Category: Talking Therapy

My Experience With Pregnancy-Related Anxiety by Georgia Anne

~ Eleanor Segall ~ Leave a comment

(image: Georgia Anne)

When I had my son in 2022, I was overwhelmed in the best way possible. 

He was blonde, blue-eyed perfection, and I fell completely in love with him. As he grew, I realised how much I enjoyed being his mum, so much that I knew I wanted to expand our family. That longing feeling stuck around until I asked my husband, “Shall we have another one? I know it’s early but I’m ready,” which he obviously was happy to!

In July 2023, I fell pregnant again with my daughter. The timing overlapped with a busy summer, including marrying my husband, Oskar, in August. With everything going on, those early weeks of pregnancy passed quickly, and my mind was completely preoccupied with wedding plans and family life.

But once things calmed down and the routine returned, something shifted.

When Everyday Anxiety Turned Into Something Bigger

By early autumn, I began to feel a growing sense of anxiety that didn’t feel like my usual ups and downs. By October, it reached a point where I struggled to leave the house. 

Even thinking about stepping outside would trigger panic, and it could take hours to build up the confidence to even think about stepping foot out of the door. I was consumed by fear, anxiety and the panic attacks were frequent.

I’m naturally quite open about how I feel, so I told my husband directly that something wasn’t right and that the anxiety was starting to affect my mood, and I could feel myself slipping into depression.

The guilt that followed made everything heavier.


I felt like I was letting my son down because our daily walks stopped. I worried he wasn’t getting the best version of me anymore. And the more I thought about it, the more overwhelming it all became.

My husband, being the steady and practical person he is, simply said, “Alright then Georgie, let’s get it sorted.”

Speaking Up at My Midwife Appointment

When my next midwife appointment came around, he came with me. I have a habit of downplaying things, and he wanted to make sure I didn’t brush it off.

When she asked how I was feeling, he gently stepped in and explained what had been happening.

What happened next was something I’ll always be grateful for.

Our midwife, by complete luck, was a former mental health consultant. She listened without judgement, spoke to me with genuine kindness, and immediately discussed practical steps to help me manage the anxiety.

Before I left the appointment, she’d already referred me to perinatal mental health services.

Every single time anyone asks about midwives in our area, I always rave about her because of this. She was the best person for the job, for me.

(image: Georgia Anne)

Getting Support: Talking Therapies & Medication

Within a month, I had started talking therapies, and I was given a low dosage of anti depressant, sertraline. It was a huge relief to finally feel like something was moving in the right direction.

I continued with therapy throughout the pregnancy, and in March, my daughter, Freya, was born. Giving my children a small but beautiful 17 month age gap.

After the birth, a mental health consultant at the hospital sat with me to talk through how I was feeling. We discussed baby blues, hormonal crashes, and how to manage my medication over the next few weeks.

And honestly, the main emotion I felt that day was relief. She was here. Safe. Healthy. And I’d made it through.

Where I Am Now

Freya is now a lively toddler: walking, talking, exploring everything.

I’m still on my treatment plan, and I’m okay with that. The difference in how I feel is huge. I can leave the house without fear. I no longer carry the weight of guilt or the worry that I’m letting my children down. I feel lighter, calmer, and more grounded. I’ve learned so much during my time in therapy, the coping mechanisms to help on bad days, the affirmations to remind myself of how far I’ve come and most importantly: how to open up and be completely vulnerable.

I often think back on that period in my life and feel a sense of pride that I was honest with my husband, and that he spoke up for me and didn’t let me sugarcoat. 

What I Learned And What I Want Others to Know

Mental health care is not a luxury. It’s essential, especially during pregnancy because it’s a time when so many physical and emotional changes are happening at once.

Reaching out to my midwife and being honest about how I was feeling was the most important step I took. It led to support that genuinely changed my experience of pregnancy and early motherhood.

If you’re feeling overwhelmed, anxious, low, or unlike yourself during pregnancy, please know this:

You’re not alone, and you deserve support just as much as anyone else.

There is help available through midwives, GPs, perinatal mental health teams, talking therapies, charities, and NHS services.

Reaching out doesn’t make you weak. It’s the first step toward feeling like yourself again.

Georgia Anne is a UK lifestyle blogger who writes about motherhood, identity, and alternative living. After experiencing pregnancy-related anxiety, she became passionate about speaking openly about maternal mental health and helping others feel less alone. She lives in England with her husband and two children, and shares her honest reflections at georgiaanne.co.uk.

CBT vs EMDR: Which Therapy Is Right for You? by Andrew Kemp, Therapist at Clear Mind CBT.

~ Eleanor Segall ~ 2 Comments

(image: Toa Heftiba: Unsplash)

When people begin looking for psychological support, Cognitive Behavioural Therapy, or CBT for short, is one of the most well-known and accessible forms of psychotherapy. Recently, more and more therapists are offering Eye Movement Desensitisation and Reprocessing (EMDR), particularly for trauma.Both are well established, evidence-based treatments that can help people move forward from distressing experiences — but they do so in quite different ways.

If you’ve been wondering what sets them apart, or which might be the best fit for you, this post aims to break down the differences in a clear and down-to-earth way.

Understanding CBT

Cognitive Behavioural Therapy (CBT) is arguably the most widely accessed and researched psychological approaches, particularly in the UK. It’s based on the understanding that our thoughts, emotions, physical sensations, and behaviours are all connected. When one of these areas becomes unhelpful — for example, when our thoughts become overly negative or worrisome — it creates a negative cycle that keeps us stuck and in turn maintains that distress.

CBT helps a person to notice these patterns and challenge them with practical, realistic alternatives. The aim is not to “think positively” but to think more accurately. For instance, if you often find yourself thinking “I always mess things up,” CBT would explore the evidence for and against that thought, helping you see the situation in a more balanced light.

Sessions are focused on the present and typically structured towards achieving mutually agreed goals. There is less emphasis on the past and childhood, although this can be useful to consider in relation to the development of a person’s belief system or how they see the world today. This, in turn, influences a person’s responses to distress. CBT continues outside of sessions as clients engage in task such as trying alternative response to distress, or journalling at challenging times. 

CBT for trauma focuses on making changes to the way a person thinks about a traumatic event, and themselves within that event. Re-living is a key element of CBT for trauma and enables the person to safely revisits the traumatic memory in a structured, supportive way with their therapist. This allows the brain to process the event as a memory, rather than something that is still happening now, which in turn reduces distress around the event and any associated flashbacks or nightmares. The overall aim is to reduce distress, restore a sense of safety and control, and help the person make sense of what happened so the trauma feels like something from the past — not something still happening in the present.

CBT is highly effective for anxiety, low mood/depression, panic attacks, phobias, obsessive-compulsive disorder (OCD), PTSD/trauma, poor sleep/insomnia and many other mental health difficulties.

Understanding EMDR

Eye Movement Desensitisation and Reprocessing (EMDR) might sound unusual at first — after all, what do eye movements have to do with mental health? Yet EMDR is a powerful, evidence-based therapy originally developed to help people recover from trauma.

The theory behind EMDR is that when something distressing happens, our brains sometimes struggle to process it properly. The memory can get “stuck,” remaining vivid and the person continues to experience the fear as if the event is happening again. EMDR helps the brain work through these memories so they can be stored more adaptively — as something that happened in the past, rather than something that continues to feel threatening now.

During EMDR sessions, the therapist will guide you through sets of bilateral stimulation — this could involve following their fingers with your eyes, hearing alternating tones through headphones, or feeling gentle taps on your hands. This process is thought to mimic the way the brain naturally processes memories during REM sleep.

One benefit of EMDR is that it’s not necessary to go into detail about the event if you don’t want to. The focus is on how it feels in your body and what comes up in the moment. Over time, people often report that distressing memories lose their emotional intensity, and the beliefs tied to those experiences begin to shift to something most positive and empowering, rather than fearful or critical.

Can CBT and EMDR Be Combined?

Absolutely. Many therapists are trained in both and will tailor the approach depending on your needs. For example, someone with trauma may start with CBT techniques to manage anxiety and develop coping skills, then move into EMDR once they feel more grounded and ready to process deeper memories. In some cases, EMDR can help resolve traumatic roots of long-standing patterns, while CBT provides the tools and strategies to maintain progress in day-to-day life.

It isn’t about one being “better” than the other — it’s about finding what works for you, at the right time and pace.

Which One Should You Choose?

If you’re feeling stuck in unhelpful thoughts or patterns — for example, overthinking, avoidance, or self-criticism — CBT can be a great place to start. It’s structured, practical, and gives you tools you can continue using long after therapy ends. If you’ve experienced trauma, flashbacks, or distressing memories that feel “frozen in time,” EMDR might be more suitable. It’s gentle yet powerful, and often helps people move on from experiences they’ve been carrying for years.

Ultimately, the best way to decide is to talk with a qualified therapist who can help assess your situation and guide you towards the most appropriate treatment.

Final Thoughts

Both CBT and EMDR offer genuine hope for change. Whether you’re learning to manage anxiety, heal from trauma, or simply understand yourself better, the right therapeutic relationship can make all the difference.

At its heart, therapy isn’t just about techniques — it’s about feeling safe, understood, and supported while you make sense of your experiences. Whether through CBT, EMDR, or a combination of both, the goal is the same: helping you feel more in control of your thoughts, emotions, and your life again.

This blog was written by UK therapist Andrew Kemp at www.clearmindcbt.com and contains sponsored links.

Understanding Mental Health Challenges And Recovery Options by Violet Smith Evans

~ Eleanor Segall ~ Leave a comment

(image: Zohr Nemati: Unsplash)

Mental health is an essential part of overall well-being, yet it is often overlooked until symptoms become overwhelming. Millions of people around the world live with mental health conditions that can affect their mood, thoughts, and behavior. These challenges can interfere with relationships, work, and daily routines, but the good news is that treatment options are more accessible and effective today than ever before.

When individuals understand their condition and seek the right support, they can build healthier coping strategies and regain control of their lives. Two common struggles people face are bipolar disorder and anxiety—both of which can be complicated further when substance use is involved. Exploring recovery options designed specifically for these conditions can open the door to long-term healing.

The Importance of Addressing Mental Health Early

Early recognition of mental health symptoms is critical. Too often, individuals dismiss mood swings, prolonged sadness, excessive worry, or fatigue as “just stress” or “a bad week.” However, these patterns can signal a deeper issue that requires professional support. Addressing mental health concerns at the onset not only improves outcomes but can also prevent the development of secondary challenges such as addiction, chronic stress, or physical health problems.

By taking proactive steps, individuals are more likely to develop resilience and maintain stability over time. Family members, friends, and colleagues also play an important role by offering encouragement and understanding instead of judgment or stigma.

Understanding Bipolar Disorder

Bipolar disorder is one of the most misunderstood mental health conditions. Characterized by extreme shifts in mood, energy, and activity levels, it goes far beyond the typical ups and downs that people experience in daily life. Those with bipolar disorder may experience manic or hypomanic episodes—periods of high energy, impulsivity, and elevated mood—followed by depressive episodes that bring sadness, hopelessness, or loss of interest in activities.

Because bipolar disorder exists on a spectrum, its symptoms vary greatly from person to person. This makes individualized care essential. Professional intervention, therapy, and medical management can significantly reduce the intensity and frequency of mood episodes, allowing individuals to lead fulfilling and balanced lives.

For those seeking guidance, comprehensive Bipolar Disorder Treatment programs provide structured support that combines psychotherapy, medication management, and lifestyle strategies to stabilize mood patterns. These programs focus on helping individuals better understand their triggers, strengthen coping mechanisms, and create long-term wellness plans.

The Overlap Between Mental Health and Substance Use

Mental health conditions often coexist with substance use disorders. This dual challenge, known as co-occurring disorders, can complicate both diagnosis and treatment. For example, individuals with bipolar disorder may use drugs or alcohol during manic episodes to maintain their energy or during depressive episodes to numb emotional pain. Similarly, those with anxiety might turn to substances as a form of temporary relief, leading to dependency over time.

The presence of co-occurring disorders makes it critical to find treatment centers that specialize in dual diagnosis. Traditional approaches that treat mental health and substance use separately may fail to address the underlying causes of each condition, resulting in relapse or incomplete recovery. Integrated treatment programs, on the other hand, provide a holistic approach that tackles both issues simultaneously, improving long-term outcomes.

Anxiety and Its Connection to Addiction

Anxiety disorders are among the most common mental health conditions worldwide. They can manifest as generalized anxiety, panic attacks, social anxiety, or phobias. For many, constant worry and fear interfere with work performance, social interactions, and even physical health.

When anxiety is left untreated, individuals often look for ways to escape their symptoms. Unfortunately, this can lead to reliance on alcohol, prescription medications, or illicit substances. While these may provide short-term relief, they create long-term consequences and increase the risk of developing addiction.

To break this cycle, specialized anxiety and addiction treatment programs are designed to address both issues together. These programs typically combine evidence-based therapies such as cognitive-behavioural therapy (CBT), mindfulness practices, and medical support to help individuals identify the root causes of their anxiety while also treating their substance use.

(image: Sydney Rae: Unsplash)

Building a Strong Support System

Professional treatment is only one piece of the recovery puzzle. Having a strong support network can make a tremendous difference in maintaining long-term wellness. Family therapy, peer support groups, and community-based programs help individuals stay accountable while fostering connections that reduce isolation.

Loved ones can also benefit from education and counseling, as understanding mental health conditions makes it easier to provide the right kind of support. Encouraging open conversations about mental health challenges helps break down stigma and creates an environment where healing is possible.

Healthy Lifestyle and Daily Habits

Lifestyle changes play a critical role in managing conditions like bipolar disorder and anxiety. Regular exercise, balanced nutrition, adequate sleep, and mindfulness practices can all reduce symptom severity. For example, yoga and meditation help regulate stress, while consistent sleep patterns can stabilize mood swings.

Journaling, creative activities, and spending time in nature are additional strategies that promote mental clarity and emotional balance. While these habits may not replace professional care, they work in tandem with treatment to strengthen resilience.

Long-Term Recovery and Hope

Recovery is not a one-time event—it’s an ongoing process that requires commitment, patience, and self-compassion. Relapses or setbacks may occur, but they don’t mean failure. Instead, they can serve as opportunities to re-evaluate strategies and adjust treatment plans.

The growing availability of specialized programs for conditions like bipolar disorder and anxiety shows that no one has to face these challenges alone. With proper care, individuals can achieve stability, rebuild relationships, and pursue meaningful goals.

Final Thoughts

Mental health conditions such as bipolar disorder and anxiety can feel overwhelming, especially when compounded by substance use. However, effective treatment and recovery programs provide hope and healing. By seeking out resources tailored to specific needs, individuals can find balance and create a foundation for lasting well-being. It is important to be lead by a psychiatrist about medication and treatment when someone also has substance abuse.

No matter how challenging the journey may seem, recovery is always possible. Support, understanding, and professional guidance are the keys to moving forward and embracing a healthier, more fulfilling future.

This blog contains sponsored links.

Healing The Mind And Body Through Supportive Recovery Practices by Isla Salt

~ Eleanor Segall ~ Leave a comment

(image: Yannic Laderach, Unsplash)

Recovery from addiction is a deeply personal and often challenging journey. Each individual faces unique struggles, yet a common thread binds everyone together—the need for healing that nurtures both the body and the mind. Traditional treatments like medical detox and counselling are essential, but recovery extends beyond them. To truly sustain sobriety, many people benefit from incorporating supportive practices that promote physical wellness, emotional balance, and meaningful social connections.

Holistic recovery approaches focus on treating the whole person rather than just the symptoms of substance use disorder. This means addressing the emotional, mental, physical, and even spiritual aspects of health. Within this framework, two practices stand out for their effectiveness and accessibility: yoga as a healing tool and group therapy as a platform for connection and accountability. Together, these methods create a powerful balance, helping individuals not only manage cravings and triggers but also build resilience and long-term stability.

Understanding the Need for Holistic Healing

Addiction impacts far more than just the body. While substances can cause direct harm to organs and brain function, the cycle of dependency often disrupts emotional health and weakens relationships. Recovery programs that focus exclusively on physical detoxification may overlook the importance of mental clarity, emotional regulation, and social support—elements that are equally important in building a healthy life.

Supportive recovery practices go hand in hand with evidence-based therapies to address these needs. By combining structured treatments with holistic methods, people in recovery gain tools to manage stress, regulate emotions, and connect with others who understand their struggles. This integration often leads to improved outcomes and a reduced risk of relapse.

Yoga as a Pathway to Recovery

One of the most effective practices in holistic recovery is yoga for addiction recovery. Yoga provides more than just physical exercise; it is a discipline that strengthens the body, calms the mind, and fosters inner awareness. For people in recovery, yoga offers a constructive way to process emotions, cope with stress, and rebuild confidence.The benefits of yoga extend into multiple dimensions of healing:

  • Physical strength and resilience: Addiction often leaves the body weakened. Yoga helps restore energy, balance, and flexibility, giving individuals a sense of vitality.
  • Mental clarity: Breathwork and meditation in yoga reduce anxiety and improve focus, making it easier to navigate triggers and cravings.
  • Emotional regulation: Yoga encourages mindfulness, helping individuals respond to stress rather than react impulsively.
  • Spiritual connection: For many, yoga fosters a sense of purpose and inner peace, providing a meaningful counterbalance to past struggles.

Practicing yoga in recovery also creates structure and routine, both of which are essential for maintaining sobriety. Whether practiced individually or in a group setting, yoga can become a safe space to reconnect with oneself and rediscover a healthier way of living.

(image: Unsplash: Helena Lopes)

The Role of Community in Recovery

While practices like yoga are powerful for personal healing, recovery is not meant to be a solitary process. Addiction thrives in isolation, and overcoming it requires connection, support, and accountability. This is where community-based approaches such as group therapy play a vital role.

Human beings are social by nature, and support networks are key to emotional resilience. In group settings, individuals can share their stories, listen to others, and gain reassurance that they are not alone in their struggles. This shared experience often reduces shame and fosters empathy, which are critical for long-term healing.

Group Therapy as a Cornerstone of Support

Group therapy for substance abuse provides a safe and structured environment where individuals can open up about their experiences. Guided by a trained therapist, group sessions encourage honesty, accountability, and peer support. Unlike individual therapy, which focuses on one person’s journey, group therapy highlights the power of collective healing. Key benefits of group therapy include:

  • Shared understanding: Listening to others with similar struggles helps normalize feelings and experiences.
  • Accountability: Members often motivate each other to stay on track and celebrate progress.
  • Skill-building: Sessions may teach coping strategies, communication skills, and relapse prevention tools.
  • Hope and inspiration: Seeing others succeed in recovery can inspire confidence and determination.

Group therapy also helps individuals rebuild social skills that may have eroded during addiction. By practicing healthy communication and learning to trust again, participants strengthen the foundations of meaningful relationships outside the therapy room.

Balancing Individual and Collective Healing

The combination of yoga and group therapy illustrates how both individual and collective healing practices can work hand in hand. Yoga allows individuals to reconnect with themselves, build strength, and find calm in the face of challenges. Group therapy provides the encouragement and accountability that comes from shared experiences. Together, these practices address both the internal and external dimensions of recovery.

For many, the integration of body-focused and community-based approaches creates a balanced recovery journey. It ensures that healing is not only about overcoming physical dependence but also about cultivating emotional stability and social connection.

The Long-Term Impact of Supportive Practices

Recovery is not a short-term process—it is a lifelong commitment. Supportive practices like yoga and group therapy provide tools that individuals can carry with them long after formal treatment has ended. These practices foster resilience, helping individuals manage stress, cope with setbacks, and continue growing on their path to wellness.

Some people incorporate yoga as part of their daily routine, using it as a grounding practice. Others rely on ongoing group sessions or peer support communities to maintain accountability. The beauty of supportive recovery practices is their adaptability—they can evolve with a person’s needs and provide consistent strength throughout life.

Creating a Sustainable Recovery Lifestyle

The journey to sobriety is about much more than simply avoiding substances. It is about creating a lifestyle that supports health, purpose, and connection. A sustainable recovery lifestyle often includes:

  • Regular physical activity, such as yoga or other mindful exercises.
  • Participation in therapy or peer support groups.
  • Healthy nutrition and sleep habits.
  • Engagement in meaningful work, hobbies, or service.
  • Building strong, supportive relationships.

When individuals embrace both holistic and therapeutic practices, they are better equipped to live fulfilling lives beyond addiction.

Final Thoughts

Healing from addiction requires more than detoxification or medication—it requires a comprehensive approach that nurtures the mind, body, and spirit. Practices like yoga provide personal healing and inner balance, while group therapy fosters community, accountability, and shared growth. Together, they create a powerful foundation for lasting recovery.

By embracing supportive recovery practices, individuals not only overcome addiction but also rediscover the strength, resilience, and joy needed to build a healthier and more purposeful life.

This blog contains sponsored links.

World Suicide Prevention Day Webinar with Bipolar UK

~ Eleanor Segall ~ Leave a comment

Today is World Suicide Prevention Day.

A year or two ago, I recorded this webinar with Bipolar UK talking about our family story (mine and my Dads) with bipolar disorder, suicidal ideation, depression and both of us finding recovery.

Suicide is a terrible but common outcome of bipolar and acute mental health episodes. I also know what it is like to lose a loved one to suicide and mental illness and the pain that brings.

I share this webinar today to raise awareness, but also to encourage people to go to their GP/psychiatrist/ family/ spouse and talk, if safe, about what is going on for you.

Watch here, with care, trigger warning : discusses bipolar episodes, suicidal ideation

In this webinar, Bipolar UK CEO Simon Kitchen shares the findings of the Bipolar Commission on the critical link between bipolar and suicide. He is joined by Ashley Brice, an experienced crisis negotiator with the British police specialising in suicide prevention, and Eleanor Mandelstam, author and freelance writer who lives with bipolar. Together, they explore the risk factors, warning signs, and practical strategies to prevent suicide, offering crucial insight for anyone living with bipolar, supporting someone with bipolar, or wanting to better understand how bipolar impacts mental health and suicide risk.

Eleanor x

Dual-Diagnosis Care: Tackling Addiction and Mental Illness Together by Elizabeth Howard

~ Eleanor Segall ~ 2 Comments

(Image: Unsplash)

A dual diagnosis occurs when an individual simultaneously struggles with a mental health disorder and a substance use disorder. Far more common than many realise, dual diagnoses can involve combinations such as depression and alcohol dependence, anxiety and benzodiazepine misuse, bipolar disorder coupled with stimulant abuse, or PTSD alongside opioid addiction. Attempting to treat one condition in isolation while neglecting the other typically leads to inadequate results and higher relapse rates. Dual-diagnosis care addresses both issues in tandem, recognising the complex interplay between mental health and addiction. Below, we explore five essential components of an effective, integrated treatment approach that fosters sustainable recovery.

Understanding the Link Between Mental Health and Addiction

Self-medication is a common pathway to substance misuse: someone experiencing chronic anxiety may reach for alcohol to calm racing thoughts, while an individual with untreated depression might use opioids to numb emotional pain. Unfortunately, what begins as short-term relief often worsens underlying psychiatric symptoms. Alcohol, for example, disrupts sleep and brain chemistry, intensifying anxiety or depression over time. Conversely, the guilt, shame, and isolation that emerge from addiction can spark or aggravate mood disorders.

Recognising this bidirectional relationship is critical in dual-diagnosis care. Clinicians assess not only which substance came first, but also how each condition fuels the other. By identifying triggers—whether social stressors, traumatic memories, or genetic vulnerabilities—therapists can help patients develop healthier coping strategies. Early psychoeducation enables individuals to see how their mental health and addiction are intertwined, fostering motivation to engage in comprehensive treatment.

Comprehensive Assessments for Accurate Diagnosis

Misdiagnosis is rampant in dual-diagnosis cases: withdrawal symptoms can mask depression, and manic episodes may be mistaken for cocaine highs. To avoid these pitfalls, providers conduct thorough biopsychosocial evaluations that delve into psychiatric history, substance use patterns, family dynamics, medical background, and co-occurring health issues. Standardised screening tools—such as the PHQ-9 for depression, GAD-7 for anxiety, CAGE for alcohol misuse, and the Addiction Severity Index—offer structured insights that guide diagnostic clarity.

Laboratory tests and, when indicated, neuroimaging can reveal medical complications—like liver dysfunction in heavy drinkers or neurochemical imbalances in long-term stimulant users. Ongoing assessments throughout treatment help clinicians monitor progress, adjust medication, and refine therapy goals. An accurate, layered diagnosis ensures that neither the mental health disorder nor the addiction is minimized, laying the groundwork for a cohesive care plan.

The Role of Integrated Treatment Plans

Unlike traditional models that silo psychiatric care and addiction treatment, integrated plans bring multidisciplinary teams together. Psychiatrists, addiction medicine specialists, psychologists, social workers, and certified peer support counsellors collaborate on a unified treatment blueprint. Core elements may include:

  • Medication management to stabilise mood disorders and reduce cravings (for instance, SSRIs for depression and buprenorphine for opioid dependency)
  •  Evidence-based psychotherapies such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and trauma-focused interventions for PTSD
  • Group therapy sessions that address both substance use behaviours and coping skills for anxiety or mood regulation
  • Family therapy and psychoeducation to repair relationships and build a supportive home environment
  • Holistic modalities—mindfulness training, yoga, nutritional counseling—aimed at restoring overall well-being

Coordinated care prevents mixed messages and redundant treatments. When each provider shares a common set of goals and progress metrics, patients receive consistent guidance, and their support network remains informed and engaged.

(image: Alysha Rosly, Unsplash)

Flexible Care Through Programs Like the Intensive Outpatient Program

Not everyone with a dual diagnosis needs round-the-clock residential care. For those with strong support systems, manageable symptom severity, and stable living conditions, outpatient solutions can strike the right balance. A reputable intensive outpatient treatment program offers structured therapy multiple times per week, while allowing individuals to live at home and maintain work or family responsibilities.

These programs typically include group counselling, individual therapy, psychiatric check-ins, and relapse prevention workshops. They serve as a transitional step either before entering less intensive outpatient care or following discharge from an inpatient facility. Flexible scheduling and a mix of virtual and in-person sessions accommodate diverse lifestyles, enabling more people to access high-quality dual-diagnosis treatment without uprooting their lives. In the UK, these were known as ADTU units attached to hospitals, but there are less of these on the NHS.

The Importance of Ongoing Support and Aftercare

Recovery from a dual diagnosis doesn’t end when formal treatment ends. Long-term success hinges on robust aftercare and relapse prevention strategies that recognize recovery as a lifelong process. Essential components of sustained support include:

  • Peer support groups—such as Dual Recovery Anonymous or integrated 12-step fellowships—that offer lived-experience encouragement
  • Regular outpatient counselling or case management to address emerging challenges and adjust treatment plans
  • Medication-assisted maintenance, when appropriate, to stabilise chronic mental health conditions and prevent relapse
  • Life-skills workshops for stress management, financial planning, and vocational training to strengthen daily functioning
  • Digital tools and telehealth check-ins that enhance accessibility, especially for those in remote areas

Family involvement remains vital: ongoing family therapy sessions and education empower loved ones to recognize early warning signs and respond effectively. Community resources—like sober living homes and recreational recovery programs—further enrich social support, reducing isolation and reinforcing positive lifestyle choices.

Conclusion

Effective dual-diagnosis care transcends the simplistic view of treating mental illness and addiction separately. By acknowledging their deep interconnection, clinicians can offer comprehensive assessments, integrated treatment plans, flexible program options, and enduring aftercare. Whether delivered through residential facilities or outpatient settings, these five components—link recognition, accurate diagnosis, collaborative treatment, adaptable program structures, and sustained support—equip individuals with the skills and stability needed for lasting recovery. Embracing a holistic, patient-centered approach that addresses the whole person, not just isolated symptoms, paves the way for renewed health, purpose, and hope.

This article was written by Elizabeth (Lizzie) Howard, writer and contains a sponsored link.

Doctor’s Insights: Navigating Life With Bipolar Disorder By Dr Antti Rintanen MD Of The Internet Doctor

~ Eleanor Segall ~ Leave a comment

(image: Emily Underworld: Unsplash)

Living with bipolar disorder can often feel like your emotions are swinging between two extremes. The highs (mania) can be energising but risky, and the lows (depression) can be draining and isolating. As a doctor, I’ve worked with many patients who face this condition—and I’ve seen firsthand how the right tools, treatments, and habits can lead to a more stable and fulfilling life.

What Is Bipolar Disorder?

Bipolar disorder is a mental health condition marked by episodes of depression and mania or hypomania. These mood shifts can affect how a person thinks, feels, and acts. It’s more than just having a bad day or being in a good mood—it can seriously impact relationships, work, and daily functioning.

According to the World Health Organisation, bipolar disorder is one of the top causes of disability for people between 15 and 44 years old.

Medications: The Backbone of Treatment

Most people with bipolar disorder need medication to help manage their symptoms. Lithium, for example, has been used for decades and is one of the most reliable treatments to prevent manic episodes and reduce the risk of suicide. Other options include other mood stabilisers and certain antipsychotic medications.

It’s really important to stick with your medication plan. Stopping suddenly—even if you feel better—can cause serious setbacks. Never adjust or stop medications without medical supervision—even if you’re feeling better, as this significantly increases the risk of relapse, especially into mania. If you have side effects, don’t stop on your own—talk to your doctor about switching or adjusting your dose.

How Therapy Helps

Therapy can help you understand your thoughts, manage emotions, and build better habits. One helpful option is Cognitive Behavioural Therapy (CBT). It teaches people to recognise unhelpful thought patterns and replace them with healthier ones. CBT is especially useful for managing depression and maintaining stability between episodes, though it is less effective during manic phases.

Another type of therapy, called Interpersonal and Social Rhythm Therapy (IPSRT), focuses on keeping your daily schedule steady—especially your sleep and social routines. Why does this matter? Because disruptions to your daily rhythm can trigger mood episodes.

Family-focused therapy also makes a big difference. When your loved ones understand your condition and know how to respond, you’re more likely to stay on track. If you face trauma around your condition, then EMDR therapy can also help with any PTSD or anxiety symptoms.

These therapies don’t replace medication, but they add valuable tools for coping, improving communication, and building resilience.

Everyday Habits That Make a Difference

Beyond medication and therapy, lifestyle habits have a huge effect on mood. Here are a few evidence-based strategies:

  • Stick to a regular sleep schedule. Going to bed and waking up at the same time helps stabilize your mood.

  • Get moving. Exercise—even walking—has been shown to lift mood and reduce stress.

  • Eat well. Omega-3 fats (like those found in fish or flaxseed) may support brain health. While the evidence is mixed, some studies suggest they could help support mood as part of a healthy diet.

  • Manage stress. Mindfulness, breathing exercises, or journaling can help you stay grounded.

  • Avoid alcohol and drugs. These can interfere with treatment and trigger episodes.

It’s worth remembering that lifestyle changes work best alongside—not in place of—medication and therapy. These small, daily actions help support long-term stability and overall well-being.

Pay Attention to Early Warning Signs

Everyone’s symptoms are different, but common early signs of mania include less need for sleep, racing thoughts, and impulsive decisions. Signs of depression may include feeling hopeless, withdrawing from others, or sleeping too much.

Keeping a mood diary or using an app can help track how you’re doing. You might also ask a trusted friend or family member to gently point out changes you might not notice.

Build a Strong Support System

Having a support system—whether friends, family, or a support group—makes a real difference. Research shows that people with strong social support tend to manage bipolar disorder better and have fewer hospitalisations.

It also helps when your loved ones are informed and involved. When people understand what you’re going through, it’s easier for them to support you in ways that actually help.

Final Thoughts

Living with bipolar disorder isn’t easy, but it’s manageable. With the right treatment, daily routines, emotional awareness, and a good support network, it’s absolutely possible to live a meaningful and empowered life.

You are more than your diagnosis. And there are tools—backed by science—that can help you thrive.

About the Author

Dr. Antti Rintanen is a licensed physician from Finland and founder of The Internet Doctor, where he shares reliable, accessible health advice. He writes about both physical and mental well-being with a focus on evidence-based care.

What Makes A Great Hypnotherapist? by Kevin Whitelaw of Perma Hypnotherapy.

~ Eleanor Segall ~ Leave a comment

(image: Chelsea Gates, Unsplash)

On a regular basis, I speak to people who are set to benefit from hypnotherapy: they have a compelling need to make those changes in their lives, they take responsibility for the outcome and, they’re looking forward to enjoying the benefits. Solution Focused Hypnotherapy is an effective, modern, evidence-based talking therapy. It is designed to support you in making positive changes leading to your sustained wellbeing.

Often, people get a bit stuck when looking for a therapist as they try to find the right therapist for them at that time.

So, what makes a hypnotherapist the right hypnotherapist for you at the moment?

The over-riding factor is your gut instinct: rapport between therapist and client is so important in achieving the best outcomes for wellbeing. What are your feelings as you look through their website and speak to them?

Beyond that, consider the following – any credible hypnotherapist would be happy to confirm the below.

Make sure you consider these when speaking to a hypnotherapist for your mental health:

  • They are open about what certifications they have, from where and what continuous professional development they do. Remember that the term ‘diploma’ is, in itself, meaningless. The key things to look for when assessing a certification are how much work did it take to obtain, who accredited it and what competence does the accreditor have?
  • That they are required to undertake a level of continuous professional development.
  • They are members of recognised professional governing bodies. There are many of these – The key thing to look for is the organisation’s affiliation with the National Council for Hypnotherapy and / or the Complimentary and Natural Health Care Council. Nb – this holds true for the UK. Other countries – especially the USA – have their own arrangements.
  • That they have Professional Indemnity Insurance (PII). This is not to expect anything to go wrong but it does give a degree of assurance as to the quality of their qualifications. Each broker offering PII to hypnotherapists has a list of certifications they accept as being suitable – and they are very shrewd about who they insure.
  • They have lived-experience of the issues you have chosen to resolve. Nb – there is no right or wrong with this one. You will find therapists who both agree and disagree with this point.
  • They are clear about their overall balance between therapy and hypnosis.
  • They allow you to set your own goals and they work to your (rather than their) agenda.
  • They encourage and support you to become proficient in self-hypnosis and managing your wellbeing for the long term.
  • They are happy to share content, resources, and references with you to give a deeper understanding of what they, and you, are doing.
  • They focus on you achieving your goals efficiently – there are no signs of them spinning things out for extra sessions.

(image: Marcel Straub, Unsplash)

 Ready to break free? 

The author Kevin Whitelaw helps adults across the globe overcome anxiety, stress, and self-doubt using Solution Focused Hypnotherapy. Book your free consultation today.

Social Anxiety: Find What Makes You Feel Alive. by Eleanor

~ Eleanor Segall ~ Leave a comment

(image: yourhappyplaceblog)

For those of you who have read my blogs or book, you will know that I have lived with mental health issues since I was young (diagnosed with bipolar at 16, depression and anxiety at 15 and lots of anxiety as a younger child).

My bipolar is medicated so that my brain functions fairly ‘typically’ ie i don’t get mania or severe depression, but I do get bad anxiety and milder depression.

What started as a teen to protect me from harm, became a full fledged panic disorder and social anxiety. Hiding away became my way to protect myself from the world, from people’s negative judgements, from life.

Even now at 36, I navigate a lot of the same anxious thoughts, behaviours and feelings. I don’t often share this part of my life anymore but I feel it is essential.

Yesterday, after having a particularly bad patch with anxiety where I cancelled many arrangements, stayed inside a lot etc, I spoke to my wonderful therapist because I needed to unpack what was going on for me.

In the course of the discussion about the different issues going on for me that could be causing the social anxiety/agoraphobia element I realised this key truth.

I have built metaphorical walls around myself in many parts of my life (my body, my friendships, my relationships in general), to keep myself safe from trauma I have faced. Part of that comes out as social anxiety as a protection mechanism and there’s time when that worsens. And times when its better.

But what I did realise is this.

I would like to feel properly alive and start taking down some of the walls, so I can live. Sometimes, the walls keep me safe and cosy. Sometimes they are not serving me anymore. I also want to boost my self esteem so that I stop retreating and hiding, or if it happens as it will, to find a way to work with it. I have had EMDR before so it may be returning to that for a while to unpick the knots!

I am very much a work in progress and so, I know I will always live with some level of anxiety. It is about how I learn to live well despite life’s challenges.

Do you find you put up walls or have social anxiety too?

I am sharing because it is therapeutic but I was even anxious sharing this as its so personal.

Love,

Eleanor x

Cognitive Behavioural Therapy For Perfectionism by NOSA CBT

~ Eleanor Segall ~ Leave a comment

(image: Kateryna Hliznitsova, Unsplash)

Struggling with perfectionism? Learn how CBT for perfectionism helps challenge self-criticism, set realistic goals, and break free from the pressure to be perfect.

If you ever feel paralyzed by the thought of making mistakes or constantly push yourself to impossible standards, you might benefit from CBT for Perfectionism. At NOSA CBT, we understand how perfectionism can lead to burnout, procrastination, and nonstop anxiety. In this blog, we will explore what perfectionism really is, why it develops, and how Cognitive Behavioural Therapy (CBT) provides practical ways to break out of the perfectionist trap.

What Is Perfectionism?

Perfectionism is not just about wanting to do things well. It usually means aiming for flawless results and feeling that anything less than perfection is a failure. Many perfectionists believe their worth depends on never making mistakes. This can cause chronic stress and harsh self-criticism whenever the outcome is not 100 percent perfect.

Sometimes, perfectionistic habits come from fear of judgment or failure in front of others. This fear creates a cycle: always striving, never satisfied, and relying on achievement for self-esteem. Ironically, trying to be flawless can keep you from getting started on projects, since the fear of messing up becomes more overwhelming than the desire to make progress.

How Perfectionism Develops

Perfectionism can grow from many sources: family expectations, social pressures, or ways of coping you learned over time. You might have grown up in a home where you were praised only when you excelled, making you feel like mistakes were unacceptable. Or maybe you live in a culture where success is linked to being the best, reinforcing the idea that any slip-up equals total failure.

Often, perfectionists tie their self-worth directly to their accomplishments. Rather than seeing an outcome as separate from who they are, they treat any disappointment as a personal shortcoming. Once these ideas take hold, they shape your approach to work, relationships, and even leisure activities. Recognizing why perfectionism developed does not mean it vanishes overnight, but it can help you spot triggers that feed that anxiety about not being “good enough.”

(image: Brett Jordan: Unsplash)

How CBT for Perfectionism Works

CBT for Perfectionism focuses on finding and challenging the thoughts and beliefs that drive unhealthy perfectionism. Instead of telling you how to get perfect results, CBT helps you understand why imperfection feels so scary in the first place. Then, you can test whether those fears are truly accurate and replace them with more realistic, kinder ways of thinking.

  1. Mapping Unhelpful Thoughts
    Early on, you might keep track of moments when you feel overwhelmed or anxious about not doing something “well enough.” This reveals the core thoughts fueling your stress, such as “If I don’t get every detail right, I’m a failure.”
  2. Challenging Distorted Beliefs
    Next, CBT teaches you to question these beliefs. Is it realistic to think one mistake ruins everything? Are you really worthless if you miss a tiny detail? Finding evidence that contradicts these absolutes can weaken their hold.
  3. Encouraging Realistic Standards
    CBT does not say you have to lower your standards across the board. Instead, it prompts you to set challenging but achievable goals. This shift allows you to celebrate progress rather than obsessing over small flaws.
  4. Self-Compassion
    One of the most important parts of CBT is learning to be gentle with yourself when things do not go perfectly. Instead of harsh self-criticism, you practice talking to yourself in a supportive, encouraging way. This approach boosts resilience and motivation, even when you stumble.

By repeating these steps and noticing changes in your thoughts and behaviors, you can develop a healthier mindset that balances striving for excellence with recognizing that mistakes are a normal part of growth.

Key CBT Techniques for Perfectionism

Several CBT techniques help reduce the pressure to be perfect:

  1. Thought Records
    • Write down situations that trigger perfectionistic stress, along with the thoughts and emotions they spark. Then, look for evidence that challenges these extreme conclusions. Over time, seeing flaws in your perfectionistic thinking can loosen its grip.
  2. Behavioural Experiments
    • Sometimes, you might intentionally aim for “good enough” rather than perfect results. Whether it’s a work project or a household task, see how it feels to let go of total precision. Often, you’ll realize minor imperfections rarely lead to disaster.
  3. Graded Exposure
    • Gradually face your fear of imperfection. For example, leave a small mistake in a draft and show it to a friend or colleague, just to prove to yourself that a minor error doesn’t lead to rejection or failure.
  4. Self-Compassion Exercises
    • Through affirmations or mindfulness, you learn to accept that everyone slips up sometimes. Treat mistakes as opportunities to learn, not signs of personal failure.

When practiced consistently, these strategies help you maintain high standards without feeling constantly overwhelmed by the need to be flawless.

Dealing with Setbacks and Ongoing Habits

Real change rarely happens in a straight line, especially if you’ve spent years developing perfectionistic habits. It’s normal to have setbacks when deadlines loom or when life throws unexpected challenges your way. If you catch yourself slipping back into rigid thinking, it doesn’t mean CBT “failed.” It just means it’s time to revisit the strategies and tools that helped you before.

Setbacks can even be helpful. Each time perfectionistic thoughts resurface, you have another opportunity to apply the CBT methods you’ve learned. Over time, these relapses often become less intense and less frequent because you have a more flexible framework for coping.

Who Can Benefit from this Therapy?

Anyone who struggles with all-or-nothing thinking can find CBT useful. High achievers sometimes get stuck in endless cycles of tweaking or revising because they feel nothing is ever “perfect.” Students may push themselves to the limit, convinced that a single slip in grades defines their future. Even in personal settings, the need to appear flawless can drain your energy and enjoyment of everyday life.

It’s also important to remember perfectionism isn’t limited to a certain personality type. You might feel confident in some areas yet be extremely hard on yourself in others. CBT meets you where you are. It offers practical tools for tackling unhelpful beliefs and separating your self-worth from your achievements.

Rounding Up 

Ultimately, CBT for Perfectionism aims to loosen the grip of harsh self-standards and critical inner voices that overshadow day-to-day satisfaction. Striving for excellence can be motivating, but perfectionism can turn into a never-ending burden that undermines your confidence and well-being.

By challenging black-and-white thinking, trying out more balanced behaviours, and learning self-compassion, you can find a healthier mindset that values progress over flawlessness. If you’ve noticed perfectionistic habits affecting your life, consider exploring CBT techniques or reaching out for professional support to build a more flexible and resilient approach to reaching your goals.