A successful cyclist suffering from the fear of having to pass a urine sample before becoming professional died of an overdose of heroin.
Jacob Pilkington, 24, of Arnolds Way, Cirencester, has suffered from a phobia of publicly using toilets since childhood, but knew that he would have to rehearse to follow his dream of professional riding, his father explained.
His anxiety grew so much before his death on January 16 that he self-medicated and used pills he bought over the Internet to "move on the day and calm down at night," the hearing in Communicated to Gloucester.
Postmortem showed that he had some codeine in his system, as well as the prescribed drugs citalopram and diazepam – but he also had heroin in an amount more than six times the known lethal dose.
Jacobs general physician Charles Urquhart, who overcame his fears over a mental health nurse, said he knew that Jacob got self-medication in January, just before his death.
The doctor said Jacob was always "articulate," but could not be a particular trigger for his anxiety.
"He took the cycling very seriously and some of the fears seemed related to it and the need to provide a urine sample," he said.
Jacob asked for a self-cataract kit, but Dr. Uruquhart said that they could not dictate this, and it would be something he would have to discuss with the bicycle authority.
Where to get help and what to do if you are worried about mental health issues
Where to get help and what to do if you are worried about mental health issues. What to do if you feel bad
If you do not feel yourself, go through a bad time, or are just sadder than usual, you may be suffering from depression or anxiety.
This does not mean that you are necessarily in danger, there are both scales and you may have only a bad mood or moderate anxiety.
Most importantly, let people around you know how you feel.
A conversation with a partner, family member or friend is essential. They can offer support and can be there for you during a difficult time.
Where can I get help?
You should also talk to your family doctor.
Your family doctor can find out if you are suffering from anxiety, stress and depression.
You can suggest ways to feel better naturally, such as increasing your level of training, or suggesting medication and advice.
They may also point you to other psychosocial services.
Who else can I call?
let's talk is a free NHS service for anyone suffering from mental health problems such as anxiety, stress and depression. It can be contacted on 0800 073 2200 or via www.talk2gether.nhs.uk.
If you feel you need more help, you can call 2 together NHS Foundation Trust in Gloucestershire on 0800 073 2200 to make an appointment.
The charity for mental health mind A hotline will be made under 0300 123 3393 or 86463 for text.
The Samaritans is always there for those who can not turn elsewhere.
It emphasizes, however, that it is not meant only for those who think suicidal. In fact, they say, "Most people who contact us are not suicidal, and when you talk to us, we will give you the opportunity to talk about your thoughts or feelings, whatever they are. "
You can call the Samaritans at 116 123.
In Cheltenham the Suicide Crisis Center provides important support. In addition to the services in the center in High Street, Cheltenham, the charity also visits service users. Sometimes they stay for hours when exposed to a high risk of suicide.
Contact the Suicide Crisis Center on 07975 974455 or visit www.suicidecrisis.co.uk
Charles Pilkington, Jacob's father, said the fear of having a urine sample came from childhood. Jacob always had a phobia about public urination.
Sue Lovell, a psychiatric nurse for Stroud and Cirencester, said she's been taking care of Jacob's mental health since October 2017 alongside Jacobs.
She spoke of Jacob's anxiety disorder and said that this is mainly related to his cycling career.
"His concern was to make a urine sample to become a professional, which he saw as a major obstacle to cycling," she said.
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In January, Mrs. Lovell said, Jacob's attitude towards his cycling career had changed.
"It was not all that, he saw it as a hobby and considered other possibilities," she said.
In conclusion, chief medical examiner Katie Skerrett made a conclusion on drug-related death and said that although a notebook found confirmed dark thoughts, there was no evidence of suicide.
His anxiety seemed to be spinning around his cycling career, he was always concerned about the provision of urine samples and in 2016 he started taking antidepressants.
"He was encouraged to help himself and CBT, but his anxiety persisted, and in January he confirmed that he medicated himself and was told that he was putting himself at risk."
"I do not feel there was a missed opportunity in his care, they offered services, they can not force it," Mrs. Skerrett confirmed.