team of my biopic. The armed robbery, the madwoman’s siege – this was my action sequence, and I had given a fabulous performance. As my psychiatric report also says: “Ms Bolton did not question the reality of these voices, as she was in a euphoric manic state and believed she should be famous and on television.”
When I was arrested, I was napping in the dramatic, floor-length nightgown I’d spent far too much money on a few weeks before. I believed I was being filmed at all times, so I had to look glamorous even when asleep, but I often couldn’t sleep because I was always thinking of the cameras, so I would just lie there pretending, giggling to myself. My memory starts to come back at the loud banging at the door that I tried to ignore, but I must have recognised it as a police-knock because, around this time, friends had been calling police to my home a lot, usually in fear that I was dead. My nightie was rank with days’ worth of sweat; there were russet-red spatters of blood at the hem. I had wounds that had become infected because weeks of not eating or sleeping properly, combined with alcohol and drug abuse, had completely obliterated my immune system. But when I looked at my face reflected in the tiny prison van window, I saw an image of unmatched beauty – my word, I thought, I’m stunning, no wonder I’m a film star! This was all part of the delusion I’d been caught up in, an informal but well-recognised psychotic phenomenon I now know to be called The Truman Show delusion, where a person with a psychotic illness begins to believe their whole life is being filmed and watched by millions. Normally, this is a paranoid delusion, but if Truman had been in a manic phase, perhaps he’d have been delighted to have the world’s attention. I know I was.
Prison feels a lot like a prototype of a functioning society. HMP Styal, where I stayed, is made up of a wing, a segregation unit and three leafy avenues of houses that accommodate about 20 women apiece. When you walk to your prison job or education, you feel you are in a microcosm of a world you’re just learning about. Most of us in there had lived only half-lives, whether through addiction, mental illness, socioeconomic disadvantage or abuse. We would talk about getting ready for work as a grown-up novelty that wasn’t available to us on the outside, and when going to see the psychiatrist we wore our good clothes. You become deferential by design: you call anyone in a position of authority Sir or Miss, and that’s a hard habit to break, especially when you say it on your release day to the woman working at Superdrug.
Seeing a doctor or optician or dentist, while not instant, is a lot more possible than it would be on the outside. If you need to get clean from alcohol or opiates, a medical detox is immediately offered, whereas on the outside you’re waiting months for a space to open up at a detox centre, and must continue drinking or using in the meantime to avoid life-threatening withdrawals. You can get back into education, go to the library, get a job and even have a side-hustle: I paid for vape capsules by fixing people’s clothes with a sewing kit I bought from the prison’s craft store, and by helping prisoners on remand write letters to their judges, showing their remorse. I keep telling people that prison feels like a fever dream, and part of that unreality is down to the bizarre community of it all, where most of us mumbled around in something of a daze, be it through psychiatric medications, methadone, spice or gear.
Girls who had committed white-collar crime or came from a middle-class background were more likely to distance themselves from the prison populace and act in ways that betrayed a deep sense of denial and fear, so any busybodying they did – telling tales about inmates in relationships with each other, or taking it upon themselves to enforce prison rules – would earn them the nickname Officer No-Keys. You had to adapt and survive, not divide and conquer. Every week I went to the prison Alcoholics Anonymous meeting and held hands with the other girls as we chanted, “God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” I felt comfort in this deeply feminine environment. So many of our crimes came back to our womanhood being the first offence: women who had finally snapped at abusive partners and patriarchal systems being persecuted for lashing out.
In very real ways it’s a deeply flawed and tragic environment, where women who self-harm measure their own blood in bottles, to prove they have lost the required amount to warrant a trip out to the hospital; anything to get off-campus. It reminded me of living in Calderdale, a deep valley in West Yorkshire. There was a phenomenon known as valley bottom fever: you were so surrounded by tall, imposing moors and so deprived of vitamin D that you’d often feel an undeniable urge to run, jump, escape. The suicide rates were high, and there have been at least 11 self-inflicted deaths in HMP Styal in the past 18 years. When a prisoner dies, the governor calls an emergency meeting in every unit and explains one of us has passed away. This happened three times during my six-month stay, and each time the governor said these were suspected suicides. That smell of blood sticks with you, like burnt, sugary pennies, but it’s a traumatic environment you’ve invited yourself into, so to feel in any way affected by it just adds an emotional guilt to the guilty plea – this is the mess I had got myself into, how dare I feel anything but sorry?
The prison estate is extremely self-aware. It knows it is functioning as a rehab and mental health hospital, that prison is not so much a prison as it is a last resort. We are all hit hardest when it comes to our families, and when my children visited me in the on-site soft-play area, I felt joy and love and unbearable shame and sadness. We all had our walls up in jail, and it became evident that the fear of being vulnerable had, in some butterfly-effect way, landed us here. When it came to talking about our families, though, our emotions were free-flowing, open, and unequivocally accepted. I will never forget the officers who were kind and empathic. I will also never forget the one who sang little songs about our broken lives and punishments as a joke.
The one big question is: how did it come to this? Surely, if I had a mental health team, a long-term diagnosis, a history of psychosis and hospitalisations, and a good support network of friends and family around me, how could it have possibly come to this? Well, I’ll tell you. And I’m afraid it’s not very good news. From my experience, there are two truths universally acknowledged by long-term users of psychiatric services: the crisis team will never not recommend a warm bath and a hot beverage, and unruly behaviour will be punished with a personality disorder diagnosis.
Unruly behaviour can look like any number of things: being upset when a mental health team break promises of care, showing anger in the face of abuse (historical or otherwise), questioning a psychiatrist’s judgment, asking for an advocate on the ward, identifying your triggers and early warning signs, and understanding when you are suicidal or in the early phase of a manic episode (this will probably be called “care-eliciting behaviour” – “attention-seeking” in medicalese). Psychiatry in 2025 would argue we’ve come a long way from Freud, but I can tell you, as someone who’s been “making use of services” my whole adult life, that everything you are and everything you do is because of your mother or father or both, and every expression of pain can eventually be boiled down to hysteria, which we now call emotionally unstable personality disorder (EUPD, also known as borderline personality disorder).
I’d been diagnosed with bipolar disorder when I was 22. Before that, the early intervention in psychosis team tried a few diagnoses on me to see if they would fit. Schizophrenia? Not quite. Paranoid personality disorder? Close, but no cigar. We all seemed to agree bipolar was correct, so that was my label, and I took bipolar medication with good results for a long time. That all changed very quickly when the trust’s new psychiatrist appeared not to like me raising my voice to him for dismissing my suicidal thoughts. It seemed he barely made eye contact with me as he told me I was on the wait-list for an inpatient bed, as if my pain was an inconvenience to him personally. I was wild, having rolling panic attacks that would last for hours, so when he saw me cry and demand to know what treatment I was going to get, if any, he stormed out in a huff, and I was told shortly afterward by the team manager that my diagnosis had been changed from bipolar disorder to EUPD; a diseased ego.
This diagnosis came at the denouement of a time when I had been going through the end of my marriage, detoxing from alcoholism and recovering from a serious sexual assault by a stranger in my own home, all while we were plunged into an unprecedented global pandemic. I did not behave well in the face of these events; I was not a very good victim. I was loud and angry. I was desperate and afraid. I was emotionally unstable in emotionally unstable times, and my psychiatrist decided this temporary reaction to a series of huge stressors was now my permanent state of being. And let me be clear – this is a diagnosis of exclusion, a washing of hands. Psychiatry is paternalistic and this is especially true when it comes to EUPD, which is seen as a refusal to be better, an unwillingness to behave. After all, who can help put your disordered personality back in order but yourself? There’s no licensed medication for it; it’s purely behavioural. Not long after my diagnosis, despite being clearly symptomatic, I was discharged from the community mental health team.
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Some argue EUPD is a misogynistic diagnosis that mostly serves to dismiss women in distress. The disorder itself has been in psychiatric practice only since 1980 when it appeared in the Diagnostic Statistical Manual of Mental Disorders III. The criteria are decidedly questionable: impulsivity, unstable relationships, unstable sense of self, fear of abandonment, anger, feelings of emptiness. These describe trauma responses and neurodiversity, and can easily be crafted into very feminine shapes: I’ve had friends clinically admonished for dyeing their hair different colours, as a sign of impulsivity and an unstable sense of self. But if that’s the case, why do cosmetics shops sell so much brightly coloured hair dye? I was never formally assessed, but I was later told my history of childhood physical, sexual and emotional abuse played a part in my diagnosis, and it’s not just the abuse, it’s how you deal with it – it must be processed with elegance and good grace. If you go off the rails, do drugs, drink, screw around, then the criteria are met, the diagnosis is made, rinse and repeat.
After this diagnosis, any other symptoms of my bipolar illness were assumed to be malingering. I had two serious suicide attempts and four hospitalisations in those two years, and psychosis and mania that went untreated, because I had to be moulded into the EUPD diagnosis rather than a diagnosis fitting my experience. Adult social services, crisis resolution and home treatment team, police, local accident and emergency departments and my GP were all aware of my rapidly deteriorating mental state in the weeks and months before my arrest. All must refer back to the behemoth of the community mental health team, and if they need you to not be sick, then you are not sick, and no amount of concerned professionals, family and friends, or members of the public can convince them otherwise.
The process of diagnosis in prison is a lot more urgent and thorough. It’s not the time to speculate or wait the patient out to see if she gets bored of her own distress and moves on to something more ladylike, such as taking up embroidery or getting married. You can’t release a patient from prison because you think that they’re too dramatic. Under section, you can be held for as long as it takes a consultant to figure out what your whole deal is, years in some cases, and if the consultant doesn’t fancy doing that, they can just release you back into the community, out of sight and out of mind. In prison, you are against the clock: either you are on remand waiting for a psychiatric report, or you have been sentenced and need to be fixed as soon as possible before your release date to stop this happening again.
After a long talk with the forensic psychiatrist in the jail, the diagnosis of EUPD was withdrawn and I was told I was dealing with schizoaffective disorder, and given some information on what this illness is and how it is treated. Unlike when I was diagnosed with EUPD, and left to navigate a series of vague, nebulous criteria that felt as though they’d reached me by hearsay, the forensic psychiatrist explained to me how she arrived at schizoaffective disorder, and it made as much sense to me as a physical health diagnosis would – the symptoms were clearcut and highly relatable: intense and enduring manic episodes, long and unexplainable depressions, regular hallucinations, outlandish delusions, a twitchy tendency to paranoia. The real proof for me was seeing how highly effective the medications became for me; I was given a high dose of some familiar antipsychotics, and I signed lots of consent forms and got a contraceptive implant allowing me to take a mood stabiliser that works amazingly well, but is very dangerous in pregnancy. My personality hadn’t been diseased; my brain had been glitching. At the very least, at the end of all this, I felt a small sense of vindication, but at what cost? I knew I had been telling the truth, but it was a pyrrhic victory. In the prison psychiatric department waiting room, I kept thinking of Spike Milligan’s gravestone: I told you I was ill.
On the day of my sentencing, after three months on remand, I was shown the CCTV of my crime. I imagined I’d bumbled into the place, maybe knocked a pyramid of tinned beans over and made a farce of the whole thing. I pictured it as a completely nonsensical event. But as I watched myself on the big screen, I saw the unbearable truth: this really had happened, and it all looked so horribly real – me screaming at the cashier with a convincing toy pistol, committing real armed robbery. As the psychiatric report had stated: “According to witness statements, she appeared to be erratic and violent, which is in keeping with a manic episode.” Erratic. Violent. I cried in the dock with convulsions of grief I had never experienced before. It was as if the years of pain and anguish were being wrenched out of me on this final day of judgment. The holding cell, in the bowels of the crown court building, knows my secrets. It held me coldly as I prayed for justice, whatever that may look like, and as I said the names of my children over and over as if to telepathically communicate my remorse and my failure, and frantically figure out how I’d cope with the three to five years away from them my legal team had told me to expect. But then came another act of extreme grace and humanity: the judge ruled I had to serve only three more months. She said that she has seen this kind of thing a lot in recent years, that she accepted I’d been “passed round from pillar to post” with no help, no end in sight. She even considered releasing me that day, but was told that I’d be released without mental health support, something I could access on the outside only as a sentenced convict on community licence (just in case the system wasn’t broken enough already). But something else changed in me that day. For the first time in years, I wanted to survive, to really live, and be the most myself I could be.
When I got back to HMP Styal, I asked the prison chaplain for any spare notebooks and pens, so I could start writing poetry again. I sent a few early drafts to my publisher and he said if I could put a full collection together, he’d publish it. Now I had a goal, this hadn’t all been for nothing. I got a job on the inside working on National Prison Radio, a radio station that broadcasts to prisons across England and Wales, and now on the outside, I still do that job. It’s the best job I’ve ever had. I called my children every night from jail; my friends inside knew everything about them. At night when I can’t sleep, I wish and hope they are too young to remember when Mama was so crazy she went to jail.
I actually cried leaving prison. Not just through the sheer joy of being reunited with my sons, but a grief at leaving my prison friends behind. You make strong bonds inside; you have to – it’s a pressurised environment and making friends is how you pull through. You say you’ll stay in touch but you know you can’t, for the same reason you don’t stay in touch with rehab or psych ward friends: it’s a trauma bond, you have to go and stay gone. But I was also terrified of going back into the community. I’d received better help in prison than any hospital or community care unit, and did it really have to come to all this? Did I have to serve six months in prison to get my old prescription back? Does the fact that good things came from my incarceration mean it was all for the best? Are these the things we are supposed to count as blessings?
Life is undeniably better now. I have never been so present and open with my children: I have more to offer them as a mother now than I ever did bed-hopping from one psychiatric hospital to the next. I’ve been clean and sober for 15 months, with no desire to self-medicate now that I’m stabilised on medication. I live in sheltered accommodation, but I am able to look for my own place soon, now that I feel ready to live alone again. I still experience mild ups and downs, but they’re like a teaser trailer for schizoaffective disorder – I get the general gist but don’t have to sit through the whole thing, wondering when the hell it’s going to end. But can I say this will never happen again, back under the care of the same community mental health team that let this happen in the first place? I’ll be honest: that part continues to scare me. I can advocate for myself, even when I am exhausted, and I can keep hoping and fighting for my life. I am grateful every day that my ability to hope and love and feel gratitude is still with me, and every day when I walk through the front door of my ex’s house where my children currently live, and they shout, “It’s Mama!” and throw their chubby little arms around me, I realise a person can absolutely feel two things at once: angry at the system that tried to annihilate them, and gloriously content at the life they now have.
