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8 questions in the "Mental Health" category

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I think my friend is depressed. what should i do to support them without being patronising. also, should i (and if so, how should i) try get them help?

Answering this question is incredibly difficult because, as is so often the case with issues of poor mental health, there is no simple answer. The fact that you have asked this question probably means that you are already helping them without realising it, by being aware of the change in their mental health.

Sometimes asking questions can be helpful. A simple “are you ok?” or “how are you feeling?” is always a good place to start – but the really important thing is that you make sure you are really listening to their answers. We are so used to greeting people with a cursory, automatic “how are you?”, hearing them say “fine thanks, you?” and replying with a “good, thank you”. If this is true – fantastic. But because we are so used to these kinds of exchanges we rarely take the time to actually sit down with people, take some time and really listen to each other. So that's a good place to start – you can invite your friend over for a cup of tea or just to hang out, as long as you're going to have a time and space to talk, and take it from there. That way you're being a good friend without being patronising.

It may sound obvious, but make sure that your friend is included in social activities etc. – people who are depressed often experience feelings of very low self-worth and therefore if they aren't included in events this feeling might worsen. I'm not saying invite them along to your supermarket trip… but just make them feel valued and supported when the opportunity arises.
If your friend opens up to you and confesses their depression (even if they don't use the words “depressed” or “depression”) that is a massive step. I think in most cases this step should occur before you then try to think about getting them help because coming to terms with your own poor mental health is a huge deal and your recovery should be on your terms, not someone else's. The only situation in which I would personally advocate trying to get someone help without their explicitly asking you is if they are putting themselves or someone else in danger because of their depression – for instance, substance abuse or self-harm to the point of hospitalisation.

If your friend admits that they do want help and to feel better, you can support them with that. Generally speaking I think the first thing to do is to get an appointment with their local GP, who should be able to provide support and advice, and recommend counselling if appropriate. However as this can take time in the interim you can look at resources from organisations that might be helpful – Mind is fantastic and they have a section dedicated to helping those who are helping others.

Asked on 5th February 2012 in Mental Health

How do you talk to a doctor about mental health problems? I'm struggling but scared of speaking to someone about it.

Talking about mental health is a growing public health priority and becoming increasingly visible in popular media. Only this week, Freddie Flintoff hosted a documentary on the BBC about mental health distress in the sports world with a number of sports celebrities talking openly about their experiences. However despite the recent media attention, talking to someone about a mental health problem can be the most difficult part of dealing with a mental health condition. 1 in 4 of us will experience a mental health problem in our lifetime so decreasing the stigma around mental health through talking about it is everyone's responsibility. Deciding to take the step to talk to someone, be it a family member, friend or health professional is a sign of courage and strength and I hope these tips will help make the step as easy as possible.

Speaking to your GP is often the first stage in accessing specific support around mental health.

- Booking the appointment.
Try and pick the best time for you, for many mornings may be a difficult time so requesting an afternoon appointment may be helpful. If you are fitting in the appointment around work or studies, consider the pros and cons of booking a half day off to give you plenty of time, rather than rushing or having to go straight back to work providing additional stress.

- Remember the scouts, be prepared.
Spend some time before the appointment thinking about what you want to say. Try and prepare some questions so help you keep on track and to ensure you get what you want from the appointment. This can also help as our memories can fail us easily if we are feeling stressed. If the appointment is particularly difficult you can always pass the written questions to your GP too.

- Two heads are better than one, take someone with you
Taking someone with who you trust can be helpful for a number of reasons. They could simply provide reassurance in the waiting room or could also come into the appointment with you. They could help explain how you are feeling, prompt you if you have forgot a question you wanted to ask and also help remember anything said in the appointment or discuss how it went. If you don't feel you have someone who could accompany you most areas have an advocacy service. Advocates are people trained to support people to be heard whilst being neutral and restraining from giving advice.

- What to expect.
GPs vary in their level of experience of supporting people with mental health problems and areas also differ on the range of support services available. As a general rule GPs will enquire how you have been feelings, for how long and how this has been affecting your ability to function day to day. They may also ask about any recent life events (e.g. bereavement, loss of job etc.), and your lifestyle including use of drugs and alcohol. You may also be asked if you feel safe or if the level of distress experienced is leading to thoughts of self-harm or suicide. Whilst these questions can feel intrusive and can be difficult to answer, they are asked to help the GP decide which support avenue is most appropriate and how urgently. If at any point you are asked a question you do not understand or feel your response has been misunderstood do not be afraid to clarify.

- Then what...
This is difficult as mental health distress and services vary considerable from person to person and area to area. It may be the GP prescribes medication or refers you for a referral to the local mental health team. The majority of mental health support today is dealt with by the GP and primary care mental health teams, it is not routine to be referred to a psychiatrist, though in some cases this may be appropriate. The most important thing at the end of the appointment is to be clear of the outcome:

- If prescribed medication, have you been given information on what it is? How it works? How long typically before changes may be seen? Any side effects to look out for? Do not be afraid to ask about medication, understanding how medication works can be helpful in taking the medication correctly

- If you have referred to the mental health team or another service is it clear what you have been referred for and the next stage? Services vary; it may be an initial referral appointment or direct access to psychological therapies such as counselling or cognitive behavioural therapy. Clarifying this and any waiting lists involved can be helpful. Minds website has some good information on what to expect from psychological therapies.

- On some occasions GPs may give advice on diet and exercise and ask you to come back in a number of weeks if nothing has changed. Try not to feel fobbed off by this response, as this can be sign the GP thinks minimal changes are needed for an improvement. However after trying the advice, if nothing has changed do not hesitate in booking a repeat appointment

- Sticking points
Below are some general points for difficulties that can sometimes be encountered in the process of accessing support:

- My GP is not listening: if you feel you are not being heard you can always request to see a different GP for a second opinion. Word of mouth is quite helpful in discovering local GPs known for responding positively to people with mental health problems. You can also seek support from advocacy services to help in being heard, they can also support you in putting in a complaint if necessary

- Long waiting list or lack of support available: On occasions there can limited support available or long waiting lists. At these times seek information from your local community where there are often a range of support options. This could be from your local college, university, employer or local charities. Many areas also have mental health peer support groups which can be helpful for meeting people with similar experiences who can provide advice from experience and often give an idea of what to expect from local services. If these services are also limited there are some great self-help resources on the internet some of which are listed below.

- Speaking to friends and family
Time to change, the national campaign to end mental health discrimination has some great advice for talking generally about mental health to friends and family and is also a good site to forward people to if they are struggling to understand. There are also great video and personal stories about talking about mental health problems. Having someone who understands and who you can talk to about mental health distress is important. It is also helpful to remember the Samaritans are available 24hours a day if you need to talk and family or friends are unavailable. Most local Samaritan branches also have the facility for you to go in and speak to someone in person.
Ultimately remember everyone will have experienced mental health distress personally or know someone close to them who has. Let's get talking about mental health, the more we talk, the easier it will become for everyone.

Asked on 14th January 2012 in Mental Health


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Asked on 14th January 2012 in Mental Health

Is it normal to have lots of sexual partners to deal with low self esteem?

When it comes to sexual behaviour it isn't really a case of what is 'normal' or what is 'abnormal'. But when it is about using sexual behaviour to manage your own feelings about yourself, it becomes about what is good for you. Personally, for a long time I had sex with huge numbers of people to validate my attractiveness. I would seek out the most attractive person I could find and sleep with them, because, if they slept with me, I must be attractive, right? Wrong.

Unfortunately casual sex for many doesn’t reflect what the other person thinks about you. Casual sex in itself isn't necessarily a bad thing, but to use if to boost your own self-esteem is a desperate own goal. You cannot build up your own worth, by treating yourself as worthless. It just doesn’t work. And when you come out the other side, you are left not only having to manage your self esteem about your attractiveness, or sexuality, but also how you feel about having showed your body so little respect. And it IS showing your body little respect when you are using it as a tool for your worth.

I have to make some assumptions about the type of people you are sleeping with, if you are seeking out sex to try to improve your self-esteem. If the situations you are getting yourself into are anything like mine were, when you stop you will see the people you are sleeping with for what they were - predatory, parasitic and abusive. This is not an easy thing to realise, it is incredibly difficult, and it is an incredibly hard pattern to break. If you are using drugs or alcohol to give yourself the confidence to seek out these people, managing your use of them is the first step towards freedom.

People like that can never validate you, they are not a part of your sexual liberation, and you will never be able to start rebuilding yourself while you are letting them use you. You can only do that on your own, and believe me when I tell you, you will feel so, so, much better about yourself when you realise you’re worth more than that.

Asked on 12th January 2012 in Mental Health

How can you tell if you're depressed or just really sad or in a rut?

This is a really good question and it doesn't have a simple answer. It's important to recognise the difference between ‘sadness’ and ‘depression’, but it's often not that easy, because being sad or in a rut can lead to depression and depression often puts you in a rut! The most useful way to think about it is probably that sadness tends to be very much related to a situation. Ask yourself if you think you would feel better if you changed your routine, or spent more time doing enjoyable things or talking to someone close to you. Another way to think about it is that sadness is usually only one symptom of depression. Other symptoms vary from person to person, but they may include having little or no interest in doing things that would normally make you happy, low self-esteem, and lacking in motivation to the point where it begins to affect your life. As you can see, the lines are very blurred, and it can be hard to be objective when you’re in the middle of it all. For this reason, if you experience a lot of sadness, it is a good idea to speak to a counsellor or a GP to try to make sense of what you're feeling. And always remember that whether you are 'sad' or 'depressed' or both, it's important to take it seriously and it's nothing to be ashamed of!

Asked on 5th January 2012 in Mental Health



Asked on 3rd November 2011 in Mental Health

What can you do if you don't like or feel that you aren't being taken seriously, by an NHS-assigned psychiatrist/psychologist?

Please have a look at the following website which we hope will answer your question:

Here is what they have to say regarding complaints:

Q: What do I do if I am unhappy with my psychiatrist?

Everyone is entitled to a second opinion. You need to ask your GP, or your psychiatrist, to refer you to another psychiatrist for a second opinion.

Q: How do I make a complaint about my care and treatment?

The Royal College of Psychiatrists is not the disciplinary body for its members and, as such, is not able to deal with complaints about psychiatrists. You can write to, or speak with your psychiatrist to tell them how you feel about your care and treatment. Your hospital will have a complaints procedure. To make a complaint, contact either the Complaints Officer or the relevant Hospital Manager hospital, or ask somebody to do this on your behalf.

Q: How do I make a complaint about the conduct of a psychiatrist?

You can complain directly to your psychiatrist. If you are unhappy with their response, you can complain to their employer, clinic or hospital. If the complaint is to report serious misconduct, you can complain to the General Medical Council (Tel: 0845 357 0022). The last step for dealing with unresolved complaints is to contact the Health Service Ombudsman who acts as a final arbitrator.

Q: What should I do if I wish to make a complaint about a psychiatrist working in the private/independent sector?

You can complain to the clinic where the psychiatrist works. In cases of professional misconduct, you can also contact the General Medical Council (Tel: 0161 923 6602).

Q: As a carer can I make a complaint on behalf of the person I care for?

Yes you can. In some cases you may need the consent of the person you care for. You may follow the same complaints procedure as above. The College has more information on the Partners in Care pages.

Q: If I'm sectioned under the Mental Health Act, how do I make a complaint?

If your complaint is about the use of the Mental Health Act, you can contact the Care Quality Commission (Tel: 03000 616161). You can write or speak to the Complaints Officer at the hospital, or ask somebody to do this on your behalf.

Asked on 4th October 2011 in Mental Health

What does it mean to be sectioned?

Most patients in hospital for psychiatric treatment are there voluntarily, may leave when they wish, and their consent must be obtained before treatment is given. However, the Mental Health Act 1983 allows some people to be detained. When this happens, they are called ‘detained’ patients and their consent to treatment may no longer be required. This is often known as being ‘sectioned’.

Asked on 30th September 2011 in Mental Health

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