Tag Archives: week

Do you work more than 39 hours a week? Your job could be killing you

Long hours, stress and physical inactivity are bad for our wellbeing – yet we’re working harder than ever. Isn’t it time we fought back?

Health at work illo 1


Illustration: Leon Edler

When a new group of interns recently arrived at Barclays in New York, they discovered a memo in their inboxes. It was from their supervisor at the bank, and headed: “Welcome to the jungle.” The message continued: “I recommend bringing a pillow to the office. It makes sleeping under your desk a lot more comfortable … The internship really is a nine-week commitment at the desk … An intern asked our staffer for a weekend off for a family reunion – he was told he could go. He was also asked to hand in his BlackBerry and pack up his desk.”

Although the (unauthorised) memo was meant as a joke, no one laughed when it was leaked to the media. Memories were still fresh of Moritz Erhardt, the 21-year-old London intern who died after working 72 hours in a row at Bank of America. It looked as if Barclays was also taking the “work ethic” to morbid extremes.

Following 30 years of neoliberal deregulation, the nine-to-five feels like a relic of a bygone era. Jobs are endlessly stressed and increasingly precarious. Overwork has become the norm in many companies – something expected and even admired. Everything we do outside the office – no matter how rewarding – is quietly denigrated. Relaxation, hobbies, raising children or reading a book are dismissed as laziness. That’s how powerful the mythology of work is.

Technology was supposed to liberate us from much of the daily slog, but has often made things worse: in 2002, fewer than 10% of employees checked their work email outside of office hours. Today, with the help of tablets and smartphones, it is 50%, often before we get out of bed.

Health at work illo 2


Illustration: Leon Edler

Some observers have suggested that workers today are never “turned off”. Like our mobile phones, we only go on standby at the end of the day, as we crawl into bed exhausted. This unrelenting joylessness is especially evident where holidays are concerned. In the US, one of the richest economies in the world, employees are lucky to get two weeks off a year.

You might almost think this frenetic activity was directly linked to our biological preservation and that we would all starve without it. As if writing stupid emails all day in a cramped office was akin to hunting-and-gathering of a previous age … Thankfully, a sea change is taking place. The costs of overwork can no longer be ignored. Long-term stress, anxiety and prolonged inactivity have been exposed as potential killers.

Researchers at Columbia University Medical Center recently used activity trackers to monitor 8,000 workers over the age of 45. The findings were striking. The average period of inactivity during each waking day was 12.3 hours. Employees who were sedentary for more than 13 hours a day were twice as likely to die prematurely as those who were inactive for 11.5 hours. The authors concluded that sitting in an office for long periods has a similar effect to smoking and ought to come with a health warning.

When researchers at University College London looked at 85,000 workers, mainly middle-aged men and women, they found a correlation between overwork and cardiovascular problems, especially an irregular heart beat or atrial fibrillation, which increases the chances of a stroke five-fold.

Labour unions are increasingly raising concerns about excessive work, too, especially its impact on relationships and physical and mental health. Take the case of the IG Metall union in Germany. Last week, 15,000 workers (who manufacture car parts for firms such as Porsche) called a strike, demanding a 28-hour work week with unchanged pay and conditions. It’s not about indolence, they say, but self-protection: they don’t want to die before their time. Science is on their side: research from the Australian National University recently found that working anything over 39 hours a week is a risk to wellbeing.

Is there a healthy and acceptable level of work? According to US researcher Alex Soojung-Kim Pang, most modern employees are productive for about four hours a day: the rest is padding and huge amounts of worry. Pang argues that the workday could easily be scaled back without undermining standards of living or prosperity.

Health at work illo 3


Illustration: Leon Edler

Other studies back up this observation. The Swedish government, for example, funded an experiment where retirement home nurses worked six-hour days and still received an eight-hour salary. The result? Less sick leave, less stress, and a jump in productivity.

All this is encouraging as far as it goes. But almost all of these studies focus on the problem from a numerical point of view – the amount of time spent working each day, year-in and year-out. We need to go further and begin to look at the conditions of paid employment. If a job is wretched and overly stressful, even a few hours of it can be an existential nightmare. Someone who relishes working on their car at the weekend, for example, might find the same thing intolerable in a large factory, even for a short period. All the freedom, creativity and craft are sucked out of the activity. It becomes an externally imposed chore rather than a moment of release.

Why is this important?

Because there is a danger that merely reducing working hours will not change much, when it comes to health, if jobs are intrinsically disenfranchising. In order to make jobs more conducive to our mental and physiological welfare, much less work is definitely essential. So too are jobs of a better kind, where hierarchies are less authoritarian and tasks are more varied and meaningful.

Capitalism doesn’t have a great track record for creating jobs such as these, unfortunately. More than a third of British workers think their jobs are meaningless, according to a survey by YouGov. And if morale is that low, it doesn’t matter how many gym vouchers, mindfulness programmes and baskets of organic fruit employers throw at them. Even the most committed employee will feel that something is fundamentally missing. A life.

Peter Fleming’s new book, The Death of Homo Economicus: Work, Debt and the Myth of Endless Accumulation, is published by Pluto Press (£14.99rrp). To order a copy for £12.74 with free UK p&p, go to guardianbookshop.com

Calls to NHS hotline peaked in week before Christmas

Non-emergency calls to the NHS hotline reached the highest level for the year in the week before Christmas, official figures have shown.

NHS England’s weekly operational update showed a spike in the number of calls to its 111 service in the seven days up to Christmas Eve, 396,262, compared with 325,042 the previous week.

It was the biggest number since the last week of 2016, during which there were 457,084 calls.

Bed occupancy rates on Christmas Eve dropped to 84.2%, compared with 95.3% the previous week.

Public Health England (PHE) confirmed two further flu-related deaths, taking the total so far this winter to 15.

The number of hospital diverts – when patients are rerouted to another hospital – fell from 30 to six for the week ending 24 December.

There were 812 beds closed due to norovirus or diarrhoea and vomiting in the week before Christmas, down from 1,071 the previous week, according to NHS England figures.

An NHS England spokesman said: “The NHS has been busy in the run-up to Christmas, with record levels of 111 calls. Despite this, ambulance handover delays, bed occupancy and norovirus levels all dropped thanks to the hard work of NHS staff.

“Additional winter funding will be used to open over 1,500 additional beds in the coming weeks, and the public can continue to play their part by using local pharmacies and NHS 111 for medical advice, along with GP appointments available 8am-8pm throughout the holiday period.”

Major NHS trust turns away A&E patients 13 times in a week

A major NHS hospital trust had to turn patients away from its A&E units 13 times last week – including four times in one day – as the snow left it facing “extremely challenging” conditions.

Worcestershire Acute Hospitals NHS Trust was forced to divert emergency patients away from the A&Es at two of the hospitals it runs, the Worcestershire Royal in Worcester and Alexandra in Redditch.

The increased number of patients seeking care as the first cold snap of winter hit meant it had to declare an “A&E divert” four times on both 4 and 5 December, and a further five times last week.

NHS England’s latest performance figures

Two patients died at the trust last winter, one reportedly after spending 35 hours on a trolley, days before the British Red Cross said the chaos in many hospitals constituted “a humanitarian crisis”.

Snow put the trust under such pressure that it issued a plea last Sunday for nurses, doctors and healthcare assistants who could safely get to either hospital to come in and help out. Some staff slept in the hospitals and others stayed well past the end of their shifts as part of a major operation to keep the hospitals open.

The unusually high number of diverts illustrates how the cold weather has added to the already heavy pressure on hospitals, especially A&E units.

The trust’s 13 diverts – more than three times more than any other trust – were disclosed in NHS England’s latest performance figures. They emerged as a senior doctor warned that some hospitals were already experiencing “carnage” as a result of winter’s arrival.

“All we can say and see is pressure, pressure and more pressure – the system is on a knife-edge,” said Dr Nick Scriven, president of the Society for Acute Medicine.

“This week alone frontline staff from across the UK are reporting their hospitals are ‘imploding’, there is ‘carnage on the ground’ and they are run off their feet. Some hospitals are already cancelling planned surgery and that is something patients will face increasingly over the winter months,” Scriven added.

The Midlands trust said the 13 diverts were between its two A&E departments and none involved patients being sent to another trust. “If one unit is significantly busier than the other we work with West Midlands ambulance service to divert to the less busy one if it is safe to do so – meaning that the patient gets seen more quickly and the ambulance crew are able to transfer their patient to us in a more timely way and go on to their next call. This proved particularly useful during the recent spell of bad weather,” it said in a statement.

NHS data also showed that the Worcestershire trust treated just 70.1% of patients within the required four hours of their arrival in A&E during November – the ninth worst record among 137 acute trusts in England. The target is 95%. A total of 2,983 of the 9,984 patients had to wait longer than four hours.

Blackpool Teaching Hospitals trust performed by far the worst against the four-hour target; it managed to treat just 57.8% of patients within that time period.

The Worcestershire trust is also the ninth worst in England at treating cancer patients urgently within 62 days and the 29th poorest at giving patients non-urgent operations within the NHS-wide 18-week target. Its bed occupancy has been running at 98.4% – well over the 85% limit that the NHS accepts is the right level to ensure patients receive safe care.

“It’s tough. We are certainly feeling increased pressure,” Michelle McKay, its chief executive, told the Health Service Journal this week.

The trust suffers more than most from the understaffing causing problems at almost every hospital in the NHS. Its most recent staffing figures show that in September 40% of its wards had so few nurses they were below the “safe staffing” fill rates used by the NHS.

NHS England’s figures also showed that the flu jab had so far been administered to fewer than half of eligible adults, less than 20% of young children, and just 46% of NHS staff, despite repeated recent warnings of a potentially major outbreak.

“It’s deeply concerning that rates for flu vaccinations are currently so low. Prevention is vital in protecting the most vulnerable in our society, those with an existing lung condition, children, pregnant women and the elderly, to ensure they don’t get flu,” said Dr Penny Woods, chief executive of the British Lung Foundation.

In addition, one in eight (11,852) of all patients who arrived at hospital by ambulance last week had to wait in the vehicle for at least 30 minutes, despite NHS rules that say no one should be forced to do so for more than 15 minutes.

Norovirus, the winter vomiting bug, led to the closure of 1,123 hospital beds a day on average last week, 70% more than the 64 closures a day seen the previous week.

Major NHS trust turns away A&E patients 13 times in a week

A major NHS hospital trust had to turn patients away from its A&E units 13 times last week – including four times in one day – as the snow left it facing “extremely challenging” conditions.

Worcestershire Acute Hospitals NHS Trust was forced to divert emergency patients away from the A&Es at two of the hospitals it runs, the Worcestershire Royal in Worcester and Alexandra in Redditch.

The increased number of patients seeking care as the first cold snap of winter hit meant it had to declare an “A&E divert” four times on both 4 and 5 December, and a further five times last week.

NHS England’s latest performance figures

Two patients died at the trust last winter, one reportedly after spending 35 hours on a trolley, days before the British Red Cross said the chaos in many hospitals constituted “a humanitarian crisis”.

Snow put the trust under such pressure that it issued a plea last Sunday for nurses, doctors and healthcare assistants who could safely get to either hospital to come in and help out. Some staff slept in the hospitals and others stayed well past the end of their shifts as part of a major operation to keep the hospitals open.

The unusually high number of diverts illustrates how the cold weather has added to the already heavy pressure on hospitals, especially A&E units.

The trust’s 13 diverts – more than three times more than any other trust – were disclosed in NHS England’s latest performance figures. They emerged as a senior doctor warned that some hospitals were already experiencing “carnage” as a result of winter’s arrival.

“All we can say and see is pressure, pressure and more pressure – the system is on a knife-edge,” said Dr Nick Scriven, president of the Society for Acute Medicine.

“This week alone frontline staff from across the UK are reporting their hospitals are ‘imploding’, there is ‘carnage on the ground’ and they are run off their feet. Some hospitals are already cancelling planned surgery and that is something patients will face increasingly over the winter months,” Scriven added.

The Midlands trust said the 13 diverts were between its two A&E departments and none involved patients being sent to another trust. “If one unit is significantly busier than the other we work with West Midlands ambulance service to divert to the less busy one if it is safe to do so – meaning that the patient gets seen more quickly and the ambulance crew are able to transfer their patient to us in a more timely way and go on to their next call. This proved particularly useful during the recent spell of bad weather,” it said in a statement.

NHS data also showed that the Worcestershire trust treated just 70.1% of patients within the required four hours of their arrival in A&E during November – the ninth worst record among 137 acute trusts in England. The target is 95%. A total of 2,983 of the 9,984 patients had to wait longer than four hours.

Blackpool Teaching Hospitals trust performed by far the worst against the four-hour target; it managed to treat just 57.8% of patients within that time period.

The Worcestershire trust is also the ninth worst in England at treating cancer patients urgently within 62 days and the 29th poorest at giving patients non-urgent operations within the NHS-wide 18-week target. Its bed occupancy has been running at 98.4% – well over the 85% limit that the NHS accepts is the right level to ensure patients receive safe care.

“It’s tough. We are certainly feeling increased pressure,” Michelle McKay, its chief executive, told the Health Service Journal this week.

The trust suffers more than most from the understaffing causing problems at almost every hospital in the NHS. Its most recent staffing figures show that in September 40% of its wards had so few nurses they were below the “safe staffing” fill rates used by the NHS.

NHS England’s figures also showed that the flu jab had so far been administered to fewer than half of eligible adults, less than 20% of young children, and just 46% of NHS staff, despite repeated recent warnings of a potentially major outbreak.

“It’s deeply concerning that rates for flu vaccinations are currently so low. Prevention is vital in protecting the most vulnerable in our society, those with an existing lung condition, children, pregnant women and the elderly, to ensure they don’t get flu,” said Dr Penny Woods, chief executive of the British Lung Foundation.

In addition, one in eight (11,852) of all patients who arrived at hospital by ambulance last week had to wait in the vehicle for at least 30 minutes, despite NHS rules that say no one should be forced to do so for more than 15 minutes.

Norovirus, the winter vomiting bug, led to the closure of 1,123 hospital beds a day on average last week, 70% more than the 64 closures a day seen the previous week.

Major NHS trust turns away A&E patients 13 times in a week

A major NHS hospital trust had to turn patients away from its A&E units 13 times last week – including four times in one day – as the snow left it facing “extremely challenging” conditions.

Worcestershire Acute Hospitals NHS Trust was forced to divert emergency patients away from the A&Es at two of the hospitals it runs, the Worcestershire Royal in Worcester and Alexandra in Redditch.

The increased number of patients seeking care as the first cold snap of winter hit meant it had to declare an “A&E divert” four times on both 4 and 5 December, and a further five times last week.

NHS England’s latest performance figures

Two patients died at the trust last winter, one reportedly after spending 35 hours on a trolley, days before the British Red Cross said the chaos in many hospitals constituted “a humanitarian crisis”.

Snow put the trust under such pressure that it issued a plea last Sunday for nurses, doctors and healthcare assistants who could safely get to either hospital to come in and help out. Some staff slept in the hospitals and others stayed well past the end of their shifts as part of a major operation to keep the hospitals open.

The unusually high number of diverts illustrates how the cold weather has added to the already heavy pressure on hospitals, especially A&E units.

The trust’s 13 diverts – more than three times more than any other trust – were disclosed in NHS England’s latest performance figures. They emerged as a senior doctor warned that some hospitals were already experiencing “carnage” as a result of winter’s arrival.

“All we can say and see is pressure, pressure and more pressure – the system is on a knife-edge,” said Dr Nick Scriven, president of the Society for Acute Medicine.

“This week alone frontline staff from across the UK are reporting their hospitals are ‘imploding’, there is ‘carnage on the ground’ and they are run off their feet. Some hospitals are already cancelling planned surgery and that is something patients will face increasingly over the winter months,” Scriven added.

The Midlands trust said the 13 diverts were between its two A&E departments and none involved patients being sent to another trust. “If one unit is significantly busier than the other we work with West Midlands ambulance service to divert to the less busy one if it is safe to do so – meaning that the patient gets seen more quickly and the ambulance crew are able to transfer their patient to us in a more timely way and go on to their next call. This proved particularly useful during the recent spell of bad weather,” it said in a statement.

NHS data also showed that the Worcestershire trust treated just 70.1% of patients within the required four hours of their arrival in A&E during November – the ninth worst record among 137 acute trusts in England. The target is 95%. A total of 2,983 of the 9,984 patients had to wait longer than four hours.

Blackpool Teaching Hospitals trust performed by far the worst against the four-hour target; it managed to treat just 57.8% of patients within that time period.

The Worcestershire trust is also the ninth worst in England at treating cancer patients urgently within 62 days and the 29th poorest at giving patients non-urgent operations within the NHS-wide 18-week target. Its bed occupancy has been running at 98.4% – well over the 85% limit that the NHS accepts is the right level to ensure patients receive safe care.

“It’s tough. We are certainly feeling increased pressure,” Michelle McKay, its chief executive, told the Health Service Journal this week.

The trust suffers more than most from the understaffing causing problems at almost every hospital in the NHS. Its most recent staffing figures show that in September 40% of its wards had so few nurses they were below the “safe staffing” fill rates used by the NHS.

NHS England’s figures also showed that the flu jab had so far been administered to fewer than half of eligible adults, less than 20% of young children, and just 46% of NHS staff, despite repeated recent warnings of a potentially major outbreak.

“It’s deeply concerning that rates for flu vaccinations are currently so low. Prevention is vital in protecting the most vulnerable in our society, those with an existing lung condition, children, pregnant women and the elderly, to ensure they don’t get flu,” said Dr Penny Woods, chief executive of the British Lung Foundation.

In addition, one in eight (11,852) of all patients who arrived at hospital by ambulance last week had to wait in the vehicle for at least 30 minutes, despite NHS rules that say no one should be forced to do so for more than 15 minutes.

Norovirus, the winter vomiting bug, led to the closure of 1,123 hospital beds a day on average last week, 70% more than the 64 closures a day seen the previous week.

The week in TV: Broken; The Betrayed Girls, The Windsors and more

Broken (BBC1) | iPlayer
The Betrayed Girls (BBC1) | iPlayer
The Windsors (C4) | All4
Rock’n’Roll Guns for Hire: The Story of the Sideman (BBC4) | iPlayer
The Highland Midwife (C5) | My5

Broken, which ended its too-short run just as we were all beginning to fall a little bit in love with it, has brought a uniqueness to British TV this year in somehow managing to be both Kafkaesque and Capraesque. The former, in its portrayal of the savage non-choices daily facing the poor – the chronicling of such Sisyphean travails writer Jimmy McGovern has dedicated much of his life to – in tandem with the spirited evisceration of every political mindset that can ever judge, with squirrely impossibility, that the poor are poor because they’re taking all our money.

The latter, the Frank Capra element, arrived at the very end of last week’s closer, as the parishioners queued to essentially absolve Father Michael of his sins, such as they ever were. I defy anyone not to have simultaneously smiled and blinked back tears during the last five minutes, and it was shamelessly, undeniably, a long shiver of feel-good – but McGovern has never exactly subscribed to the Ken Loach school, preferring instead to pepper his agitprop with warmth, wit and very human seasoning.

Sean Bean, in what some are calling the performance of his life, showed that he can turn his once chiselled chops from mournful beleaguered action hero to mournful beleaguered magi. That’s not meant to diminish him: the jowly new plains of his face spoke volumes, mainly when he wasn’t doing any actual speaking himself, about conflicted men, and trying to do not just the right thing but for the right reason. Inter alia his character proved, by example, how religion can be a force for everyday good in society – not so much with the ecumenical niceties or the sweeping blandness, but simply by lifting a Hoover, pulling on the Marigolds, sliding someone an urgent fag, or taking a not even remotely metaphorical sledgehammer to the money-changers – a little over the top here but still, my, how we cheered. And we got a great cameo from Phil Davis as the tawdry slots boss, veering between wheedling reason and skull-beneath-the-skin anger. In fact the supporting cast, notably Anna Friel and Muna Otaru, have lent much to this triumph. Even the supporting music: Nina Simone’s bittersweet reworking of Randy Newman’s I Think It’s Going to Rain Today might have to become the theme song of 2017.

Former DC Maggie Oliver in The Betrayed Girls.


Former DC Maggie Oliver in The Betrayed Girls. Photograph: Grabs/BBC / Sandpaper Films

The Betrayed Girls, Henry Singer’s masterful account of the Rochdale grooming scandal, suffered only slightly from arriving the same year as the BBC drama Three Girls. If the first drew us wholly into the toxic circumstances of the scandal, the poverty of the girls’ horizons, this documentary more clearly let us sit back and assign blame. Firstly, of course, to the unconscionable perpetrators, married pillars of their community who came to view almost as a reward, as “downtime”, the concept of recreational paedophilia. But also to the legions of police, teachers, social workers and politicians who knew what was going on but froze witless in their fear – no, it was often simple discomfort, an emotion that doesn’t even attain the nobility of squeamishness – at the racial implications. Far easier to list the (very) few who were unafraid: DC Maggie Oliver, sexual health worker Sara Rowbotham, MP Ann Cryer, prosecutor Nazir Afzal, Andrew Norfolk of the Times. Incidentally, Maggie resigned from the police a few years ago. Sara was made redundant, later suffering depression and PTSD. Not one senior officer has faced so much as a reprimand.

The Windsors are back on our box, welcomely, and still happily unfettered by such restrictive critical considerations as, for instance, taste. The satirical royal soap takes a blunderbuss approach to its humour: precisely how sharp might you have to be to take the rip out of Charles’s ineffectuality or Theresa May’s bullying incompetence? But the delights arrive with the minor royals: a vicious Pippa, casting gypsy curses, or Beatrice and Eugenie (Celeste Dring and Ellie White), mangling every posh diphthong available into a gargoyled simulacrum of the English language and thus gently, gleefully, reminding us of that old head-scratching question: what are they all, y’know, for?

You could look a long way before finding a music-based programme with insights to rival some of those vouchsafed in Rock’n’Roll Guns for Hire, a great little documentary about the sidemen and women behind and beside some of rock music’s behemoths.

Differing from session musicians in that they don’t necessarily always play on recordings, the “sidies” have performed, often for as long as 30 years, on tour and on stage with the biggest names going. Bernard Fowler, who has to contend with the occasional naysayer – “but there’s no black guys in the Rolling Stones!” – and Crystal Taliefero (sax, drums, keyboards, everything, with Billy Joel), the sainted Steve Cropper, chubby white unlikely hero to generations of soul fans, Crystal Torres (Beyoncé), Lisa Coleman and Wendy Melvoin (Prince).

Sideman Earl Slick performing with David Bowie in 2003.


Sideman Earl Slick performing with David Bowie in 2003. Photograph: KMazur/WireImage

They were, almost to a man and woman, self-effacing, happy to stand, literally, in the shadows, contentedly unrecognised, anxious only that the tour dates might dry up and the money run out. This was winningly fronted by Earl Slick (real name, um, Frank Madeloni), guitarist to Bowie and laid-back to the point of catalepsy, and, as might have been expected, much interest focused on the big-name stars and fascinating glimpses of the egos involved. I suspect Bowie rated Slick, but Bowie also, a little more, rated Bowie. I’m sure Otis Redding rated Cropper, not least for writing Knock on Wood (simply by reversing the chords from In the Midnight Hour ). Lisa and Wendy hinted, not all that subtly, at more than one over-precious hissy fit from Prince. As so often, Keith Richards charmed. “Sidies… the better you are at your job, the less people notice you. And that’s the point, heh heh. But Bernard Fowler – he is a Stone, now. Brother Bernard’s a rock, man.”

The Highland Midwife was an unexpected treat from C5. What this doc lacked in the scripted dramas of Call the Midwife – and it lacked a lot here – it made up for in simple watchability: for the views, certainly, but also for the oddly captivating small dramas of every single birth.

The fathers’ dilemmas, the mothers’ fears, the simple logistics and tiny burbling panics necessitated by having chosen to live four hours from the nearest hospital. The crucial personalities of the midwives themselves, who surely by the end know every inch of their charges, down to the fusty back of the teabag cupboard. And we were reminded, should we have needed it, that for all a mother’s preparations – hopeful winsome notes to self, felt-tipped and stuck to banisters and bathroom mirror, “my birth will be easy, for my baby is loved” and other such sub-Hallmark toshness – every mother is, at least once in her life, reduced to a wrack of shuddering agony, her entire body glimmering with pain.

Anastasia’s little Olya will grow up speaking Russian, English and Scots Gaelic. Which is nice.

I took my first antidepressant this week. The effects were frightening | Deborah Orr

Most people know about SSRIs, the antidepressant drugs that stop the brain from re-absorbing too much of the serotonin we produce, to regulate mood, anxiety and happiness. And a lot of people know about these drugs first hand, for the simple reason that they have used them. Last year, according to NHS Digital, no fewer than 64.7m antidepressant prescriptions were given in England alone. In a decade, the number of prescriptions has doubled.

On Tuesday I joined the throng, and popped my first Citalopram. It was quite a thing – not least because, like an idiot, I dropped my pill about 90 minutes before curtain up for the Royal Shakespeare Company’s production of The Tempest at the Barbican. That’s right. This isn’t just mental illness: this is metropolitan-elite mental illness. It was a pretty overwhelming theatrical experience.

The first indication that something was up came as I approached my local tube station. I noticed that I was in a state of extreme dissociation, walking along looking as though I was entirely present in the world yet feeling completely detached from it. I had drifted into total mental autopilot.

Luckily, I was able to recognise my fugue. It’s a symptom of my condition, which, as I’ve written before, is complex post-traumatic stress disorder. The drug-induced dissociation was more intense than I’m used to when it’s happening naturally. I use the word advisedly. Much of what is thought of as illness is actually an extreme and sensible protective reaction to unbearable interventions from outside the self.

Because I’ve been in very good psychotherapy for about a year now, I’ve learned to identify times of dissociation, and “ground” myself. Hitting myself in the centre of the chest works best for me, especially now that I’ve stopped wearing the necklace I used to thump into my breastbone. Of course, you look like a bit of a prat, striding about banging your chest, but there you are. The one thing that makes you feel normal is the one thing that alerts others to the fact that something weird’s going on.

I’ve been resisting dissociation for pretty much every minute I’ve been on the drug since then. Being in good company helps most, and being in parks, fields, gardens and nature. You have to keep busy. The leaflet that came with the drug, which I read thoroughly before starting the course, does warn that in the first few days you might find that the symptoms you’re trying to escape come back more strongly. Unfortunately, I tend to dissociate in order to avoid having panic attacks. So, as I get better at managing the dissociation, the panic attacks surge. It’s like playing symptom whack-a-mole, except that you’re whacking bits of your psyche, as well as your chest.

I spent pretty much all of Thursday in one long low-level panic attack – keeping busy, telling no one. I didn’t want to mention it, because that would make it worse. At one point, in the park with my brother, he insisted, randomly, that I walk up the hill to the bus stop instead of down it, like I wanted to, in the heat. By the time I got to the bus stop, my legs were barely working, and I was in the grip of convulsive shudders.

I go along with things I don’t want to do, things that ignore my wants and needs, then hate myself for my compliance. The little examples, such as this one, reawaken my feelings about the huge ones. I was bullied a lot as a child, and my parents were needlessly strict and deludedly all-knowing. It’s grown into a major cognitive dissonance. I loathe being bullied or bossed about, yet at the same time it feels so familiar and comfortable that I’m complying before I even know it, eager to please people who can’t be pleased.

Then I feel full of resentment and anger against the perpetrator of the control – so much so that it becomes overwhelming, and my mind and body rebel. I literally shake the feelings out. It’s the reason why I recently began to seek NHS psychiatric help, on top of private psychotherapeutic help. A couple of interventions of epic proportions have recently been perpetrated against me. They have left me so poleaxed that I’m unable to assert myself enough to walk downhill.

A breakthrough occurred, though. I was able to tell my brother, calmly, what was happening to me and why. He kissed me on the cheek. He never does that.

Why am I writing this down for publication? Practically, it’s because these powerful drugs arrived with so little guidance about what to expect. An NHS case-worker I’d been interviewed by once – not a doctor – called my GP’s practice and arranged for a prescription to be written by a GP I’d had nothing to do with. I was told on the phone what the prescription was, and that it was waiting for me to pick up from the local pharmacy. I wasn’t consulted about the drug I was being offered at all, although I had said that I wanted to try an antidepressant. I’ll meet a different GP and the case-worker in two weeks’ time.

The process has taken about five weeks, and has been circular. In crisis at the end of May, I asked my GP practice for help and was told to go to A&E instead. I didn’t react well, and left upset and furious. Returning a few days later, I said that I would prefer a less dramatic referral to mental health services than A&E, which is how I met the case-worker. Then, back to the GP practice and that remotely dispatched prescription. Which is not to blame the practice. The whole system is itself in crisis mode all the time. Which is particularly bad, obviously, for people with mental health problems.

There is “soaring demand” for NHS mental health services. Some 80% of bosses of NHS trusts surveyed by the trade organisation, NHS Providers, have expressed worries that they have too little budget to provide “timely, high-quality care”. That’s so dangerous. I absolutely needed a year of psychotherapy before I started taking this drug. At the start of the therapy, I had become emotionally numb, unable even to weep. I wouldn’t have had the insight to understand what this drug was doing to me, let alone control it or explain it to others when I couldn’t.

I might never even have got the diagnosis that helps me so much to make sense of my entire life, because that took months. All I can do, apart from look after myself and my kids, is speak out about how complex is the task of managing a mental health condition. There’s so very, very much more to it than popping pills.

  • Comments on this article are premoderated

I took my first antidepressant this week. The effects were frightening | Deborah Orr

Most people know about SSRIs, the antidepressant drugs that stop the brain from re-absorbing too much of the serotonin we produce, to regulate mood, anxiety and happiness. And a lot of people know about these drugs first hand, for the simple reason that they have used them. Last year, according to NHS Digital, no fewer than 64.7m antidepressant prescriptions were given in England alone. In a decade, the number of prescriptions has doubled.

On Tuesday I joined the throng, and popped my first Citalopram. It was quite a thing – not least because, like an idiot, I dropped my pill about 90 minutes before curtain up for the Royal Shakespeare Company’s production of The Tempest at the Barbican. That’s right. This isn’t just mental illness: this is metropolitan-elite mental illness. It was a pretty overwhelming theatrical experience.

The first indication that something was up came as I approached my local tube station. I noticed that I was in a state of extreme dissociation, walking along looking as though I was entirely present in the world yet feeling completely detached from it. I had drifted into total mental autopilot.

Luckily, I was able to recognise my fugue. It’s a symptom of my condition, which, as I’ve written before, is complex post-traumatic stress disorder. The drug-induced dissociation was more intense than I’m used to when it’s happening naturally. I use the word advisedly. Much of what is thought of as illness is actually an extreme and sensible protective reaction to unbearable interventions from outside the self.

Because I’ve been in very good psychotherapy for about a year now, I’ve learned to identify times of dissociation, and “ground” myself. Hitting myself in the centre of the chest works best for me, especially now that I’ve stopped wearing the necklace I used to thump into my breastbone. Of course, you look like a bit of a prat, striding about banging your chest, but there you are. The one thing that makes you feel normal is the one thing that alerts others to the fact that something weird’s going on.

I’ve been resisting dissociation for pretty much every minute I’ve been on the drug since then. Being in good company helps most, and being in parks, fields, gardens and nature. You have to keep busy. The leaflet that came with the drug, which I read thoroughly before starting the course, does warn that in the first few days you might find that the symptoms you’re trying to escape come back more strongly. Unfortunately, I tend to dissociate in order to avoid having panic attacks. So, as I get better at managing the dissociation, the panic attacks surge. It’s like playing symptom whack-a-mole, except that you’re whacking bits of your psyche, as well as your chest.

I spent pretty much all of Thursday in one long low-level panic attack – keeping busy, telling no one. I didn’t want to mention it, because that would make it worse. At one point, in the park with my brother, he insisted, randomly, that I walk up the hill to the bus stop instead of down it, like I wanted to, in the heat. By the time I got to the bus stop, my legs were barely working, and I was in the grip of convulsive shudders.

I go along with things I don’t want to do, things that ignore my wants and needs, then hate myself for my compliance. The little examples, such as this one, reawaken my feelings about the huge ones. I was bullied a lot as a child, and my parents were needlessly strict and deludedly all-knowing. It’s grown into a major cognitive dissonance. I loathe being bullied or bossed about, yet at the same time it feels so familiar and comfortable that I’m complying before I even know it, eager to please people who can’t be pleased.

Then I feel full of resentment and anger against the perpetrator of the control – so much so that it becomes overwhelming, and my mind and body rebel. I literally shake the feelings out. It’s the reason why I recently began to seek NHS psychiatric help, on top of private psychotherapeutic help. A couple of interventions of epic proportions have recently been perpetrated against me. They have left me so poleaxed that I’m unable to assert myself enough to walk downhill.

A breakthrough occurred, though. I was able to tell my brother, calmly, what was happening to me and why. He kissed me on the cheek. He never does that.

Why am I writing this down for publication? Practically, it’s because these powerful drugs arrived with so little guidance about what to expect. An NHS case-worker I’d been interviewed by once – not a doctor – called my GP’s practice and arranged for a prescription to be written by a GP I’d had nothing to do with. I was told on the phone what the prescription was, and that it was waiting for me to pick up from the local pharmacy. I wasn’t consulted about the drug I was being offered at all, although I had said that I wanted to try an antidepressant. I’ll meet a different GP and the case-worker in two weeks’ time.

The process has taken about five weeks, and has been circular. In crisis at the end of May, I asked my GP practice for help and was told to go to A&E instead. I didn’t react well, and left upset and furious. Returning a few days later, I said that I would prefer a less dramatic referral to mental health services than A&E, which is how I met the case-worker. Then, back to the GP practice and that remotely dispatched prescription. Which is not to blame the practice. The whole system is itself in crisis mode all the time. Which is particularly bad, obviously, for people with mental health problems.

There is “soaring demand” for NHS mental health services. Some 80% of bosses of NHS trusts surveyed by the trade organisation, NHS Providers, have expressed worries that they have too little budget to provide “timely, high-quality care”. That’s so dangerous. I absolutely needed a year of psychotherapy before I started taking this drug. At the start of the therapy, I had become emotionally numb, unable even to weep. I wouldn’t have had the insight to understand what this drug was doing to me, let alone control it or explain it to others when I couldn’t.

I might never even have got the diagnosis that helps me so much to make sense of my entire life, because that took months. All I can do, apart from look after myself and my kids, is speak out about how complex is the task of managing a mental health condition. There’s so very, very much more to it than popping pills.

  • Comments on this article are premoderated

I took my first antidepressant this week. The effects were frightening | Deborah Orr

Most people know about SSRIs, the antidepressant drugs that stop the brain from re-absorbing too much of the serotonin we produce, to regulate mood, anxiety and happiness. And a lot of people know about these drugs first hand, for the simple reason that they have used them. Last year, according to NHS Digital, no fewer than 64.7m antidepressant prescriptions were given in England alone. In a decade, the number of prescriptions has doubled.

On Tuesday I joined the throng, and popped my first Citalopram. It was quite a thing – not least because, like an idiot, I dropped my pill about 90 minutes before curtain up for the Royal Shakespeare Company’s production of The Tempest at the Barbican. That’s right. This isn’t just mental illness: this is metropolitan-elite mental illness. It was a pretty overwhelming theatrical experience.

The first indication that something was up came as I approached my local tube station. I noticed that I was in a state of extreme dissociation, walking along looking as though I was entirely present in the world yet feeling completely detached from it. I had drifted into total mental autopilot.

Luckily, I was able to recognise my fugue. It’s a symptom of my condition, which, as I’ve written before, is complex post-traumatic stress disorder. The drug-induced dissociation was more intense than I’m used to when it’s happening naturally. I use the word advisedly. Much of what is thought of as illness is actually an extreme and sensible protective reaction to unbearable interventions from outside the self.

Because I’ve been in very good psychotherapy for about a year now, I’ve learned to identify times of dissociation, and “ground” myself. Hitting myself in the centre of the chest works best for me, especially now that I’ve stopped wearing the necklace I used to thump into my breastbone. Of course, you look like a bit of a prat, striding about banging your chest, but there you are. The one thing that makes you feel normal is the one thing that alerts others to the fact that something weird’s going on.

I’ve been resisting dissociation for pretty much every minute I’ve been on the drug since then. Being in good company helps most, and being in parks, fields, gardens and nature. You have to keep busy. The leaflet that came with the drug, which I read thoroughly before starting the course, does warn that in the first few days you might find that the symptoms you’re trying to escape come back more strongly. Unfortunately, I tend to dissociate in order to avoid having panic attacks. So, as I get better at managing the dissociation, the panic attacks surge. It’s like playing symptom whack-a-mole, except that you’re whacking bits of your psyche, as well as your chest.

I spent pretty much all of Thursday in one long low-level panic attack – keeping busy, telling no one. I didn’t want to mention it, because that would make it worse. At one point, in the park with my brother, he insisted, randomly, that I walk up the hill to the bus stop instead of down it, like I wanted to, in the heat. By the time I got to the bus stop, my legs were barely working, and I was in the grip of convulsive shudders.

I go along with things I don’t want to do, things that ignore my wants and needs, then hate myself for my compliance. The little examples, such as this one, reawaken my feelings about the huge ones. I was bullied a lot as a child, and my parents were needlessly strict and deludedly all-knowing. It’s grown into a major cognitive dissonance. I loathe being bullied or bossed about, yet at the same time it feels so familiar and comfortable that I’m complying before I even know it, eager to please people who can’t be pleased.

Then I feel full of resentment and anger against the perpetrator of the control – so much so that it becomes overwhelming, and my mind and body rebel. I literally shake the feelings out. It’s the reason why I recently began to seek NHS psychiatric help, on top of private psychotherapeutic help. A couple of interventions of epic proportions have recently been perpetrated against me. They have left me so poleaxed that I’m unable to assert myself enough to walk downhill.

A breakthrough occurred, though. I was able to tell my brother, calmly, what was happening to me and why. He kissed me on the cheek. He never does that.

Why am I writing this down for publication? Practically, it’s because these powerful drugs arrived with so little guidance about what to expect. An NHS case-worker I’d been interviewed by once – not a doctor – called my GP’s practice and arranged for a prescription to be written by a GP I’d had nothing to do with. I was told on the phone what the prescription was, and that it was waiting for me to pick up from the local pharmacy. I wasn’t consulted about the drug I was being offered at all, although I had said that I wanted to try an antidepressant. I’ll meet a different GP and the case-worker in two weeks’ time.

The process has taken about five weeks, and has been circular. In crisis at the end of May, I asked my GP practice for help and was told to go to A&E instead. I didn’t react well, and left upset and furious. Returning a few days later, I said that I would prefer a less dramatic referral to mental health services than A&E, which is how I met the case-worker. Then, back to the GP practice and that remotely dispatched prescription. Which is not to blame the practice. The whole system is itself in crisis mode all the time. Which is particularly bad, obviously, for people with mental health problems.

There is “soaring demand” for NHS mental health services. Some 80% of bosses of NHS trusts surveyed by the trade organisation, NHS Providers, have expressed worries that they have too little budget to provide “timely, high-quality care”. That’s so dangerous. I absolutely needed a year of psychotherapy before I started taking this drug. At the start of the therapy, I had become emotionally numb, unable even to weep. I wouldn’t have had the insight to understand what this drug was doing to me, let alone control it or explain it to others when I couldn’t.

I might never even have got the diagnosis that helps me so much to make sense of my entire life, because that took months. All I can do, apart from look after myself and my kids, is speak out about how complex is the task of managing a mental health condition. There’s so very, very much more to it than popping pills.

  • Comments on this article are premoderated

I took my first antidepressant this week. The effects were frightening | Deborah Orr

Most people know about SSRIs, the antidepressant drugs that stop the brain from re-absorbing too much of the serotonin we produce, to regulate mood, anxiety and happiness. And a lot of people know about these drugs first hand, for the simple reason that they have used them. Last year, according to NHS Digital, no fewer than 64.7m antidepressant prescriptions were given in England alone. In a decade, the number of prescriptions has doubled.

On Tuesday I joined the throng, and popped my first Citalopram. It was quite a thing – not least because, like an idiot, I dropped my pill about 90 minutes before curtain up for the Royal Shakespeare Company’s production of The Tempest at the Barbican. That’s right. This isn’t just mental illness: this is metropolitan-elite mental illness. It was a pretty overwhelming theatrical experience.

The first indication that something was up came as I approached my local tube station. I noticed that I was in a state of extreme dissociation, walking along looking as though I was entirely present in the world yet feeling completely detached from it. I had drifted into total mental autopilot.

Luckily, I was able to recognise my fugue. It’s a symptom of my condition, which, as I’ve written before, is complex post-traumatic stress disorder. The drug-induced dissociation was more intense than I’m used to when it’s happening naturally. I use the word advisedly. Much of what is thought of as illness is actually an extreme and sensible protective reaction to unbearable interventions from outside the self.

Because I’ve been in very good psychotherapy for about a year now, I’ve learned to identify times of dissociation, and “ground” myself. Hitting myself in the centre of the chest works best for me, especially now that I’ve stopped wearing the necklace I used to thump into my breastbone. Of course, you look like a bit of a prat, striding about banging your chest, but there you are. The one thing that makes you feel normal is the one thing that alerts others to the fact that something weird’s going on.

I’ve been resisting dissociation for pretty much every minute I’ve been on the drug since then. Being in good company helps most, and being in parks, fields, gardens and nature. You have to keep busy. The leaflet that came with the drug, which I read thoroughly before starting the course, does warn that in the first few days you might find that the symptoms you’re trying to escape come back more strongly. Unfortunately, I tend to dissociate in order to avoid having panic attacks. So, as I get better at managing the dissociation, the panic attacks surge. It’s like playing symptom whack-a-mole, except that you’re whacking bits of your psyche, as well as your chest.

I spent pretty much all of Thursday in one long low-level panic attack – keeping busy, telling no one. I didn’t want to mention it, because that would make it worse. At one point, in the park with my brother, he insisted, randomly, that I walk up the hill to the bus stop instead of down it, like I wanted to, in the heat. By the time I got to the bus stop, my legs were barely working, and I was in the grip of convulsive shudders.

I go along with things I don’t want to do, things that ignore my wants and needs, then hate myself for my compliance. The little examples, such as this one, reawaken my feelings about the huge ones. I was bullied a lot as a child, and my parents were needlessly strict and deludedly all-knowing. It’s grown into a major cognitive dissonance. I loathe being bullied or bossed about, yet at the same time it feels so familiar and comfortable that I’m complying before I even know it, eager to please people who can’t be pleased.

Then I feel full of resentment and anger against the perpetrator of the control – so much so that it becomes overwhelming, and my mind and body rebel. I literally shake the feelings out. It’s the reason why I recently began to seek NHS psychiatric help, on top of private psychotherapeutic help. A couple of interventions of epic proportions have recently been perpetrated against me. They have left me so poleaxed that I’m unable to assert myself enough to walk downhill.

A breakthrough occurred, though. I was able to tell my brother, calmly, what was happening to me and why. He kissed me on the cheek. He never does that.

Why am I writing this down for publication? Practically, it’s because these powerful drugs arrived with so little guidance about what to expect. An NHS case-worker I’d been interviewed by once – not a doctor – called my GP’s practice and arranged for a prescription to be written by a GP I’d had nothing to do with. I was told on the phone what the prescription was, and that it was waiting for me to pick up from the local pharmacy. I wasn’t consulted about the drug I was being offered at all, although I had said that I wanted to try an antidepressant. I’ll meet a different GP and the case-worker in two weeks’ time.

The process has taken about five weeks, and has been circular. In crisis at the end of May, I asked my GP practice for help and was told to go to A&E instead. I didn’t react well, and left upset and furious. Returning a few days later, I said that I would prefer a less dramatic referral to mental health services than A&E, which is how I met the case-worker. Then, back to the GP practice and that remotely dispatched prescription. Which is not to blame the practice. The whole system is itself in crisis mode all the time. Which is particularly bad, obviously, for people with mental health problems.

There is “soaring demand” for NHS mental health services. Some 80% of bosses of NHS trusts surveyed by the trade organisation, NHS Providers, have expressed worries that they have too little budget to provide “timely, high-quality care”. That’s so dangerous. I absolutely needed a year of psychotherapy before I started taking this drug. At the start of the therapy, I had become emotionally numb, unable even to weep. I wouldn’t have had the insight to understand what this drug was doing to me, let alone control it or explain it to others when I couldn’t.

I might never even have got the diagnosis that helps me so much to make sense of my entire life, because that took months. All I can do, apart from look after myself and my kids, is speak out about how complex is the task of managing a mental health condition. There’s so very, very much more to it than popping pills.

  • Comments on this article are premoderated