Category Archives: Psoriasis

UEA course cut a blow for mental health work | Letters

All the parties in the general election have adopted mental health as a key issue. But this enthusiasm is not reflected on the ground and the electorate should not be fooled. We are students and former students on the internationally renowned counselling programme at the University of East Anglia. We trained to be counsellors, or “shrinks”, to quote Prince Harry in his recent interview. But now the university has closed the course and even made it impossible for some students to complete their professional qualification. As part of this draconian process, in which consultation was at a minimum, responsibility to students, staff and the wider local community has been completely deprioritised. This is exactly the opposite of what the princes, applauded by the government, were calling for.

The impact is not only on the course itself, but also on those therapy organisations where students have for many years worked as volunteers on placement and beyond, and on the availability of the kind of in-depth listening relationship – described as so crucial by the princes – in the university’s own counselling service. The management-speak reason given by the university for this closure is “a need for greater alignment of courses and a more coherent portfolio of activity centred on the teaching of education theory and practice”. What is the point of accenting mental health if there won’t be any counsellors to deliver it?
Sara Bradly, Dr Rachel Freeth, Bridget Garrard, Nikki Rowntree
Norwich

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

UEA course cut a blow for mental health work | Letters

All the parties in the general election have adopted mental health as a key issue. But this enthusiasm is not reflected on the ground and the electorate should not be fooled. We are students and former students on the internationally renowned counselling programme at the University of East Anglia. We trained to be counsellors, or “shrinks”, to quote Prince Harry in his recent interview. But now the university has closed the course and even made it impossible for some students to complete their professional qualification. As part of this draconian process, in which consultation was at a minimum, responsibility to students, staff and the wider local community has been completely deprioritised. This is exactly the opposite of what the princes, applauded by the government, were calling for.

The impact is not only on the course itself, but also on those therapy organisations where students have for many years worked as volunteers on placement and beyond, and on the availability of the kind of in-depth listening relationship – described as so crucial by the princes – in the university’s own counselling service. The management-speak reason given by the university for this closure is “a need for greater alignment of courses and a more coherent portfolio of activity centred on the teaching of education theory and practice”. What is the point of accenting mental health if there won’t be any counsellors to deliver it?
Sara Bradly, Dr Rachel Freeth, Bridget Garrard, Nikki Rowntree
Norwich

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

General election 2017: ITV hosts first leaders’ debate – politics live

16:37

Question 5 – Young people

16:32

16:25

16:21

16:19

16:17

16:17

Question 4 – Education

16:12

16:11

16:10

16:08

Corbyn’s inspiring manifesto takes me back to Labour 1945 blueprint for hope | Harry Leslie Smith

It was at Bradford University on Tuesday that Jeremy Corbyn unveiled the Labour party’s election manifesto. In the grand hall, Corbyn spoke to an enthusiastic gathering of students and party faithful about the concrete plans Labour has to transform Britain into a country where the many will prosper instead of the few. Corbyn spoke about the need to properly fund the NHS, provide free tuition to students, end the blight of zero-hours contracts, and raise the living wage to £10 an hour.

For me, a man who was born and bred in the harsh poverty of Britain after the first world war, it was inspiring. But what moved me most was the venue he chose to announce this manifesto of equality and fairness – because Bradford University is built on ground that, in my youth, was a site of great suffering and death.

You see, within the boundaries of what is now the university campus, my boyhood dreams and idealism were crushed under the cruel weight of austerity during the Great Depression. When I was young, this was not a place where one’s future was made but where it was condemned. The grounds that now hold this university contained a slum, and hope never penetrated its dark, enveloping canopy of destitution.

My family arrived in the neighbourhood that once covered this well-maintained university as penniless and jobless economic migrants from Barnsley in 1929. Then, it was an endless, warren-like landscape of dilapidated houses that nestled in cul-de-sacs where no one expected to enjoy either a decent or a long life because there was no welfare state or NHS. If hard luck struck, all that was available was poor relief, which paid a mean weekly stipend that guaranteed either starvation or homelessness.

My family couldn’t survive on poor relief, so we ended up living cheek by jowl in a doss house with a multitude of other desperate characters. Like us, all of them had been washed up on its doorstep like the flotsam that crashes on to a desolate beach after a terrible tempest. Soldiers from the first world war who had been promised a land fit for heroes by lying politicians resided in the doss where my family kipped. During the day, they still tried to hold themselves up bravely.

Like my dad, these Tommies looked for work in a city whose factories had been hushed by the collapse of the world’s economies. But at night when they tried to sleep, weary from unemployment and PTSD, I’d hear their cries of terror because their dreams had sent them back into battle at Ypres or the Somme.

As for me, my childhood was a nightmare of indentured servitude and malnutrition. At bedtime, my sister and I would huddle together for warmth on a piss-stained flock mattress on an unlit garret floor. We would try to quell the gnawing in our stomachs by wondering what our king had eaten for his tea that evening.

Even while playing, my boyhood was never blissful. In this part of Bradford I was always reminded that death for the poor is miserable, brutal and lonely: from open windows, I heard the inhuman howls of cancer sufferers dying in agony because poverty denied them the dignity of morphine.

But all of that changed in 1945 when, at the end of the second world war, the Labour party fought a general election on a manifesto that promised the creation of the NHS, affordable education, an end to that era’s housing crisis and fair conditions for all workers. The Labour party’s 2017 election manifesto echoes the sentiments found in Labour’s 1945 manifesto that inspired my generation to build a just society.


I can tell you as a very old man: I am afraid for the future of ordinary people in Britain

When I remember all the pain and sadness that once populated the part of Bradford that now houses its university, I can’t think of a better tribute to all those whose lives were blighted by the Great Depression than for Labour to have unfurled its manifesto here for the nation to see.

But I fear that the 2017 manifesto, no matter how just and how right for our times, may not catch the wind it needs to help this country sail forward to hope and prosperity because we have forgotten the hardships, tragedies and triumphs of my generation. It’s sad for me to ponder how on Remembrance Sunday people speak solemnly about their commitment to never forgetting those who fell in war, while those uncountable lives that were cut short because of economic injustice throughout the early part of the 20th century are forgotten.

I can tell you, as a very old man, that I am afraid for the future of ordinary people in Britain. Because by the time the next general election is scheduled, in 2022, most of those from my generation, who have survived for so long, will be dead or incapacitated. No one then may be left alive to remember the profound suffering, the hardship, the sorrow and the eventual victory all those nameless, ordinary people achieved in 1945 with election of a Labour government.

Forgetting them, and the lessons your parents or grandparents taught you from their lives about how to overcome austerity and build a proper and just society, will condemn you to something far worse than I experienced growing up.

Corbyn’s inspiring manifesto takes me back to Labour 1945 blueprint for hope | Harry Leslie Smith

It was at Bradford University on Tuesday that Jeremy Corbyn unveiled the Labour party’s election manifesto. In the grand hall, Corbyn spoke to an enthusiastic gathering of students and party faithful about the concrete plans Labour has to transform Britain into a country where the many will prosper instead of the few. Corbyn spoke about the need to properly fund the NHS, provide free tuition to students, end the blight of zero-hours contracts, and raise the living wage to £10 an hour.

For me, a man who was born and bred in the harsh poverty of Britain after the first world war, it was inspiring. But what moved me most was the venue he chose to announce this manifesto of equality and fairness – because Bradford University is built on ground that, in my youth, was a site of great suffering and death.

You see, within the boundaries of what is now the university campus, my boyhood dreams and idealism were crushed under the cruel weight of austerity during the Great Depression. When I was young, this was not a place where one’s future was made but where it was condemned. The grounds that now hold this university contained a slum, and hope never penetrated its dark, enveloping canopy of destitution.

My family arrived in the neighbourhood that once covered this well-maintained university as penniless and jobless economic migrants from Barnsley in 1929. Then, it was an endless, warren-like landscape of dilapidated houses that nestled in cul-de-sacs where no one expected to enjoy either a decent or a long life because there was no welfare state or NHS. If hard luck struck, all that was available was poor relief, which paid a mean weekly stipend that guaranteed either starvation or homelessness.

My family couldn’t survive on poor relief, so we ended up living cheek by jowl in a doss house with a multitude of other desperate characters. Like us, all of them had been washed up on its doorstep like the flotsam that crashes on to a desolate beach after a terrible tempest. Soldiers from the first world war who had been promised a land fit for heroes by lying politicians resided in the doss where my family kipped. During the day, they still tried to hold themselves up bravely.

Like my dad, these Tommies looked for work in a city whose factories had been hushed by the collapse of the world’s economies. But at night when they tried to sleep, weary from unemployment and PTSD, I’d hear their cries of terror because their dreams had sent them back into battle at Ypres or the Somme.

As for me, my childhood was a nightmare of indentured servitude and malnutrition. At bedtime, my sister and I would huddle together for warmth on a piss-stained flock mattress on an unlit garret floor. We would try to quell the gnawing in our stomachs by wondering what our king had eaten for his tea that evening.

Even while playing, my boyhood was never blissful. In this part of Bradford I was always reminded that death for the poor is miserable, brutal and lonely: from open windows, I heard the inhuman howls of cancer sufferers dying in agony because poverty denied them the dignity of morphine.

But all of that changed in 1945 when, at the end of the second world war, the Labour party fought a general election on a manifesto that promised the creation of the NHS, affordable education, an end to that era’s housing crisis and fair conditions for all workers. The Labour party’s 2017 election manifesto echoes the sentiments found in Labour’s 1945 manifesto that inspired my generation to build a just society.


I can tell you as a very old man: I am afraid for the future of ordinary people in Britain

When I remember all the pain and sadness that once populated the part of Bradford that now houses its university, I can’t think of a better tribute to all those whose lives were blighted by the Great Depression than for Labour to have unfurled its manifesto here for the nation to see.

But I fear that the 2017 manifesto, no matter how just and how right for our times, may not catch the wind it needs to help this country sail forward to hope and prosperity because we have forgotten the hardships, tragedies and triumphs of my generation. It’s sad for me to ponder how on Remembrance Sunday people speak solemnly about their commitment to never forgetting those who fell in war, while those uncountable lives that were cut short because of economic injustice throughout the early part of the 20th century are forgotten.

I can tell you, as a very old man, that I am afraid for the future of ordinary people in Britain. Because by the time the next general election is scheduled, in 2022, most of those from my generation, who have survived for so long, will be dead or incapacitated. No one then may be left alive to remember the profound suffering, the hardship, the sorrow and the eventual victory all those nameless, ordinary people achieved in 1945 with election of a Labour government.

Forgetting them, and the lessons your parents or grandparents taught you from their lives about how to overcome austerity and build a proper and just society, will condemn you to something far worse than I experienced growing up.

Cybersecurity stocks boom in wake of ransomware attack

The ransomware attack that disrupted the NHS and businesses around the world has led to a boom in share prices of cybersecurity companies – including the firm used by the health service to protect it against hackers.

With governments and companies expected to increase spending on IT security after being caught out by the attack, cybersecurity firms have seen their stock market values climb sharply over the past two days.

Sophos, a cloud network security specialist which counts the NHS among its clients, has seen its shares jump 8%. Over the weekend, a claim on the company’s website that “the NHS is totally protected with Sophos” was changed to “Sophos understands the security needs of the NHS”. Last week, Sophos tweeted its “top five tips for securing NHS organisations”. But its shares have been performing well over recent months because of the increased need for cyber defences.

Meanwhile, NCC group added 5% to its share valuation and cyber consultancy group ECSC surged 42%. ISE, a fund invested in cybersecurity businesses, added nearly 4%.

The surge has been put down to the attacks refocusing businesses on the need for adequate cybersecurity. “Significant increases in public sector cyber defence spending [are] now looking inevitable,” said Nicholas Hyett, equity analyst at Hargreaves Lansdown. “[Sophos] already provides services to the healthcare industry and will be looking to increase selling to the sector in the aftermath of the attack.”

US firms have also benefited, with FireEye’s prices rising 7%, Symantec up more than 3% and Palo Alto Networks 2.7% better. Neil Campling, head of technology research at financial services firm Northern Trust, told Reuters: “These attacks help focus the minds of chief technology officers across corporations to make sure security protocols are up to date, and you often see bookings growth at cybersecurity companies as a result.”

It was also suggested that the success of the WannaCry hack could make other attacks more likely in the future amid doubts over governments’ ability to secure “cyberweapons” from theft.

“The attacks raise significant questions about whether or not countries that are developing and stockpiling cyberweapons can do more to protect those tools from being stolen and turned against their own population,” said Thomas Fitzgerald, associate fund manager at EdenTree Investment Management. “The WannaCry attack is likely to be a catalyst for more of these types of cyber-attacks from copycat criminal organisations.”

The effects of the attack continued to be felt on Tuesday, although one of the seven NHS trusts which had still been experiencing serious problems on Monday, James Paget university hospitals trust in Norfolk, said that all of its operations and appointments were going ahead as scheduled.

Elsewhere the disruption continued. East and North Hertfordshire trust advised people to only go to A&E if absolutely essential.

Southport and Ormskirk hospital said it was continuing to experience difficulties with its clinical information systems but insisted that patient safety was being maintained. It advised all patients scheduled for surgery on Tuesday not to attend unless contacted and said all outpatients and endoscopy appointments were cancelled.

Barts health NHS trust said it was no longer diverting ambulances from its hospitals but was still experiencing delays and disruption. York teaching hospital NHS trust said bone scans at Scarborough hospital were not going ahead on Tuesday and that breast screening clinics in some areas had been cancelled. A number of affected trusts asked patients not to contact them by email because of ongoing IT problems.

NHS Digital said none of its services had been affected by the attack.

Damian Hopley on the end of his rugby career: ‘It was like a bereavement’

Damian Hopley knows from bitter experience that being a professional athlete can exact a heavy price on the mind as well as the body. Rugby players have always been in harm’s way and Hopley discovered this as a young man 20 years ago. Playing at centre for English Premiership rugby team Wasps, he won what looked like the first three of many England caps in 1995. Rugby union had just stopped being an amateur sport and the Cambridge graduate had given up his job in the City to ride this first wave of professionalism, but Hopley found himself in troubled waters.

In 1996, playing for England at the Hong Kong Sevens, Hopley injured his knee. He saw a surgeon but he injured the knee again and nine operations and two reconstructions later his professional career was over before it had really begun. “The hardest thing is the huge dent in your self-esteem and purpose and realising that you are not a rugby player. It was like a bereavement. Your sense of worth goes out of the window. I didn’t belong any more. Your personal life then goes into freefall because you become so self-obsessed. I had a girlfriend at the time and she walked out on me. Quite rightly, because I would have been a nightmare to live with.”

At 27, Hopley began working in the media and tried to get his life back on track. He met other sportsmen including the former Coventry City footballer David Busst and the former Gloucestershire and England cricketer David “Syd” Lawrence, whose careers had also been cut short by gruesome injuries. Meeting them, Hopley says, helped give him a fresh sense of perspective.

Damien Hopley (centre) in action for England against New Zealand at World Cup Sevens match in 1993.


Damien Hopley (centre) in action for England against New Zealand at World Cup Sevens match in 1993. Photograph: Mike, Hewitt/ALLSPORT

In the summer of 1998 Hopley set up the Rugby Players’ Association (RPA). “I was pissed off with the way I had been treated and that was the catalyst,” he says. There was initial opposition from the RFU and some club owners so Hopley began his project without being paid. But today, he runs an organisation that has about 700 current professional players, both men and women, and about 400 former players on its books.

Outside the sport, the perception of elite rugby players is one of steely alpha males, but the reality is often different. Several players have talked about their battles with depression, linked to the end of a career in the sport. The RPA has a new campaign, Lift the Weight, which includes a 24-hour counselling service. With chilling timing the initiative was launched in the week that Dan Vickerman, a recently retired Australia lock, was found dead at his home in Sydney. The 37-year-old had taken his own life.

Lift the Weight aims to encourage men – and not just elite rugby players – to talk about the issues. “Once people get to share the stories of their frailties it makes all the difference,” says Hopley. “Jonny Wilkinson, for instance, has been very frank about his demons.”

Fatal consequences of a lack of regulation | Letters

The government attributes 40-50,000 premature deaths each year to the effects of airborne pollution; there are some 1 million cases of foodborne illness, which result in 20,000 hospital admissions and 500 deaths a year; and up to 50,000 people die each year as a result of injuries or health problems originating in the workplace (Enemies of the state: the 40-year Tory project to shrink public services, G2, 9 May). Yet the rate of inspection and enforcement actions for environmental health, food safety and hygiene, and health and safety have all been falling. The statistically average workplace now expects to see a health and safety inspector once every 50 years.

In the name of cutting red tape, governments of all political persuasions have attacked independent regulation and enforcement. Budget cuts in the name of austerity have compounded the problem – especially at the level of local authorities. There is now a plethora of schemes to outsource and privatise wholesale some regulatory and enforcement activities. Private companies are increasingly involved in “regulating” either other private companies, or themselves, or both. Such changes mark the beginning of the end of the state’s commitment to forms of social protection put into place since the 1830s.
Steve Tombs
Professor of criminology, Open University

Recent reports say parts of the British Isles are in the early stages of drought, with less than normal amounts of rain in the past few months. South-east England is particularly affected. But hasn’t our climate often broken the norms in the last 40 years? Past performance is no guide to what will happen in the future. It would be a good time now, in this pre-election period, to ask our politicians what contingency plans they have for a prolonged drought lasting two or more years. Our survival may depend upon them.
Geoff Naylor
Winchester

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

Labour expels three members over attempt to unseat Jeremy Hunt

Labour has expelled three senior members in Surrey for trying to unseat the health secretary, Jeremy Hunt, by forming a progressive alliance with local Greens and Liberal Democrats to unite behind an NHS doctor standing against him.

Kate Townsend, the South West Surrey party secretary who stood in last week’s local elections, and Steve Williams, a party member for 46 years who sits on the constituency party’s executive committee, were notified of their expulsion this week.

Robert Park, a Labour member for almost five decades who chaired the Surrey Fabians and ran the regional remain campaign, has also been expelled.

Townsend and Williams have been leading figures in the campaign for a progressive alliance between local parties, where the Conservative cabinet minister has a 28,000 majority.

Williams has been working on behalf of Compass, the centre-left thinktank and champion of grassroots progressive alliance initiative, in defiance of the national party, which has said it will not entertain any notion of local party cooperation at election time. Party rules state that members must not support any other candidate for election who is running against Labour.

“We have massive support from the local party,” Williams told the Guardian. “It is such an overkill reaction to a group of people who are trying to unseat the health secretary. There was a campaign meeting last night, we only found out a few hours before that we had been expelled from the party so we weren’t able to go. People were storming out of the meeting, really very, very upset and angry.”

In a letter from the party’s head of disputes, Sam Matthews, Williams was told: “It has been brought to our attention with supporting evidence that you have publicly stated your support for a party that is standing against the Labour party in the 2017 general election, which is incompatible with membership of the Labour party.”

Williams was “ineligible to remain a member of the Labour party and have been removed from the national membership system”, the letter said, adding that he was no longer entitled to attend local Labour party meetings.

The party will consider an application for readmission only after five years, the letter said, though Williams said he was planning to appeal. The letter included supporting evidence, including Williams’ appeal for signatures for a letter to the Guardian supporting Irvine’s candidacy.

“We have been doing our best to unseat Jeremy Hunt, to hold him to account on his record because of what he has done to the health service over the last five years,” Williams said.

The initiative to back the National Health Action party’s Dr Louise Irvine, who received just over 8% of the vote in 2015, has the backing of local Labour leaders, including Townsend. Irvine, a GP, was the chair of the Save Lewisham hospital campaign, which defeated the government in court over the proposals to downgrade A&E and maternity units.

Williams said Irvine was “able, articulate, very capable of being able to hold Jeremy Hunt to account, when the NHS is such a key issue in his constituency”.

Local Lib Dem activists have also agreed not to campaign, after a meeting in Farncombe organised by Compass with members from progressive parties. The Green party has said it will not field a candidate.

Neal Lawson, chair of Compass, said: “Steve Williams has given 46 years of service to Labour and was backing a local doctor to take on Jeremy Hunt and defend the NHS. For this he got expelled by email. Labour is a tribal party in a non-tribal age.”

Park, who also stood for election for Labour last week, told the Guardian he had been expelled after an interview with the BBC’s Today programme in which he expressed cautious support for Labour standing aside.

“I have to say, I was upset,” he said. “It was a blunt, legalistic email message, I joined the party as student in 1963, I had thought particularly that somebody might have phoned to talk to me first, I’ve spent most adult life helping the cause.

“The irony is that [we are] three most loyal Labour members you could hope to get; when people were attacking [Labour leader Jeremy] Corbyn, we’ve stuck by him. Now we’re all out on our neck.”

Park said he still intended to volunteer to help Labour MPs in marginal seats, as well as considering campaigning to help the Lib Dem former cabinet minister Vince Cable regain his seat in Twickenham, south-west London.

“Whatever we do, the likelihood is that Jeremy Hunt going to win,” he said of his constituency. “Nonetheless we’re tired of having a small share of the vote and we do feel that if we get behind one candidate we can stand some chance of denting his majority.”

Labour has selected IT manager David Black to fight the seat for the party after the CLP chair, Howard Kaye, the party’s candidate in 2015, has said he would not stand again. The Lib Dems have also selected a candidate, Ollie Purkiss.

The Green party co-leader Caroline Lucas has called for talks with Corbyn, and the Lib Dem leader, Tim Farron, to make a “series of electoral alliances” in some areas against the Conservatives before the election, though both have publicly rejected her entreaties.

Local Greens made the decision to stand down in the recent Richmond Park byelection, in which the Lib Dems’ Sarah Olney unseated the former Tory mayoral candidate Zac Goldsmith.

The party has also decided to stand aside in several seats at the general election in June, including Ealing Central and Acton, to bolster the chances of Labour’s Rupa Huq in the marginal.

Lucas has called for Labour and the Lib Dems to respond similarly to strengthen her party’s chances of taking the Isle of Wight, where the party hopes to capture the traditionally Conservative seat after its good showing in local elections.

‘I don’t know who I am without it’: the truth about long-term antidepressant use

Sarah never planned to take antidepressants for 14 years. Three years after she began taking them, when she was 21, she went to her GP and asked to stop: 20mg of Seroxat a day had helped her live with anxiety and panic attacks, but she began to feel uncomfortable about being on medication all the time. Her doctor advised her to taper down her medication carefully.

At once, “I was a mess,” she says. “I thought I was losing my mind. My appetite completely went. I lost the best part of two stone. I was anxious constantly. My mouth was dry. It was difficult to sit and be calm.” She became withdrawn, refusing to see friends, and remembers asking her mother to get her a couple of boxes of paracetamol, thinking, “I’m going to have to take all these tablets, because I can’t live like this.”

Sarah’s doctor encouraged her to go back up to 20mg. “Within a week, I was much better. I feel anger when I look back. That wasn’t me relapsing, that was withdrawal. But I was so unwell, I didn’t stop to think, ‘I’ve never had this before.’ I truly thought it was me. Now the only reason I am on the drug is because I am dependent upon it. And that is not good enough.”

Prescriptions of SSRIs (selective serotonin reuptake inhibitors), the most common type of antidepressant, have doubled in the past decade. There are now more than 70m prescriptions dispensed in the UK in a year, the “greatest rise” of any drug in the last year, according to NHS research. But while the side-effects of starting and then withdrawing from these drugs are reasonably well known (the patient information leaflet accompanying the SSRI Seroxat is six pages long), there is very little research into the long-term effects of using antidepressants.

Last year, an all-party parliamentary group began hearing evidence as to whether there is a link between a measurable rise in mental health disability claims – 103% between 1995 and 2014 – and that in antidepressant prescriptions. (Claims for other conditions fell by 35% in the same period.) “We need to have a serious rethink about current levels of prescribing, because it may well be that the drugs are in fact contributing to the disability burden,” Dr Joanna Moncrieff, a consultant psychiatrist and senior lecturer at University College London, told the committee.

Reports both anecdotal and clinical have included side-effects such as constant pain, an altered sense of smell, taste or hearing, visual problems, burning hands and feet; food or drug intolerances and akathisia (the medical term for a deep inner restlessness). When a patient begins tapering down their dosage, these effects are generally ascribed to the drug leaving their system; if it is long after withdrawal is supposed to be over, however, patients are often disbelieved (according to the drug companies, withdrawal should take just two weeks for most people, though they acknowledge that for some it can be months).

Professor David Healy, director of the department of psychological medicine at Cardiff University and author of 22 books on psychopharmacology, believes that antidepressants are overprescribed. “If you go into your average doctor – if you’ve been off the drug for half a year or more – and you complain [of a range of symptoms] and say, ‘I think it’s caused by this pill I was on’, he or she would say, ‘It’s been out of your body for months. You’re neurotic, you’re depressed. All we need to do is put you on another pill.’”

GPs, Healy says, are “relying on your word, and if it’s a choice between believing what you say and relying on what drug companies say to them, they [tend to] believe the drug companies”. Healy, who has been a consultant for, and expert witness against, most of the major pharmaceutical companies, has long argued that long-term side-effects are routinely ignored or misunderstood.

But many experts believe these drugs do more good than harm. “Most of the people I see who have moderate to severe depression benefit from them,” says Daniel Smith, a professor of psychiatry and researcher into bipolar disorder at the University of Glasgow. For some, medication can be no less than “transformative. It can get them through a really critical period of their life.”

However, when it comes to long-term impact, especially after a person stops taking SSRIs, Smith says it can be hard to work out which symptoms relate to the drug use and which to the underlying conditions. “There’s obviously an issue of cause and effect. How can we be certain the SSRI caused it? Depression affects libido and sexual interest. How much [of the reported effects] is depression and/or anxiety symptoms coming back?”

A Seroxat box and pills


By 2003, worldwide sales of Seroxat, manufactured by GlaxoSmithKline, were worth £2.7bn. Photograph: Alamy

SSRIs have been around for more than 40 years, but grew in popularity in the late 1980s and 90s after pharmaceutical company Eli Lilly launched fluoxetine, otherwise known as Prozac. Time magazine put the drug on its cover twice, asking, “Is Freud finished?” and describing SSRIs as “mental health’s greatest success story”. In 2001, a landmark report on a clinical trial into paroxetine (sold as Seroxat in North America and Paxil in the UK), called Study 329, concluded that it demonstrated “remarkable efficacy and safety”. Study 329 led directly to a massive increase in prescriptions: by 2003, worldwide sales of Seroxat (manufactured by GlaxoSmithKline) were worth £2.7bn.

But concerns were raised about the study –the US food and drug administration (FDA) officer who reviewed the data disagreed with the findings, calling it a failed trial – and in 2015 the British Medical Journal published a re-evaluation. Seven authors went through as many of the thousands of individual case reports as they could, and found not only that “the efficacy of paroxetine… was not statistically or clinically different from placebo”, but that “there were clinically significant increases in harms, including suicidal ideation and behaviour”. The original study reported 265 adverse reactions; the BMJ found 481. The re-evaluation also found that psychiatric responses were grouped together with “dizziness” and “headaches”, rather than given their own category. In 2003, the UK banned the use of Seroxat by anyone under 18; and in 2004 the FDA required a “black box warning” on all antidepressants, its strictest level of patient warning.

“Patient safety is our number one priority,” a GlaxoSmithKline (GSK) spokesperson tells me. “We believe we acted responsibly in researching paroxetine, monitoring its safety once it was approved and updating its labelling as new information became available.”


It’s more reliably predictable that they’re going to get rid of sexual function than get rid of depression

Many SSRI users report blunted emotions, even long after they have ceased taking pills, and an impact on sexual function. “They should be called anti-sex drugs rather than antidepressant drugs,” says Jon Jureidini, a child psychiatrist of 30 years’ standing, a professor of psychiatry and paediatrics at the University of Adelaide and co-author of the BMJ study, “It’s more reliably predictable that they’re going to get rid of sexual function than it is that they’re going to get rid of depression.” Again, some people find this persists long after they cease taking the drug. One person I spoke to, Kevin, had taken Prozac for six months when he was 18; now 38, he hasn’t had an erection since.

Last September, Healy and colleagues published a further examination of the data gathered for Study 329. This data followed the trial participants for six months after they started taking paroxetine (the “continuation phase”) and while they were tapered off it. GSK, which in 2004 published a clinical study report, had argued that “the long-term safety profile of paroxetine in adolescents appears similar to that reported following short-term dosing”. Healy and co, however, concluded that the “continuation phase did not offer support for longer-term efficacy”. More alarmingly, they found that the taper phase, when patients were being taken off the drugs, was the riskiest of all, showing a “higher proportion of severe adverse events per week of exposure”. This, they said, opens up the risk of a “prescribing cascade”, whereby drug side-effects are thought to be symptoms, so are treated with further drugs, causing further side-effects and further prescriptions – thus increasing the risk of long-term prescription drug-dependency.

In October, the British Medical Association published its response to a two-year fact-finding exercise into long-term use of psychoactive drugs. It noted that while benzodiazepines, z-drugs, opioid and antidepressants are “a key therapeutic tool”, that their use can “often lead to a patient becoming dependent or suffering withdrawal symptoms… the evidence and insight presented to us by many charity and support groups… shows us that the ‘lived experience’ of patients using these medications is too often associated with devastating health and social harms”; it was therefore, the report concluded, a “significant public health issue”.

The BMA made three key recommendations: first, and most urgently, that the UK government establish a 24-hour helpline for prescribed drug dependence; second, that it establish well-resourced specialist support units; and third, that there should be clear guidance on prescription, tapering and withdrawal management (they found the current approach to antidepressants, in particular, to be inconsistent: too many patients were suffering “significant harm”). There are also increasingly urgent calls for studies into long-term effects that are not funded by drug companies, because, Moncrieff says: “We don’t have very much data. This research is really important, but hasn’t been done. It’s a massive blind spot. It’s extraordinary – or maybe, given the pressures and interests at work, not extraordinary at all – that it hasn’t been filled.”

In March this year, members of the BMA, along with MPs and researchers from Roehampton University, went to parliament to lobby Public Health England, armed with research estimating that there are 770,000 long-term users of antidepressants in England alone, at a cost of £44m to the NHS per year (a figure that does not account for the cost of GP appointments, or the impact of side-effects, withdrawal effects and disability payments).

“I think you have to adopt a very conservative approach,” says psychiatrist Jon Jureidini. “These are brain-altering drugs, and our overall experience with brain-altering drugs of all kinds is that they tend to have a detrimental effect on some proportion of people who take them long term. All we know about the benefits is from short-term symptom-reduction studies. The careful prescriber needs to say, ‘Well, in balancing the likely benefits and harms, I need to be very cautious about how much benefit I’m expecting, and I need to be very generous about the possibility that the harms might be more than they appear to be.’”

Quite a few long-term users, such as those I spoke to below (and who wished to be anonymous), would agree.

‘Tapering off is the hardest thing I’ve ever done’: Sarah, 32; has taken Seroxat for 14 years

I was prescribed Seroxat when I was 18, the year I started university. I grew up with a disabled sister, so things at home were very stressful, and I had a history of anxiety and panic attacks. I had counselling, but the problems persisted, so I went back to the GP. I don’t remember everything that was said, but there was no conversation about side-effects.

Within the first two weeks of starting Seroxat, I remember I was sitting in the front room watching TV when out of nowhere I had this intense feeling of heat, like an electric shock. It started in my hands, went all the way up my arms and through to my head.

The GP said it was probably just my body getting used to the drug. And after a few weeks the weird sensations did ease off. I had a fabulous time at university. I still had panic attacks, and there were certain situations I would avoid – as I still do – so it wasn’t a wonder drug, but there were no major problems.

But in 2006 I tried to come off it. There were a couple of Panorama documentaries about the side-effects and I was starting to become concerned. The GP said, “That’s fine, but do it gradually, over three weeks.”


I thought I was losing my mind. I was going to work, but it was difficult to get through the day. My mouth was so dry

I immediately became incredibly unwell. I thought I was losing my mind. I was going to work, but it was difficult to get through the day. My mouth was so dry, I was constantly drinking water. I had bizarre thoughts – not hallucinations – that were frightening or distressing. I had a strong sense of detachment from reality.

Eventually, the doctor said, “Look, you coming off is obviously not working: we need to get you back to 20mg.” Within a week I was much better.

A few years later, when I realised my mental health was getting worse, even though I was on the medication, I started to do some research, reading case studies about withdrawal. I find it so offensive when a GP says, “This is who you are.” I didn’t have these symptoms 10 years ago. I didn’t have this sense of detachment. I saw various psychiatrists. They just kept saying, “The drug is safe, you need to be on it.” A couple of others told me the reason I was having these problems was because I wasn’t taking enough. Another said, “If you were diabetic, you’d take insulin and you wouldn’t have an issue. Why are you so bothered about taking this drug?”

I’ve been on it since I was 18, so I don’t know who I am without it, as an adult. Who knows? I might have all kinds of problems, but I need to know I’ve tried. Tapering off is the hardest thing I’ve ever done. It’s taken me three years just to get from 20mg to 5mg. I’m no longer with my partner – we were together for six years. I believe Seroxat has played a part: it affected my moods, it made my anxiety worse and, by necessity, I’ve had to be selfish, really. I don’t want to say all my problems are to do with Seroxat, because they’re not. But I do believe that it has caused me harm.

‘I don’t have much of an interest in interacting romantically or physically with the opposite sex’: Jake, 24; took SSRIs for eight years

I had been dealing with symptoms of OCD and anxiety for a lot of my childhood. It’s in my family, affecting two siblings and one parent. I was prescribed Zoloft when I was 12; I took a variety of SSRIs, Zoloft to Prozac to Lexapro, and then two others, for eight years.

Did they help? You know, I can’t really tell you, because I got through school. I got high marks, I had a lot of friends. So, in that sense, they must have helped. That’s the thing: for people with major depression, it’s easy to say, this has a measurable effect. But I kept taking them just because that’s what I’ve always done.

I went to university right out of school. I did very poorly. I had a bit of a breakdown, isolating myself, not sleeping. I was still on medication. I came home and enrolled at a community college. That was my worst period – I was very depressed. And I started to think, “I’ve been on these medications a long time. I’m not doing well – why not get off them?” I don’t recommend this at all to anyone, but I stopped going to a psychiatrist and took myself off.

prozac


Prozac. Photograph: Getty Images

For months I had trouble sleeping. I was jittery. I had brain zaps. My anxiety was pretty ramped up. I would feel numbness in my extremities – generally my arms. My psychiatrist told me these were just normal withdrawal symptoms, and they’d be gone in four to six weeks: “Anything you feel beyond that is your anxiety and depression returning.” Basically, if you still feel anything beyond this window that the medical community has established, it’s all in your head.

Eventually I went back to school full-time, and I remember doing OK, feeling somewhat better.

I’ve now been drug-free for four years. What’s lasted are the sexual side-effects. They were definitely worse in withdrawal than they had been on the drug, even though I didn’t really realise or understand it at the time, primarily because I started to take SSRIs at 12. While my brother took the same medicine over the same period and had a normal sexual life, I had a lack of sexual interest. I had erections, and I have regularly masturbated my entire life. But I don’t have much of an interest in interacting romantically or physically with the opposite sex.

I didn’t even start thinking about sex until a couple of years ago. It’s almost like I woke up one day and thought, “OK!” I started getting these windows – days or weeks – when normal sexual feelings would appear. But they’re new to me and I don’t know what to do about them. And because I don’t know what to do, I get anxious, and the anxiety kills any feeling – and then I’m anxious because I’ve lost all my feeling.

Online, I’ve come across a big asexual community. Some also took antidepressants; I think there are a lot of people like me out there. I’d like to think that if I keep going to counselling and sleeping and eating properly, I can rectify these things.

In the end, it’s about pros and cons. If you’re lying in bed and can’t get up, is it better to function? If it was up to me, I’d say that, barring extreme circumstances, nobody under 18 should be prescribed these things. Your brain develops around them. Drug companies should be thinking of the long-term effect on people who can’t even consent.

‘If I missed a dose, I’d get shocks down the side of my body’: Chris, 43; has been taking Seroxat for 26 years

I was originally prescribed Seroxat for mild anxiety about my GCSEs. It was 1991, about the time GlaxoSmithKline released Seroxat. I was one of the first people to be given it.

I was prescribed 20mg, the basic dose, to start with. It helped me: I got through school, I went to uni, I went to work. But I had side-effects from the off: profuse sweating, low libido. I’m quite a placid person, but I became aggressive. I never suffered, in the beginning, with the suicidal thoughts that people talk about now, but what I did notice was that if I missed a dose – especially after eight years of taking it – I’d get shocks down the side of my body. I’d be nauseous, my limbs would become weak. I’d be in a constant state of confusion and was very impatient. I couldn’t communicate well with people. I said this to the doctor, and he said, “We’ll up the dose to 40mg.” That was 1998.


I tried to go back to 20mg, but my words became slurry, so the doctor put me back up to 60mg

The 10 years after that weren’t too bad. I managed to work, as a sales rep, for 18-20 years. But by 2012, by which time I was up to 60mg, I had tried on numerous occasions to withdraw. I tried to go back to 20mg, but my words became slurry, so the doctor put me back up to 60mg.

By the time I was 38, even that wasn’t enough. I tried to take my life. The doctor wouldn’t prescribe a higher dose. I couldn’t do my job, I couldn’t concentrate, I couldn’t drive. A psychiatrist once said to me that coming off Seroxat is harder than quitting heroin. That really hit home.

I have now been unable to work for four years. I’m still seeing a psychiatrist. I’ve also been diagnosed with fibromyalgia: constant tiredness, aches in the neck, and in the lower back and lower limbs. I’m 43 and still live with my mum and dad.

I also have no libido. Since the age of 30, I have had no feelings in that regard whatsoever. I have had relationships, but they’ve all failed. I haven’t been in a relationship for 10 years, which is a long time to go without sex, but I just don’t get the urge.

I don’t really have emotions, to tell you the truth. The drug takes your emotions away. I’m sort of existing, not living.

And when the drugs do work…

‘I wanted to be able to feel good when good things were happening, bad when bad things were happening’

By Simon Hattenstone

I suppose I was a depression snob. A purist. Why should I take antidepressants? Yes, there was something rubbish about crying all the time, not functioning, being unable to answer simple questions because of the fug in my head. But, hey, at least I was true to myself.

My depression went back to my late teens. I didn’t like to think of myself as depressive, because depressives were losers. And I didn’t think I fitted the bill: I was pretty funny and able, and I could get girlfriends. I guess most depressives don’t think they fit the bill.

It might have been genetic. My dad had paralysing depression, and so did his father. As a young boy, I’d spent three years off school with encephalitis – an inflammation of the brain that is often fatal. Survivors are often left with depression.

I remember as a teenager being on holiday in Greece with friends. The weather was gorgeous, and I thought, “Why can’t it piss down, because then at least I’d have a reason to feel this way?”

That is what I always craved – objectivity. To be able to feel good when good things were happening, to feel bad when bad things were happening. I hated the fact that my feelings rarely correlated to what was going on in my outer world.

In my 20s, I got by. I held down a good job, fell in love, had kids, made friends, had a pretty good life. But things came to a head when my best friend killed herself. I’d find myself weaving in between traffic wondering what the impact would be like. I took a period off work and gratefully accepted my Prozac prescription.

Things had changed since I first rejected them. Prozac looked cool (lovely green-and-white pills) and rock bands wrote great songs about it (even if REM’s Shiny Happy People was supposed to be dystopic). After telling people I was off work with depression, I ended up feeling like a priest at confessional. It turned out that virtually everybody I knew was a depressive and pilling their way out of it; now it was “our secret”.


I would try to come off the pills and felt rubbish again – not more rubbish than before, but the same. So I returned

Initially, Prozac made me feel sick. And then magically, after a couple of weeks, I felt lighter, as if something had been lifted. I could hear questions properly, answer logically, enjoy a sunny day.

My partner said I was transformed. Occasionally, I would try to come off the pills and felt rubbish again – not more rubbish than I had before, but the same. So I returned, and after a while, I thought, “What’s the point of even thinking about coming off the pills if they make life work for me?”

There are times now when I wonder if I weep and fret and withdraw too much, and whether I’m becoming immune to the Prozac. But on balance I think not, because life is still so much better than it was.

If Prozac was no longer working for me, would I stop taking it? Probably. Would I stop taking antidepressants full stop? I doubt it. I’d simply look for another super pill.

Are you a long-term user of antidepressants? Tell us about your experiences

  • If you are affected by the issues raised in this piece, contact the Samaritans here.