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It would be easy to dismiss tabletop gaming as a “geeky” hobby played by young boys in the basements of their homes.

For those who have never enjoyed the rush of playing a miniature wargame, it may come as a surprise that it is in fact a multi-billion-pound industry loved by people from all walks of life and is continuing to boom across the country.

Tabletop gaming covers quite a lot of different things, including board games, card games, dice games, miniature war games, role-playing games and tile-based games.

In this golden age of video games and comic book movies, experts say tabletop gaming has been “pulled along” into the mainstream and is currently enjoying a “renaissance” in the UK.

Pic: Stephen Whistance
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Pic: Stephen Whistance

Games Workshop has been transformed into a billion-pound company thanks to the likes of Warhammer and Warhammer 40,000.

The firm, which was founded in 1975 by three friends, was originally a manufacturer of wooden boards for games including backgammon, mancala, nine men’s morris, and go.

It later became an importer of the US role-playing game Dungeons & Dragons, before going on to publish war games and role-playing games in its own right.

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The company opened its first shop in Hammersmith, west London, in 1978 in a chain that would later spread across the world.

The now Nottingham-headquartered company was worth about £4.7bn at the beginning of December.

To put that into perspective, at the same time Boohoo was worth around £470m, ASOS £455m, and Card Factory £315m.

Pic: Stephen Whistance
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Pic: Stephen Whistance

Superman himself, Henry Cavill, is one of Games Workshop’s A-list clients.

The gaming enthusiast has been attempting to bring a Warhammer film and television universe to life via Amazon MGM Studios, and in recent weeks it was confirmed a TV series is moving forward.

The Hollywood star celebrated the news by making a “pilgrimage” to the very first place he bought Warhammer models more than 30 years ago on his home island of Jersey.

Tabletop gaming enjoying a ‘renaissance’ in the UK

Dr Niall Moody and Dr Hailey Austin, from Abertay University’s faculty of design, informatics and business, told Sky News tabletop gaming is enjoying a “resurgence” in the UK.

Dr Moody, a lecturer in game audio and design, said “these days, geek culture is mainstream”.

He believes the box office draw of the likes of The Lord Of The Rings films and the Marvel Cinematic Universe (MCU) have helped to “pull along things like tabletop gaming”.

Pic: Stephen Whistance
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Pic: Stephen Whistance

Pic: Stephen Whistance
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Pic: Stephen Whistance

Dr Moody said part of its popularity also stems from the fact it has been around for a “very long time”.

He explained: “Board games date back to 3000BC at least. We’ve had card games since, like, the 14-15th century.

“Warhammer’s lineage is kind of from war games. The original one of those is Kriegsspiel from the 19th century.

“And the other big part of tabletop gaming today is tabletop role-playing games.”

He added: “Tabletop role-playing games in particular have become massively popular over the past like 10 years. I think part of the reason they’ve become so popular is down to the actual play stuff.”

Actual play – also called live play – is a genre of podcast or web show where people play tabletop role-playing games (TTRPGs) for an audience.

It often encompasses in-character interactions between players, storytelling from the gamemaster, and out-of-character engagements such as dice rolls and discussion of game mechanics.

Dr Moody, a game designer and artist, said highly polished shows have inspired would-be players to take up the hobby.

Pic: Stephen Whistance
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Pic: Stephen Whistance

Pic: Stephen Whistance
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Pic: Stephen Whistance

Colleague Dr Austin, a lecturer in visual media and culture, said there is a “huge culture” around playing games right now in the UK.

She noted: “This culture has been huge in Germany and Sweden for a long time, but it’s having a renaissance here now.

“I think it’s similar to sports. Some people know a lot about sports and teams and trends, and watch other people playing sports. And others play it themselves.

“It’s the same with games and board games. Some people only like to watch, and others like to join in casually, or competitively.

“I think some people don’t know how popular it is because we are in an age of information overload and there’s no way to know about everything, while there’s no excuse not to know anything.”

Dr Austin, whose PhD is in comic books, believes role-playing games like Dungeons & Dragons – which celebrated its 50th anniversary in 2024 – are enjoying a revival in part due to the popularity of the likes of Netflix show Stranger Things, as well as podcasts and well-produced live sessions like Critical Role and Dimension 20.

Pic: Stephen Whistance
Image:
Pic: Stephen Whistance

Dr Austin, a programme lead for Abertay University’s BA (Hons) game design and production course, noted the hobby is often thought of as being “consumed by predominantly young men” but that isn’t the case.

She said: “Board games, card games, party games and role-playing games are incredibly popular with all kinds of people and have been for a long time.

“In fact, by most accounts, women tend to make up around 50% of game players. They just aren’t thought of as the main market.”

She also believes Generation Z’s alcohol habits could also be playing a positive role in the hobby’s popularity.

A YouGov survey released at the beginning of 2024 found that almost half of the UK’s youngest drinkers were turning down booze for low or no-alcohol alternatives.

Dr Austin said: “From what I understand, young people don’t want to go out drinking much anymore. They would rather stay home with friends and play games.

“It’s a nice, lowkey way to be social, meet like-minded people, and a safe space to express themselves.”

An important lifeline to those seeking friendship

Crossfire Gaming Club
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(L-R) Chris Mooney, Stephen Bannerman, Curtis Walker and Simon Lewis are on the Crossfire Gaming Club committee

One Scottish club is testament to the popularity of tabletop gaming.

Crossfire Gaming Club was founded by a group of six friends in February 2023.

Club chairman Chris Mooney, 37, told Sky News the men needed a place to game after “getting it in the neck” from their wives and partners for repeatedly playing at each other’s houses.

They hired out Cumbernauld Village Hall in North Lanarkshire and hoped to attract a few other gamers.

It has since grown exponentially with club nights held on both Mondays and Thursdays.

Crossfire Gaming Club
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Crossfire Gaming Club has used some of its Lotto funding to purchase high-quality gaming terrain

Crossfire Gaming Club

Mr Mooney said: “We thought if we get eight to 10 people that’ll be a massive success for us. Now we’re averaging 50-odd. It’s no longer a small operation.”

Members play a wide variety of games, from the likes of Warhammer 40k, Age of Sigmar and Infinity to Blood Bowl, Kill Team and Star Wars: X-Wing.

Starter armies are available to players who don’t have any gaming equipment, and intro games can be arranged for those who have never played before.

Crossfire Gaming Club
Crossfire Gaming Club

There’s even a hobby area where members can sit down and paint their models while chatting to others.

The club has invested in board games, and other groups that need a space for the likes of Dungeons & Dragons are additionally invited to get in touch.

Since its inception, the club has received £25,248 from National Lottery Awards for All Scotland.

The committee has used some of the money to purchase high-quality gaming terrain.

Crossfire Gaming Club

The lotto cash has also been used to fund more tables, buy merchandise like club hoodies, and subsidise expeditions – like group cinema trips and axe-throwing adventures.

Mr Mooney said the funding has helped “massively”.

He said: “It takes the pressure off us as we don’t have to worry about the next council bill that’s coming in for the hall or so.”

Crossfire Gaming Club
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The club boasts a hobby area where members can paint their models

Mr Mooney, who was part of a gaming club years ago, agrees with Dr Moody’s sentiment that the popularity of computer games and comic book movies have helped to bolster the perception of tabletop gaming.

He said: “It’s become a lot less taboo over time. It used to be one person in the classroom that collected comic books, but now it’s very accepted because Marvel is mainstream and all sorts.

“Geek culture has become very mainstream, and that’s kind of pulled along things like wargaming with it as well.”

Mr Mooney says some of those within the “gaming, wargaming and geek culture suffer from social anxiety”.

He said that’s why he personally likes the club, explaining: “I like coming out and talking to people.”

Crossfire Gaming Club
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Crossfire Gaming Club members during a games night

Dr Moody agrees that its popularity has led to the creation of public events, societies and board game cafes – all deemed to be a “safe space” for those with social anxiety.

Dr Moody said: “With social anxiety in particular, it can be really hard to socialise in more traditional settings like pubs.

“If the sole focus is social interactions, like making small talk, it can be really hard if you struggle with social anxiety, and you can often freeze up in those situations.

“But one of the really good things about games, tabletop games in particular, is that they give you something else to focus on that helps you relax around other people.

“It’s a great way to meet people in a low-stakes setting.”

Crossfire Gaming Club
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Jac Harvie

Jac Harvie, 25, is one such member who enjoys the social aspect of the club as most of his friends are not into tabletop gaming. “I’ve got anxiety and can struggle sometimes, but here I feel like I’m among friends,” he said.

“We share a lot of the same likes and talk about things like new books that have come out.”

Crossfire Gaming Club
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Jac Harvie and Connor Leitch

Even when he’s losing, Mr Harvie is still having fun.

He explained: “Even the bad nights are good because you enjoy yourself.”

Crossfire Gaming Club
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Kevin McMail

Kevin McMail, 39, is another member who believes the club offers an important lifeline to those seeking friendship.

Due to the effects of lockdown, he found himself in front of a screen a lot.

“I realised I was probably spending more time at home with the dog than out and about the way I had before. I was like, ‘I’ve got to get away from this’.”

Crossfire Gaming Club
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Mr Mooney and Mr McMail

Mr McMail said unlike basic video gaming, there are “extra elements” to the hobby as participants can express their artistic side through the painting of their battle figurines.

He added: “I think a lot of people are attached to screens a lot, but you don’t feel the same level of social experience when you’re playing online games with people.

“That level of social connection, I think it’s important for a lot of people. And that’s what you get here – just an unbelievably supportive community.”

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Oleksandr Usyk beats Tyson Fury to retain heavyweight titles

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Oleksandr Usyk beats Tyson Fury to retain heavyweight titles

Tyson Fury has responded after his defeat to Oleksandr Usyk in their heavyweight world title rematch in Saudi Arabia.

British fighter Fury, 36, had hoped to take revenge after his previous defeat to Usyk in May.

The Ukrainian, 37, who had entered the bout as a narrow favourite, retained his WBO, WBC and WBA heavyweight titles with his win at Riyadh’s Kingdom Arena.

But, the fight went to the scorecards with all three judges scoring the fight 116-112 in Usyk’s favour.

“I swear to God, I thought I won it by at least three rounds,” Fury said shortly after the fight.

“I felt a little Christmas spirit in there and I think he got a little Christmas gift from them judges. An early Christmas gift.

“I was confident I had won that fight again. I thought I’d won both fights but then again I’ve gone home with two losses on my record. I will always believe until the day I die that I won that fight.

“I’m not going to cry over spilt milk. It’s happened now.”

Fury left the ring without doing an interview, leaving his promoter Frank Warren to speak on his behalf.

“How can Tyson only get four rounds in this fight? It’s impossible,” Warren told TV network DAZN, adding he thought Fury had won.

“Only four rounds. Each of them gave him four rounds, four different rounds. I’m not saying this because I’m biased, but everyone along the front there all thought it went the same way.

“It’s nuts. It’s nuts, I don’t get it. I’m really disappointed with that. I thought he was in control of the fight and boxed extremely well. Usyk was on the back foot for most of the fight, but it is what it is.”

Tyson Fury reacts during a press conference after losing his latest boxing match. Pic: Action Images via Reuters/Andrew Couldridge
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Fury reacts during a press conference after losing his latest boxing match. Pic: Action Images via Reuters/Andrew Couldridge

Usyk became the only man to inflict a professional defeat on Fury when he beat him on points in May, becoming the first boxer to hold all four major heavyweight belts at the same time and the first undisputed champion in 24 years.

But his reign over the four belts ended just a month later when he gave up his IBF belt to fight Fury in a rematch because he was unable to make a mandatory defence against the organisation’s interim belt-holder, Daniel Dubois.

“I win,” Usyk said simply after the fight, “it’s good”.

Oleksandr Usyk celebrates winning his bout. Pic: Action Images via Reuters/Andrew Couldridge
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Usyk celebrates winning his bout. Pic: Action Images via Reuters/Andrew Couldridge

He also paid tribute to Fury.

“He’s a great fighter, a great opponent and it was a great 24 rounds. Unbelievable 24 rounds in my career. Thank you so much,” Usyk said.

Daniel Dubois, the IBF heavyweight title holder, was quick to call for a fight with Usyk following the result.

“I want my revenge,” he told Usyk directly. “Let’s go.”

Oleksandr Usyk and Tyson Fury stare at each other for 11 minutes
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Usyk and Fury stared at each other for 11 minutes ahead of the fight

Dubois, 27, defended the IBF belt with a fifth-round knockout of fellow British rival 34-year-old Anthony Joshua in October.

He faces Joseph Parker on 22 February and the Usyk win could set up a future fight to unify all of the titles.

Ahead of the bout, Usyk and Fury engaged in a stare-down for more than 11 minutes in a head-to-head press conference on Thursday.

Fury weighed in at a career-high 20 stones 1lbs, while Usyk weighed 16 stones 2lb, the heaviest he has recorded, although both men were fully clothed when they stepped on the scales.

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Princess of Wales asked Lady Gabriella Windsor to help with Christmas carol service

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Princess of Wales asked Lady Gabriella Windsor to help with Christmas carol service

It’s been revealed that the Princess of Wales asked Lady Gabriella Windsor, whose husband died earlier this year, for her help to plan her annual carol service.

During the summer, Kate invited Lady Gabriella, the daughter of Prince and Princess Michael of Kent, to join her team organising her annual Together at Christmas event at Westminster Abbey.

The heart-warming gesture was very much in tune with the overall theme of the service, recognising those who have shown love, kindness and empathy to others in their communities.

Speaking of Lady Gabriella’s reaction, a friend said she felt “honoured” and “very touched and grateful to the princess to be asked to contribute to her very special concert”.

The Princess of Wales arrives for the Together At Christmas carol service at Westminster Abbey in London. Picture date: Friday December 6, 2024.
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The Princess of Wales arriving for the carol service earlier this month. Pic: PA

Kate is understood to have been incredibly grateful for her contribution.

Lady Gabriella’s husband, financier Thomas Kingston, died on 25 February from a head injury and a gun was found near his body at his parents’ home in the Cotswolds.

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Kate Middleton hosts Christmas carol service

In October a coroner concluded he took his own life and during the inquest his widow warned about the effects of drugs used to treat mental health problems after the hearing was told Mr Kingston was prescribed drugs following complaints of trouble sleeping following stress at work.

Lady Gabriella, also known as Ella to her friends, supported Kate and played an advisory role with the organising team around the music performances that featured during the service.

The carol service took place on 6 December, with Kate joined by Prince William and their three children Prince George, Princess Charlotte, and Prince Louis, who all held candles during the service, as did the other guests in the congregation.

The service, shown on television on Christmas Eve, will start with a recorded voiceover from the Princess, featuring extracts from a letter given out alongside this year’s order of service.

She will say: “The Christmas story encourages us to consider the experiences and feelings of others.

“It also reflects our own vulnerabilities and reminds us of the importance of giving and receiving empathy, as well as just how much we need each other in spite of our differences.

“Above all else, it encourages us to turn to love, not fear. The love that we show ourselves and the love we show others.

“Love that listens with empathy, love that is kind and understanding, love that is forgiving, and love that brings joy and hope.”

Read more:
William and Kate to launch mental health programme

Prince William praises ‘amazing’ Kate

Olympic cycling champion Sir Chris Hoy, who is terminally ill with prostate cancer, lit a candle, as did Lindsey Burrow, the wife of former rugby league star Rob Burrow who died in June following a much-publicised battle with motor neurone disease.

Readings were given by Prince William and actors Richard E Grant, Michelle Dockery, Sophie Okonedo, and Olympic swimming gold medallist Adam Peaty.

The service will be broadcast as part of the programme Royal Carols: Together At Christmas, screened on ITV1 and ITVX on Christmas Eve, and will also feature three films about people and organisations who have inspired, counselled and comforted others in their times of need.

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‘I walk into a room and people start coughing’: Rare condition makes people allergic to sufferers

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'I walk into a room and people start coughing': Rare condition makes people allergic to sufferers

On rare occasions that Medinah leaves her home, people around her will cough, sneeze and rub their eyes.

“I am the allergen,” the 23-year-old, who did not want her full name used, tells Sky News.

She is one of a group of people with a condition so rare it does not have an official medical name.

It is known simply as People Allergic To Me – often shortened to PATM.

Medinah spent a year online searching her symptoms before she found social media support groups and the name that had been coined there.

During those months, she worried she was “crazy”: “I thought, yes, I’m losing it now. But then after a year and the constant reactions with people, I just realised this cannot be in my head, I can’t be crazy, I’m seeing this in real time.”

Hay fever-type symptoms

Several of the people in those groups spoke to Sky News. They described people developing hay fever-type symptoms in their presence, saying as much as 90% of a room would start coughing, choking, or sneezing when they entered.

They detailed the immense toll of isolating themselves to avoid these reactions. Some said they had been suicidal; others talked of losing friends, giving up jobs, and spending hundreds of pounds on possible remedies.

Last year, PATM sufferers had a glimmer of hope. A researcher in Japan published the first cohort study on the condition – and it indicated there could be a physical cause.

Medinah for PATM feature
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Medinah has suffered from People Allergic To Me since 2020

Speaking to Sky News from Tokyo, Professor Yoshika Sekine from Tokai University describes what he found when he compared the skin gases emitted by 20 people with PATM to a control group of 24.

He discovered the PATM group had “very specific characteristic skin gas patterns”, giving off higher levels of certain chemicals that are known to provoke respiratory symptoms in people exposed to them.

One of them, toluene, is used in the manufacture of explosives, paints and plastics and as a solvent in some types of paint thinner and glue. It can cause irritation to the eyes, nose, throat and respiratory tract, according to Public Health England – and people with PATM emitted 39 times more of it than the control group.

The other chemicals Prof Sekine identified as being particularly important are sulphur compounds, which have a “very strong, pungent odour” and hexanol, which has a hay-like smell.

These chemicals are known to trigger respiratory symptoms and skin irritation and are both linked to sick building syndrome, a condition recognised by the World Health Organisation where people are made ill by the building in which they live or work.

The study concluded: “We must carefully consider the possibility that the chemicals emitted by the PATM group may induce chemical intolerance in those around them.”

‘You feel you don’t have the right to live’

It’s been about 18 months since Fahima started noticing reactions from people around her.

“Wherever I go, if I go into a shop, if I’m out, if I walk past someone, people will sneeze and hysterically cough,” she tells Sky News.

In that time, she’s shifted to working entirely from home. She has stopped attending her nine-year-old son’s school plays because “I don’t want to impact the children”.

She shops in the early, quiet hours. The school run is the only time she regularly leaves the house.

“From the minute I wake up, the first thought is, how are people going to react to me today? I have to minimise myself so that I don’t impact other people.”

She says she also gives off an odour that developed from sweat to fish and then faeces.

There is a medically recognised condition called trimethylaminuria (TMAU) – sometimes called “fish odour syndrome” for the smell sufferers emit – that is sometimes grouped together with PATM.

However, there are PATM sufferers who say their symptoms are not accompanied by any discernible smell.

Dr Robin Lachmann, one of the country’s leading doctors specialising in TMAU, tells Sky News that unlike PATM, TMAU is a condition “which we understand well and can treat”.

A key difference is that while people around the patient may find the odour unpleasant, “these responses aren’t allergic”.

Fahima took a test for TMAU which came back negative – but even getting the test took a year of “legwork” on her part, she says.

“With PATM, doctors say even if you want to get tested, there’s no diagnosis. There’s no way to treat it.”

The reactions Fahima gets aren’t just involuntary coughs and sneezes, she says, but insults and abuse.

“You know what? I don’t blame people. Especially the people that are having allergic reactions to us, we’re physically making them sick, so I don’t expect them to have any other reaction.”

But it’s “draining”, she says, and makes her “incredibly depressed”.

“It makes you feel like you don’t have the right to live, almost. Because why should you be in a place making someone else feel uncomfortable?”

Anonymous woman at the window. Pic: iStock
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Sufferers describe isolating themselves to avoid reactions from other people. Pic: iStock

Fahima says the allergic reactions vary depending on her diet. If she eats a lot of sugar, meat or carbohydrates, the following day she will notice a lot of people sneezing.

Her son mostly doesn’t react to her, she says, but when she eats meat his reactions are so severe she will give him an antihistamine.

Prof Sekine says while skin gases are typically influenced by diet, he hasn’t yet been able to find a link for PATM. But he has spoken to people who have improved their symptoms by cutting out dairy, increasing their intake of antioxidants and working on boosting good gut bacteria.

He also suggests why not everyone reacts to people with PATM. He says it could be to do with sensitivity to chemicals, with some people affected by very low doses in the air around them.

Just as not everyone suffers from hay fever when there’s a high pollen count, not everyone will be sensitive to the higher chemicals in the skin gases of PATM patients.

‘It’s all in your head’

The PATM sufferers who spoke to Sky News invariably said they had been told the condition was “all in their head”.

There is a recognised psychological condition that bears similarities to PATM called Olfactory Reference Disorder, or ORD.

People with ORD are preoccupied with the belief they are giving off a bad smell despite there being no odour, explains Professor David Veale, a consultant psychiatrist at the Nightingale Hospital.

It can have a “devastating” impact on peoples’ lives as they dedicate their energy to tackling the perceived problem and avoid social situations out of fear of being “shamed, humiliated, rejected”, he says.

“They are very stressed and very disabled by it. But no one can convince them that they can’t smell them. They think they’re just saying that to be nice.”

Prof Veale says the difference between PATM and ORD appears to be that ORD patients are preoccupied with their perceptions of what other people think about an imagined smell, while PATM sufferers perceive physical reactions in other people.

Prof Sekine also identifies this difference in his research, concluding PATM is unique “in that it affects the people around them, at least based on descriptions by people with PATM”.

Woman sneezing in an office. Pic: iStock
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File pic: iStock

Sandra, who did not want to use her real name, says she seriously considered whether her condition could “be in my head” after her doctor suggested she had ORD.

“I’d had too many incidents happen for that to be true,” she says.

“I was even bullied at work about it in one job.”

Almost 60, Sandra has lived with the condition for 15 years. She says she used to have a good career, but no longer works “partly due to the stress and anxiety that this causes”.

Her first sign of PATM came when she returned to work after a bout of sickness and her boss had a “sneezing fit” every time he came into her office.

A deep clean didn’t sort what she thought was a dust issue – and then she noticed other colleagues reacting in the same way, then friends and even her husband.

“Eventually it occurred to me that it must be me causing this, which filled me with horror,” she says.

“When the reactions are at their worst, I have a similar reaction myself, that is I become allergic to myself.

“I have other symptoms like a bad taste in my mouth, itchy throat, itchy skin with a mild rash on my abdomen and spiking mild temperature.”

But making others react is the worst part: “It makes me feel dreadfully guilty to be causing all of this and I have severe anxiety and depression as a result.”

Alex’s 24-year-old brother Miguel first noticed PATM symptoms about 10 years ago, but didn’t tell his family until he was 19.

Many people with PATM say close relatives do not get symptoms, and Alex does not notice himself reacting to his brother.

He says it’s also hard to say whether more people cough and sneeze around his brother because it’s such a commonplace thing – but Miguel will notice every cough or nose scratch, and someone having a coughing fit can be enough to make him stay in his room for days.

Alex recalls being at a restaurant with their grandparents when Miguel first told them about the condition, and his grandmother agreed she could hear people “just constantly coughing in the restaurant”.

“That seemed like an increase to what’s normal. But then how do you know what normal is if you’re not paying attention to it?”

PATM is easy to write off as “just” psychological because “it sounds ridiculous”, Alex says, but his first concern when his brother opened up about the condition was to find a way to cope with the impact on his mental health.

“That’s the important thing – and then it doesn’t matter whether it’s real or not.”

What causes PATM?

The cause of PATM is a puzzle to sufferers and researchers alike. Some people say their symptoms started during a time when they were eating a lot of fast food or experiencing high stress.

Sufferers trade theories about possible triggers: a disrupted gut microbiome, fungal infections, sinus problems.

“You’re like your own doctor, your own medical team,” Medinah says. “I literally stay up all night researching.”

Sandra and another person who spoke to Sky News found their PATM flared after a course of antibiotics, while others described developing skin issues before other symptoms.

MEBO Research, a small collective of researchers investigating rare genetic metabolic diseases, has conducted exploratory studies of PATM without being able to pinpoint a cause beyond an apparent issue with the body’s “detoxification process”.

Mehmet Ali, MEBO’s director of community outreach and strategy, tells Sky News PATM needs attention and research from the medical community.

Prof Sekine’s research also did not identify a cause – although it is his goal to find it. “I would like to define the criteria for what PATM is, and what it is not. This is a very difficult point,” he says.

Without even a criteria of what PATM is, there is no formal diagnosis. NHS England told Sky News it follows NICE guidelines, and there are none for PATM.

A spokesperson for NICE said it “can only look at treatments that are licensed by the UK regulators… If they have not been licensed for PATM, we cannot recommend them for the condition”.

But finding a treatment seems a distant dream to sufferers who share remedies on Facebook and Reddit: supplements of every variety, antibiotics, digestive enzymes, probiotics, herbal treatments.

Sufferers go to extreme lengths in search of solutions. Fasts; eliminating sugar, gluten and dairy; raw veganism and its opposite, the “carnivore diet” – essentially just eating meat, eggs and dairy.

But what might grant one person temporary relief doesn’t necessarily work for someone else.

Sandra sees no end to her 15 years of misery: “We are all just waiting for a cure with our lives in effect on hold but I’m nearly 60 now and not confident it will happen in my lifetime.”

‘It crushes you like nothing has crushed you before’

Amir, who did not want to use his real name, says without family relying on him “I wouldn’t be here, that’s how bad I feel sometimes”.

He describes a life that has become “really, really unbearable”. He says he has lost all his friends “because they can’t be in the same areas as me” and even avoids the mosque.

“I do an experiment – I stay out of the room to see if anyone is coughing, then go in the room for a few minutes. The majority of people will start reacting.”

Not everyone with PATM who spoke to Sky News isolates themselves. Some hold down jobs and socialise – but none seem immune to the mental health impacts of the condition.

They describe the loneliness of not just being physically isolated, but of being misunderstood by doctors, friends and family; the guilt of feeling you’re making another person ill; the despair of there being no treatment or cure.

Medinah describes her mental health as “shattered, it’s non-existent”.

“In the beginning it crushes you, it crushes you in a way that nothing has ever crushed you before.”

She says she quit her job as a teaching assistant because she was getting “aggressive” reactions, and now life is at a “complete stop”.

She gets emotional talking about the future: “I don’t feel excited at all. I don’t even like to think about it. The reality is so sad. I can’t even go to the local park, I can’t do anything.”

Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email jo@samaritans.org in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK.

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