“Talking therapies don’t always work” says Kate

“Talking therapies don’t always work” says Kate

Whether the Princess was obliquely referring to her brother-in-law last week we shall never know, but one person endorses her comment wholeheartedly. John Willsher (not his real name) aged 51, a likeable and articulate clarinet player from south London, would argue strongly against the received wisdom that more men kill themselves than women because they open up less about their emotions.

John had suffered from depression from his teenage years onwards. At the age of 39 he had a heart attack. This was treated with angioplasty and stenting and heart medications for the next decade, but there was no clear explanation for this very early onset of serious health problems.

He had also sought therapy for his depression many times over the years, but nothing seemed to help. On one occasion when he sought psychological help, he was given a diagnosis of Health Anxiety – the new name for hypochondria. This was one of many times he was told ‘it’s all in your head’.

He was convinced that some systemic physiological problem underlay his misery, his fatigue, his brain fog, his heart problems and myriad other symptoms including no sexual drive. Yet, he says, “I was not listened to, I was just prescribed many ‘sticking plaster’ medications, and became a revolving-door patient, at enormous cost to the NHS.”

At one point, when he told a cardiac nurse he felt like killing himself, she warned him that he needed to be careful what he said to her, that he was ‘being extreme.’ She threatened to write to his GP if he continued to talk of suicide, yet when he did continue, she did nothing, despite her clear duty of care. “So much” says John, “for men being open about their emotions.”

Eventually, with continuing help from his brother and an unusually open-minded and helpful GP, plus ‘doctor Google’ he discovered what could be wrong with him – Growth hormone deficiency! Growth hormone deficiency (GHD) not only causes fatigue, depression and loss of libido, but it also affects the cholesterol and triglycerides in the blood and leads to cardiovascular problems. As soon as John read a list of symptoms of GHD online he was confident that he was on to something. Reading further, he knew he hadn’t had the only diagnostic test for GHD – a GH stim test.

Yet even though he had the key, getting a GH stim test was not easy.

The possibility of endocrine problems had previously been dismissed by four leading teaching hospitals for reasons that are in hindsight hard to fathom. Now he approached a distinguished professor of endocrinology at a fifth teaching hospital and she refused him the stim test on what he discovered later were very spurious grounds (see ‘Four mistaken reasons’ for the grounds of refusal frequently given by consultants).

Running out of options (the NHS only allows one second opinion), he emailed the endocrinology departments of four other hospitals to ask in advance if they would run a GH stim test in his circumstances. Within a few hours King’s College Hospital, London agreed. The referral was made, and quite quickly a glucagon stimulation test (a type of GH stim test) was arranged.

“I had made up my mind that if the test came back clear I would immediately make plans to end my life – in fact I already had a fairly advanced plan involving anticoagulant medication, a hot bath, and a sharp kitchen knife. However upsetting this would be to my friends and family, my quality of life and level of daily suffering had been far too much to bear for far too long: my life just hadn’t been worth living for years,” says John. “This wasn’t a cry for help, rather just a well-reasoned, sane decision, having weighed up the prospect of going on living.”

Providentially the results showed he had severe growth hormone deficiency. Within just ten days of daily growth hormone injections, he noticed a small positive difference. “I could finish the washing up in one go,” he says. “I still tear up, thinking about that first tiny feeling of improvement.” The injections of Somatropin had done what all his ‘opening up’ and talking therapy hadn’t done, and in fact couldn’t ever have done. They had given him his life back.

As weeks and months went by, things kept improving. Now his depression is much better, he has much more energy, and is back to playing music again. He has been tireless in helping others who he believes may have this problem, acting as a mentor, and helping campaign for better treatment. More about his story, and the decades-long failure of the British Heart Foundation to warn heart patients about the growth hormone connection can be found in this week’s Daily Mail article.