Sam Hall

Raising awareness of psychiatric drug withdrawal. Sharing the reality, the science and fight for recognition. IG - samhall404

[Sam Hall @samhall404]

1/ Thanks to @MikhailaFuller for allowing me to share my story. 🧵

My experience sits in the uncomfortable space between what patients are routinely told about antidepressants and what can, in many cases, actually unfold over time. It is not simply a story of adverse effects, it is a story about the consequences of incomplete information, overconfidence in simplified narratives and a medical culture that too often defaults to explanation rather than investigation when things go wrong.

I was prescribed the antidepressant Sertraline for situational panic attacks following a house fire when I was younger and remained on it for approximately 13 years. During that time, I was never meaningfully informed about the possibility of physiological dependence, nor about the potential difficulty of stopping the drug after long term use. The phrase “safe and effective” was presented as if it were a stable, universal truth, rather than a context dependent conclusion drawn from limited and biased data.

There was no discussion of what happens when the brain adapts to a drug over more than a decade. No acknowledgement that removing that drug might not be a neutral act. No mention of protracted withdrawal or that stopping could result in a severe and prolonged destabilisation of the nervous system. Informed consent, in any meaningful sense, was absent.
When I eventually came off the SSRI, it was done through a rapid doctor led taper that bore no relation to the duration of my use. What followed was not a return of my original symptoms, but the onset of something far more severe, complex, disabling and life changing.

Almost immediately, I began to experience intense and persistent surges of physiological anxiety and panic. These were not thoughts or worries in the conventional sense. They were full body events; overwhelming waves of adrenaline that arose without psychological trigger, accompanied by a profound sense of internal threat. They were not responsive to reasoning, reassurance or standard psychological strategies because they were not primarily psychological in origin.

Alongside this, I developed widespread neurological and sensory disturbances. I experienced constant “electric” sensations throughout my body, moving unpredictably through my arms, legs, hands and across my head and face. These were often painful, presenting as burning, tingling or sharp nerve like sensations. My muscles began to twitch involuntarily, with fasciculations and spasms becoming a daily occurrence. At times, my facial muscles would contract and twitch without warning.

One of the most severe and distressing symptoms I experienced was akathisia. It is often described clinically as restlessness, but that description is profoundly inadequate. What I experienced was an intense, unrelenting inner agitation combined with a powerful urge to escape my own body, alongside a compulsion to move that made stillness feel intolerable. At its worst, it generated intense suicidal urges, not from hopelessness, but from a desperate need to escape the sensation itself. It was not psychological distress in any conventional sense, it was a physical state that overrode any attempt at control. It is difficult to overstate how severe and destabilising this symptom has been for three years.

Sleep became almost impossible at times. I went through prolonged periods of insomnia, sometimes sleeping only three hours across several days. When I did manage to fall asleep, I was frequently jolted awake by hypnic jerks; sudden, violent awakenings accompanied by adrenaline surges. The cumulative effect of this sleep deprivation was profound, amplifying every other symptom and eroding my ability to cope.

Cognitively, I experienced significant impairment. I developed …

https://t.co/TYB7skwY3t

[Sam Hall @samhall404]

Just a heads up that I wasn’t commenting on PD at all. Agree with everything you’ve shared here. I think personality disorder is an awful diagnosis. I do not believe anyone has a personality that is disordered, so any diagnosis of it would count as overdiagnosis in my view. Think some wires got crossed when talking about Parkinson’s disease / PD with the same initials. It got confusing for me 😂

[Sam Hall @samhall404]

Sorry, I’m not sure if you mean personality disorder or Parkinson’s disease as they share the same initials 😂 I think personality disorder is an awful diagnosis. I do not believe anyone has a personality that is disordered, so any diagnosis of it would count as overdiagnosis in my view. Parkinson’s I’ve got no idea 🤷‍♂️

My ‘ridiculous’ comment, which I shouldn’t have worded like that, was in regard to you saying that PD is the only dx which is overdx. I completely disagree with that having been diagnosed with panic disorder/tx resist depression etc. which were caused by normal life circumstances and adverse effects of psychiatric drugs. I believe this happens to millions of others too.

[Sam Hall @samhall404]

@RITB_ @DrAnnieHickox I’d agree with all of this.

What is a shame is that Dr Hickox felt the need to unblock me to make a comment and then block me straight after so I couldn’t respond directly. It’s very odd behaviour from someone so sure in their position.

[Sam Hall @samhall404]

As I said in another comment, I apologise for calling it ridiculous. I was just taken back by your claim which doesn’t align with the evidence.

Imaging and other tests are not required for every Parkinson’s diagnosis but the biological basis is known and can be demonstrated. That is why the clinical criteria are considered reliable indicators of that pathology rather than free floating descriptions.

[Sam Hall @samhall404]

@RITB_ I apologised for calling it ridiculous but I was taken aback by the claim because it does not align with the current evidence.

[Sam Hall @samhall404]

@RITB_ @jaunty_aphorism One can only hope, as you said. Interventions that create new problems of their own are one of the more frustrating but necessary patterns.

[Sam Hall @samhall404]

@RITB_ @jaunty_aphorism I’d agree with all of this but would also add it is a long time relative to the period in which modern imaging, genetics and neuroscience have existed and been heavily applied to psychiatry. That’s my main concern.

[Sam Hall @samhall404]

A lot of new evidence and arguments are being put forward but the response is often to shut them down by pointing to the risk that governments will use them to justify cuts. Holding governments to account for how they use (or misuse) evidence is absolutely necessary. Treating the evidence itself as invalid or dangerous because it might be exploited is different and wrong and makes progress even harder.

[Sam Hall @samhall404]

I agree (identifying something as a physical illness does not mean only medical interventions are appropriate). TB has a known infectious cause/identifiable bacteria/ established pathological effects. That is why we can target both the environment and the organism. Most psychiatric dxs do not currently have an equivalent identified pathology or causal mechanism. Treating them as if they do, while continuing to expand the diagnostic categories on symptom clusters alone, is not the same as recognising that social conditions influence a known disease.

Improving housing, reducing poverty, or changing workplaces can reduce distress whether or not a discrete brain disease is present. That does not require the claim that the distress is produced by a biologically identified disorder in the way TB is produced by Mycobacterium tuberculosis.

Once again, I agree with you on some but not all, and I think that is ok 😊

[Sam Hall @samhall404]

That is definitely true of some physical conditions. The diagnostic categories were refined or confirmed by evidence and not simply retained as descriptive labels indefinitely.

Most current psychiatric diagnoses have not followed that path despite decades of research and substantial investment. The technology argument does not explain why the pathology remains elusive after this length of time nor why the diagnostic categories continue to expand on the basis of symptom clusters alone.

It is possible that future findings will change this for some people currently given psychiatric diagnoses. I sincerely hope these people get the tx that they need. That possibility does not make the present evidence base equivalent to conditions that already have demonstrated pathology.

[Sam Hall @samhall404]

Not much has changed in those 30 years and the situation is still a mess. That is why it is worth talking about it more and challenging each other’s perspectives. That is how progress happens. If you don’t want to challenge each other’s views, that is fine. I do notice though that you regularly challenge other people while appearing unwilling to have your own views challenged.

I think the phrase “myth of mental illness” is an awful term. It dismisses the real suffering experienced by people who accept these diagnoses and by those who do not, including myself. “The myth of brain diseases causing mental illness” fits the current evidence better imo.

[Sam Hall @samhall404]

Apologies if I misinterpreted. I still think it is dismissive to label the distinction “bollocks” when clinical diagnosis of most psychiatric conditions rests on descriptive criteria without established pathology and the system is in the state it is.

I am glad if the current approach has worked for you. It has not worked for me and it has not worked for a large number of others. I believe there are better ways of understanding and addressing severe mental distress than treating descriptive symptom clusters as discrete brain diseases. The suffering is real. The disease model applied to it remains weakly evidenced.

[Sam Hall @samhall404]

The issue is the strength of the evidence that the thing being diagnosed is a discrete disease process. After decades of research and billions spent, I do not believe that has been established for most psychiatric diagnoses.

Some physical conditions are diagnosed clinically yet still have known pathology that can be shown on imaging. Parkinson’s is one example (loss of dopaminergic neurons in the substantia nigra and the presence of Lewy bodies (thanks Google). Everyday practice does not always require those tests but the biological basis is established. Most psychiatric diagnoses lack any equivalent. The criteria describe patterns of symptoms and behaviour.

For clarity, I am not denying the extreme and torturous suffering that people given these diagnoses experience. I have received several myself and my mother has been in and out of psychiatric care for most of my life. The suffering is real. The claim that it is caused by a discrete, biologically identified brain disease is a separate claim and that is the part that remains weakly evidenced.

I’m sure you will disagree which I respect but it’s a shame you would call my opinion “bollocks” from the get go without even hearing where I’m coming from.

[Sam Hall @samhall404]

Not asking you to speak as I prefer. You’re entitled to your own views which I respect. If you don’t want people to challenge them then you should close off replies, only allow certain accounts to comment that agree with you or block people like me. I think that would be a shame as no progress happens without challenging each other. It’s a shame that we can’t have these conversations.

I shouldn’t have called your statement above ‘ridiculous’ by the way so apologies for that. I should have just said that I don’t agree.

[Sam Hall @samhall404]

I’m sorry you feel that way but why not? It’s the truth isn’t it?

Parkinson’s has objective biomarkers that can be identified on imaging (Datscan, PET and MRI as far as I recall) and at post mortem, along with a characteristic progressive pathology. I don’t claim to be an expert in Parkinson’s so please correct me if I’m wrong (I just remember this from a family friend with the dx).

Just so you’re aware, my thoughts come from someone having been given multiple MI diagnoses and psychiatric drugs over half my life so I’m not speaking about this with no lived experience etc.

[Sam Hall @samhall404]

@RITB_ I saw that and thought it was good, including the way you challenged some leading psychiatrists on the issue recently. Disagreeing with you on certain points, which is normal, does not mean I cannot also agree with you and support others where we overlap.

[Sam Hall @samhall404]

I agree with a lot of what you post, particularly on disability advocacy, as someone who is disabled myself. I also disagree with other things you say. It is a shame that respectful disagreement is met with “you can just move on.”

I am on here to advocate for myself and others in similar situations and to engage with people I do not always agree with. I am not here only to speak to accounts that already share my views. If that’s what your account if about then maybe I misunderstood your intentions. If the evidence supports a different conclusion on overdiagnosis or prescribing it should be possible to discuss that without being told to look elsewhere.

[Sam Hall @samhall404]

As I said above, you appear to set aside the evidence, which you have just demonstrated again by claiming that “the only diagnosis which is overdiagnosed is PD.” That is simply ridiculous.

People waiting years for an autism assessment is appalling and should be fixed. That does not mean every person currently on those waiting lists meets the criteria or that social media has not expanded demand by pathologising ordinary traits.

[Sam Hall @samhall404]

A fracture has a clear biological injury that can be confirmed on imaging and follows a predictable healing process. Grief, job loss or chronic financial stress do not. There is no scan that shows a “bereavement disorder” or a “poverty deficit” requiring an antidepressant.

Most people who are bereaved or under severe pressure do not end up on medication because their distress, while intense, is a proportionate response that typically eases with time and practical support. The fact that some receive a prescription does not prove their distress met a clear medical threshold (although with the subjective nature of psychiatry I’m sure it can). It more often reflects short consultations, limited alternatives and the ease of writing a prescription rather than addressing the external circumstances.

If someone is given genuine informed consent and chooses medication to blunt the intensity of these periods, that is their decision and I respect that. Part of that consent should include clear information that the drugs primarily dampen emotional and physiological responses rather than resolving the underlying situation.

Once again I see that you are appalled by governments weaponising overdiagnosis and the medicalisation of ordinary distress with drugs in order to justify cuts. I share that concern. Yet rather than holding them to account on that basis, you appear to set aside the evidence that overdiagnosis and medicalisation are themselves substantial problems. The two issues are not in conflict. Recognising that many forms of distress are being turned into diagnoses does not prevent criticising any attempt to use that fact as cover for reducing support.