A young apprentice engineer battling anxiety issues threw himself under a train after fearing he would never be able to live a life without anti-depressants, an inquest heard.
Nicholas Afzal, 20, had been attending keep fit sessions, embarked on a strict diet and went to meditation classes in an attempt to be taken off the tablets – but doctors increased the dosage when they believed his condition had worsened.
Last July 25, just four days after being prescribed an anti-depressant combined with two other medications, Nicholas told his father he was going to the cinema then went to his local railway station in Bramhall, Cheshire and jumped off the platform into the path of a train.
A letter found in Nicholas’ car which was headed ‘suicide note’ said even if his condition improved he would be ‘constantly living in fear of relapse’ adding: ‘I can’t put myself through it any longer.’
Nicholas told his father he was going to the cinema then went to his local railway station in Bramhall, Cheshire and jumped off the platform into the path of a train (stock photo)
At an inquest in Stockport Nicholas’ father Mohamed Afzal, 57, said: ‘He had been taking medication since 13 or 14 and after six years I think he lost hope that there ever would be a life without medication. He didn’t want to take it for the rest of his life.
‘Generally he just had a sense of despair, the word he used was ‘torment’ – I think he just wanted some peace.’
The hearing was told Nicholas was diagnosed with anxiety in December 2011 after bouts of self harming and he was given a trial of a drug he described as a ‘necessary evil.’
Mr Afzal, said: ‘He found it difficult to cope with things sometimes and doubted himself quite a lot.
‘He was lacking in confidence probably due to specifically his anxiety. He found interacting with other people quite difficult and he would appear to be slightly withdrawn from conversation.
‘He was a bright lad and had a promising career but anxiety was something we noticed at a relatively young age.
‘He was in a school with children from quite a few different places and he had a number of friends, one moved to the USA, one moved back to Europe and I think that lack of support affected him.
‘He thought a lot about how to tackle his difficulties. He tried mindfulness but it was like the treatment became another thing to worry about.’
‘It helped and it didn’t. For three months he had a very strict eating regime and exercised every day or every two days and he felt that would stop him having to take medication.’
‘He went to see the GP and went to the Priory at that point we were quite desperate in the sense he was losing hope and we felt he needed more help. I think it’s six years of having breakdowns he had so many.
‘When he came out of the Priory he felt a little bit lifted but still doubtful. He was prescribed medication, whereas previously he had been given one or two this time it was a combination of three. I think he was still thinking about where it would go.
‘He took the medication on the Sunday before the incident and I persuaded him to take a week from work with the hope that the medication would start to kick in and if he needed to take more time off he could either have leave or sickness.
‘On the Tuesday he seemed somewhat low I persuaded him to do a walk but I suspect that he had made his mind up.
‘The conversation was minimal he was not obstructive but was not generating the conversation.
Doctors increased Nicholas’ dosage when they believed his condition had worsened (stock photo)
‘Back home he opened the front door and said ‘I’m going watching a film, bye’. There was nothing to suggest he was doing anything on that day.
‘As a parent it’s difficult to accept that that might happen. We would have hoped he would have come to us but I think it was a decision that he made and followed through with it.’
The hearing was told Nicholas had told his father he had considered taking his own life in 2016 after being referred onto a course run by the Macclesfield Adult Mental Health service.
Nicholas’ GP Dr Carla Sharma said: ‘He needed help with OCD and difficulties with depression. In March 2017 he said he didn’t feel medication was making much difference and wanted to concentrate on lifestyle.
‘He wanted to manage symptoms with psychological therapies rather than pharmaceutical but he made a significant deterioration since stopping take his medication.
‘His dad had concerns regarding his reluctance, he said he had suicidal ideation but no plans.
‘A short course of diazepam was prescribed and he was seen by the Priory and diagnosed with severe OCD, anxiety and secondary depressive symptoms.’
Dr Tania Stanway, psychiatrist at Cheshire and Wirral foundation, said: ‘Mr Afzal said he found the CBT helpful but was never sure how useful his medication was.
‘It was my view that the medication had been helpful over time and it was unlikely there would be another medication.
‘I thought it was his obsessional thinking and we agreed he would stay on [the medicine]. His mood improved but he remained on medication and was advised to see his GP on a regular basis.’
Dr Jaya Gowrisunkur, a psychiatrist at the Priory in Altrincham, said: ‘Mr Afzal didn’t really like being on medication.
‘It was very clear that he didn’t like it. He saw it as a necessary evi.. I would have said something like if you have diabetes you have to take insulin and emphasis the best hope for recovery is the combination.
‘For therapy to work you need to perhaps start to address symptoms with medication because there’s sometimes the illusion that psychological therapy is going to solve things.’
Recording a conclusion of suicide, Ccoroner Alison Mutch, said: ‘It’s clear medication did help it’s probably a tribute to the amount of support he had that he was successful at finishing school.
‘Mr Afzal said his son didn’t like being on medication but he needed to be on medication to get him to a point where therapy would be effective.
‘He was prescribed medication but it’s clear from the evidence from his family he was resistant to the idea of going back on medication but he did.
‘We know that his family were there for him and tried to get him to take exercise and he was receptive to that, going to the gym and for a walk. It’s clear Nicholas felt that it was the time for him and he didn’t wish to go on anymore.
‘Mr and Mrs Afzal I appreciate just how difficult today had been for you and the last few months since the death of your son.
‘What is very clear to me from all the evidence I’ve heard is there was nothing more you could have done, it’s very clear just how much love and support you have your son throughout his life.’
- For confidential support call the Samaritans on 116123, visit a local Samaritans branch or see www.samaritans.org for details