Tag: Anxiety

Mental Health, Social Media and Relationships: Reality vs the Edit

~ Eleanor Segall ~ 5 Comments

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This post has been inspired by a few experiences that have happened to me in my life- regarding relationships with others- be they a friend or otherwise and social media.

I am a self confessed social media lover and addict. I love its ease, I use it as a way to store memories to look back on- photos, places I have been. A kind of virtual diary. I use it to keep in touch with friends, acquaintances who I would never normally see as they are in different countries or regions- and to keep in touch with friends I see regularly. I am always on Facebook, Instagram and Twitter (though not Snapchat- showing my age) and I truly love being online. Most of the time.

The difficult part about having bipolar disorder and anxiety disorder/ social anxiety is that it is not easily visible. Equally, on social media we always tend to present an edited version of ourselves- the good side. The positive side. The places we’ve been and the friends we’ve seen, those close to us. My Facebook profile, when I can achieve things, shows me smiling and being out and about. However, this has the potential to upset people if I have had to cancel arrangements due to anxiety.

The main refrain is often ‘But you were able to do it then- so why can’t you do it now?’.   How come the next day you could go out for dinner (I saw it on your Facebook)?

I understand this reaction. I do post a lot to celebrate achievements to myself and keep memories- happy memories for when I do become unwell again (which I hope won’t be for a long time). Social anxiety means that I want to look back on and remember the good times, the happy times.

The tough part is that relationships can become strained if one overly posts on social media. So its a complete dichotomy.

Do I post my life and enjoy the times I am able to socialise and go out without anxiety? Or do I edit what I upload so as not to hurt feelings of people I have had to cancel due to anxiety attacks? Ultimately- do I take my memories offline and into a private journal or on Instagram rather than Facebook?

All of this has been going through my head. Mental illness is not as straight forward to others as a broken leg. I don’t wear a sign saying I am bipolar or a bandage round my head.

I may look like I am having the time of my life…. but one may not see that:

Yesterday I could have had a panic attack which meant I couldn’t leave the house as I felt overwhelmed and embarrassed, and totally drained from the adrenaline. I got out to socialise now because a family member drove me somewhere as a form of exposure therapy to lessen my anxiety.

OR this scenario…..

My anxiety took over and I felt so frightened I was hyperventilating, crying and beating myself up emotionally, for not being able to see a friend. Because yes, we don’t want to have this and we care deeply about our friends feelings.

OR this scenario….

I have heard you talking negatively about me to someone else because I had to cancel an arrangement. Yet, I have anxiety about travel and socialising and sometimes feel overwhelmed. You know this, yet will still be upset- which I have to take into account.

So no, I am not really having the time of my life all the time. Friends are my priority but equally optimum health and managing day by day is to me hugely important.

I will try my very best not to let you down. If I hurt you through my social anxiety, it is never intentional.

I have learnt the hard way the pitfalls of social media with mental health issues. The large part is that we don’t want to talk about how depressed or anxious or panicked we are on Facebook. So it gets hidden and misunderstandings happen.

I hope one day it comes into the light, through my blog and when I can be more open.

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Guest post by Karen: Being a Mental Health Professional with Anxiety, my Recovery

~ Eleanor Segall ~ Leave a comment

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Working in an outpatients’ mental health service in the NHS I was well-placed to recognise the signs and symptoms of a mental health problem. I have seen most ends of the spectrum from working in a secure men’s forensic unit, treating people experiencing psychosis in a clinic and in their homes, to treating outpatients with mild to moderate depression and anxiety. Yet none of this prepared me for my own mental health crisis that crept up on me suddenly and unexpectedly last year.

I have experienced anxiety in my life on many occasions before. I developed a fear of panicking and losing control going on the tube and was starting to avoid taking tubes and trains and places I felt I could not escape from easily. Later on I realised this was panic and agoraphobia and since I was considering dropping out of my Masters degree because it involved travelling long routes by tube, I knew I had to get some help. I had a course of CBT privately using graded exposure therapy which I had to get on board with and be committed to, and was incredibly effective for me. My CBT therapist was a real lifeline for me and we had an effective rapport which really helped.

I have since moved out of London and abroad. In September last year I started a number of new part-time teaching roles (not in mental health) in my relatively new European city. I was really worried about my ability to speak the language and to be able to communicate if there was a problem. In fact, I had pretty much spent my entire summer holiday dreading, worrying and catastrophising about all the things that could go wrong, and didn’t really tell anyone exactly how I was feeling.

I started in one of my jobs and it seemed to be going just fine the first week. I did experience a lot of worry after each class and before the next one. I was really concerned about how other people would perceive and judge me, particularly as I was not yet fluent in the language and could not understand 100%. I continued to be anxious about how other people thought I was doing my job for the next few days and had consistently negative thoughts that would not go away which were concerning as they seemed to upset me more and more. I remember that on the last day of that first week, I had been introduced to my new colleague, a really lovely lady who seemed really helpful. She was really experienced and obviously had a lot of knowledge and I started to feel inadequate in that moment. That was the moment everything spiralled out of control.

I went home and over the weekend I experienced constant racing thoughts of things going wrong and worst case scenarios. My husband and I were watching TV in the evening and I just could not focus on anything as my mind was racing so much. What surprised me the most was how physically I felt the anxiety this time and how different it was to any anxiety I had before this. I felt hot and cold every few minutes, had the sweats and could not sleep for days. I could not seem to regulate my emotions and rationalise them. I retreated to bed to warm up and calm down and called my mum for moral support. I lost my appetite and could physically not put anything in my mouth apart from forcing some sugar down me.

This pattern continued the closer it came to Monday. I found it really hard to get out of bed – I was heavy, anxious and tired due to lack of sleep. It was hard to sit up straight and I forced myself to have breakfast. I have never felt before the way I felt that day. I was inconsolably crying, paralysed with terror, and curled up on the sofa. I called in sick to work and spent the best part of the entire day on the phone to my parents who flew out the next day to be with me. All of this was entirely alien to my husband. He knew I worked in mental health but I guess I never realised that he totally didn’t understand what I did and what mental health looks like. He had no idea what was going on with me and had to learn how to support me.

I am really lucky to have found a supportive and really competent GP when it comes to managing mental health. I wanted to be put on a course of medication as I know that medication is a key part of the treatment equation and the SSRIs I am on have helped tremendously. My GP also gave me a temporary course of benzodiazepine very closely monitored by her to help me with the initial stage of going to work, coping with the anxiety and helping me sleep initially.

All in all, this was a really acute depressive/anxious episode and I did go back to work the following week with a LOT of positive self-talk, support from husband and family, and a chill pill. My recovery was gradual and I guess I realised that we are all vulnerable at one time or another. My parents have both experienced anxiety and depression over their lives and I know that having a depressive episode makes it more likely that we will experience further episodes.

Recovery means making your mind your priority and this is what I’ve tried to do. I have regular follow-ups with the GP every few weeks as I’m still taking medication. I am concerned about how coming off the medication might affect me but I have a good relationship with my doctor and trust that she will manage that process with me in the next few months. When I’m feeling anxious and restless I know I need to up my exercise to channel my adrenaline elsewhere. I try to facetime friends and family more often and say what I’m feeling more. My friends have been so supportive and didn’t judge or change their behaviour towards me when I told them- I found it really hard to tell them though. Having a good night’s sleep helps too- going to bed and waking up at regular times. I have also found Acceptance and Commitment Therapy (ACT) self- help reading to be extremely helpful too and highly recommend “The Happiness Trap” by Russ Harris- a refreshingly easy way of managing difficult emotions and learning to live with them.

The biggest piece of advice I can give anyone who is struggling with negative thoughts, depression, anxiety, stress, is to tell the people closest to you what helps you. Sometimes it’s the fact that our family’s, partners, friends don’t know what helps or what to say which causes more stress or potential conflict. Tell them what you would like them to do or say to you when you are feeling a certain way. I told my husband that every time I start to feel anxious, inadequate and catastrophising about my work, to remind me of how much enjoyment I have had at work and the positive things I say when I get home from work.

I don’t believe that a cardiologist should have experienced a heart attack to make them more capable of treating a patient effectively, but as a Mental Health Professional, I do have that bit more compassion and understanding of the vulnerability that we all have, no matter which chair you are sitting in.

 

 

On Pacing Myself

~ Eleanor Segall ~ 2 Comments

pace1I am very much enjoying my work at the moment- however one thing has come to the forefront and that is balancing my work and social life. I have learnt how important it is to pace myself and take things at a slower pace in order to achieve what I would like. Also, my anxiety becomes triggered if I do too much and all at once and so its really important for me to have down time to balance out the other parts of my life.

My anxiety can strike randomly and I have to cancel arrangements, which I hate doing, but is sometimes essential. I try and do too much- so this is a reminder for me to be kind to myself and take things at the right pace for me.

I think this should be applied as a general rule. I can’t be everything to everyone. I must take time to breathe and slow down and appreciate. For only then can I be truly and optimally happy.

Guest Post: The Efficacy of Online Cognitive Behavioural Therapy- CBT by Dr Stacey Leibowitz- Levy

~ Eleanor Segall ~ 1 Comment

We are delighted to have Dr Stacey Leibowitz-Levy, psychologist writing about Cognitive Behavioural Therapy for us. As with any therapeutic practice, it is very much individual as to whether it will work for you and CBT will not work for everyone- but has been proven to work for many. Here Dr Leibowitz-Levy explains how it can work online.                        

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Online counselling is a growing field with more and more people turning to the internet to seek out counselling help. Counselling services offered online incorporate the range of therapeutic approaches that have been developed within the field of psychology. Approaches to understanding mental ill health and treatment include therapeutic approaches such as logo therapy, psychodynamic therapy, systemic therapy, psychodynamic therapy and Cognitive Behavioral Therapy (CBT). How do these therapeutic modalities translate to the online environment? This article will address the compatibility of CBT in particular as an online counselling approach.

CBT is a widely-utilised mode of therapy that focuses on an awareness of the relationship between thoughts, feelings and behaviour. The aim of CBT is to address difficulties through modifying distorted thoughts, unhelpful behaviour and unpleasant emotions. In order to achieve this end, the client works collaboratively with the therapist in building awareness and understanding of his/her condition, and an accompanying skill set for evaluating and changing distorted beliefs (as well as modifying dysfunctional behavior). The therapist develops clear objectives and a treatment plan that requires active participation from the client during sessions, and follows through on homework assignments between sessions.

This form of therapy is characterized by a structured, time limited and outcome focused approach to managing mental health challenges. Often CBT is focused on a specific issue such as anxiety or managing depressive thoughts and, as such, many CBT interventions are available in a protocol format. CBT offers a delineated and clearly defined intervention that is largely directed by a clearly defined process and structure. This is in contrast to many other therapeutic approaches that have less defined parameters and take their cue on a session to session basis from the client.

The format and approach of CBT lends itself to an online format in that the structure and process are not only defined and constrained by the relationship between therapist and client but are also defined by a clearly delineated therapeutic procedure. This procedure offers a framework within which to deliver support which can easily be translated to an online process. CBT follows a set format. It is driven by the imperative of building an understanding of the issues the client is experiencing and imparting a certain skill set to assist the client in managing his/her mental health issues. CBT is thus based on specific content and has a strong psychoeducational aspect, which means that delivery online can be located in tangible and clear cut content and outcomes for the client.

This also allows for versatility in the delivery of CBT online. While face to face time with a therapist may be desirable for some clients, the option of online delivery of psychoeducational as well as skills based elements in other formats also works well. For instance, the psychoeducational aspect could be communicated very effectively through a video delivery. CBT lends itself to the format of online courses where clients are guided through a process of identifying and understanding their particular issues and developing the skills to manage them. Interspersing this with face to face time or the opportunity to clarify or ask questions in a chat or e-mail format makes for a very effective online intervention.

While many of the issues addressed in CBT are personal to the client, the possibility of locating these issues within a more general format is very much part of the CBT approach. There is a set way of getting information from, and accessing and understanding the client’s experience, with the client having to act on this information between sessions. This more “scientific” process also makes for an approach that lends itself to an online format.

The efficacy of CBT as an online intervention is borne out by the number of sites specifically offering online CBT in a variety of formats (for some examples, see here and here). The online availability of this well researched and well-verified approach to managing mental health problems offers increased affordability, accessibility and greater choice for mental health consumers.

Dr. Stacey Leibowitz-Levy is a highly-experienced psychologist with a Master’s Degree in Clinical Psychology and a PhD in the area of stress and its relation to goals and emotion. Dr. Stacey has wide ranging skills and expertise in the areas of trauma, complex trauma, anxiety, stress and adjustment issues. Stacey enjoys spending time with her husband and children, being outdoors and doing yoga.

The Anxiety Wave: On waking up with anxiety

~ Eleanor Segall ~ 8 Comments

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In previous posts about my mental health journey, I have mentioned having an anxiety disorder. Anxiety disorders are triggered in the brain and can be very hard to keep under control. Thankfully, most of the time, I can function at optimum health. Yet, sometimes stressors come along and throw me a little off course.

The main anxiety issue I have is usually morning anxiety. This is when you wake up and almost freeze from fear- you feel like you can’t do anything or enjoy the day, panic floods the body. Sometimes, after a few hours this form of terror dissipates. You can distract yourself and it goes – but sometimes it takes a little longer for it to go and it causes exhaustion. This is due to the hormones adrenaline and cortisol which are triggered pre or during a panic attack.

I am still learning to ride the anxiety wave- it can make you feel very tired and far less productive. For me, it often happens after I have had time away from work or a disruption to my routine, the anxious thoughts and feelings will flood back, making life that little bit harder again.

It is not easy nor straightforward dealing with this. I have to be kind to myself and know it will pass. Breathe, and distract my mind. Try and use meditation techniques to keep it under control.

Guest Post by Diamond EhealthInformer: Can some Mental Health Problems be treated with Technology?

~ Eleanor Segall ~ Leave a comment

As we move into 2017 going full steam ahead, we can see how far technology has come in recent years. I wanted to set myself the task of finding out how far this tech had come in terms of treating mental illnesses, as there is some speculation and fogginess to the science and results that people are supposedly getting.

It turns out that there are multiple useful and FDA approved technologies that do indeed help treat mental health problems. In this article, I aim to uncover some actionable, useful data and solutions that will aid sufferers of various mental health issues.

Crisis Centres

This solution may surprise you, but it utilizes technology and has proven to be very effective in serious circumstances. When people feel pushed to the end of their tether with anxiety and depression, they need to be talked to, supported and experience a sense of connection to alleviate the feeling of alienation. Sometimes your best friends and family members aren’t available or you don’t feel like talking to them. You want something completely confidential, which is why text and call centres are so effective.

They’re always open and running, plus the staff are fully trained for both mild and severe cases of anxiety and depression and other mental illnesses. You can always rely on someone picking up at the other end that will know how to talk to you and do their best to bring you back to a state of calm through grounding techniques.

Having the option to text message or call is also beneficial for those who prefer to communicate in different manners. Some sufferers may not feel like talking, but texting will work for them and their mood at that given time. On the contrary, hearing a soothing and reassuring voice on the other end of the line may be more effective for certain sufferers. Both options are there to use, whenever and wherever a person may need them.

Using Apps for Improved Mental Wellness

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There are thousands of mental health apps available for both iOS and Android phones. That being said, it’s important that before you download anything, that you do your research. Given the fact that there are so many apps to choose from, you can take an educated guess and see that a lot of them won’t be very effective.

Also, be sure to check the privacy settings for the apps you’d like to download, as you’ll most likely be entering personal information and data into them. You can always protect your information using privacy tools, removing some of the worry and stress from using specific apps.

Apps such as Pacifica help to monitor and alleviate stress levels so that individuals can work out and reduce anxiety symptoms through cognitive behavioral therapy and relaxation techniques. By using an app such as Pacifica, you can prevent your symptoms from worsening and control your stress levels to produce a healthy state of mind.

Spire

 

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Spire works through wearing a clip-on device that measures your emotions, sending signals through to your smartphone which will alert you as to what your body is currently experiencing. I know this may sound a little “out there,” but Spire has been proven to reduce stress levels by up to 50 percent in certain scenarios. When emotions are detected, the device will send signals to your phone, which then pop up on your screen telling you how you can improve your mood and emotional well-being.

The nifty device is easily clipped to a belt or bra for completely anonymous use. Repetitive high-stress levels can lead to physical health issues affecting the digestive and reproductive system (as well as other areas of the body). Stress can leave you feeling drained and lethargic, so having a device that alerts you to your emotional wellbeing and gives you advice and tips on how to reduce those stress levels is very useful.

 

Conclusion

I set out to discover whether technology really could help to treat mental health problems and to see what some of the most effective and accessible treatments available are. I think it’s fair to say that there are many ways in which technology can aid sufferers of various mental illnesses. Using apps, crisis centres, and body measuring devices we can stay on top of our stress levels, and use signals to prevent our conditions and symptoms from worsening.

I feel that using these technological solutions will work best in collaboration with any existing treatment a sufferer is undergoing- with a supportive medical team. Through using medication and counseling, these modern alternatives can provide additional beneficial results that could  boost the recovery of a patient.

Guest Post by Juno Medical: 9 Things People with Anxiety Disorders Would Rather not Hear You Say

~ Eleanor Segall ~ Leave a comment

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Anxiety disorders include generalized anxiety disorders, panic disorders, and social anxiety disorders. 1 in 12 people suffers from anxiety globally, and women are twice as likely as men to experience anxiety.

If you feel overwhelmed by the behaviour of a person with anxiety, try to put yourself in their shoes, and show understanding, not stigma.

For more see www.junomedical.com

 

Be Ur Own Light is One year old!

~ Eleanor Segall ~ 4 Comments

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I can’t believe my blog, Be Ur Own Light – started on March 1, 2016 is 1 year old today.

My journey with blogging has been so exciting, inspiring and wonderful. It has reached every part of the world and a huge number of countries in UK, Europe, USA, Canada and South America, China, India and other Asian countries, Africa, the Middle East and Australasia. It is such a blessing to be read world wide!

When I began this blog it was a diary to explain and help recover from my anxiety disorder. However, over time it has evolved into so much more!

As I grew in confidence and found other kindred spirits in my writing, I began to write for other organisations and also receive and upload guest posts on mental health topics.

This year I have written blogs for Rethink Mental Illness, Time to Change, Bipolar UK, Self Harm UK, Phobia Support Forum, Counsellors Cafe, Monologues Project and the Bossing It! Academy. I have written 4 blogs for Rethink and have loved collaborating with each charity and organisation. Special mention to Louie Rodrigues at Rethink.

I have also received amazing guest posts from these wonderful charities and writers who shared their hearts in order to battle stigma. Thank you:

– Breathe Life
-Ashley Owens at Generally Anxious
– ISMA stress management
– Stephanie at Making Time for Me
– Adar (PTSD)
– Deepdene Care
– Joshua (bipolar article)
– Michael J Russ
-Richie at Live Your Now
– Megan at the Manic Years
– Quite Great Music psychotherapy
-Lystia Putranto and Karina Ramos
-Eugene Farrell at AXA PPP
-Marcus at Psychsi
– Paradigm Centre San Francisco

I can’t wait to receive more guest submissions over time!

In the past year Be Ur Own Light has grown into a #lighttribe of thousands. On Twitter we are now 2,287 , Facebook 265 of my friends and family, Instagram is 2156,  and we have 127 dedicated WordPress followers. Thank you to each and every one of you for following, commenting, sharing and reading and for helping fight stigma through talking..

This blog has also raised money for Jami mental health charity and I am excited to be starting work for Jami soon.

Its been an incredible year of sharing, writing and breaking down barriers. Its OK to talk about mental illness and mental health. Its alright to feel lost or broken or ill. Seek support for recovery and you can get better. You are not alone.

With gratitude and love on our first birthday 

Guest post: Loneliness at Valentines (by Eugene Farrell, AXA PPP)

~ Eleanor Segall ~ 4 Comments

Valentine’s Day. For some, it’s a day full of romance and spending time with loved ones, yet for others, this focus can make them feel more isolated and alone.

According to the Office for National Statistics, Britain is the loneliness capital of Europe, with many Brits unlikely to know their neighbours or feel they have friendships that they believe they can rely on in a crisis.

Research by the charity, Relate, found that 9% of Brits of all ages don’t have a single close friend, while separately, a study by AXA PPP healthcare that British adults aged 18 to 24 are four times as likely to feel consistently lonely than those over 70.

 “The build-up to Valentine’s Day and the day itself can be quite intense, which is difficult for those who are already feeling isolated or lonely,” explains Eugene Farrell, Head of Trauma Support Services at AXA PPP healthcare.

“Although loneliness is often associated with the elderly, it’s actually an issue which can affect the physical and mental wellbeing of people of all ages.”

“In fact, studies have found that loneliness can increase the risk of high blood pressure, and have an impact on cognitive decline, dementia and depression. While addressing your experience of loneliness may take time, taking steps to build new and improve existing connections will help to improve your overall wellbeing.”

Here, Eugene gives his top tips on how to overcome feelings of loneliness:

1.     Making new connections can be an obvious way to combat loneliness and yield positive results, for example joining a group or class you are interested in will increase your chances of meeting like-minded people to connect with. Increasingly too we are turning to the internet for companionship, with community groups existing in almost every niche interest group you could imagine.

2.     Be more open. If you feel that you have plenty of connections but don’t feel close to any of them, the underlying issue may be that you need to open up to them more to deepen your connection, as an example letting the friend or acquaintance in on a vulnerability felt or your honest opinion about an issue.

3.     Stop comparing yourself to others. The desire to ‘keep up with the Joneses’ is not a new one, however the rise of social media has only exacerbated the problem by giving individuals the chance to constantly compare themselves to others. If you’re already feeling lonely, the idea that everyone else’s life is more idyllic than yours can make you feel even more isolated and alone. This can lead us to ‘compare and despair’ – which further exacerbates our negative experiences. Remind yourself that people only share what they want others to see about their lives. Don’t form unrealistic expectations about life and friendship based on what you see online.

4.     Keep all lines of communication open. Having a chat with a friend or relative over the phone can be the next best thing to being with them. Or you can stay connected with loved ones online. Video chat, exchange photos and keep up to date with the latest news from friends and family with Facebook, Instagram, Snapchat or simply keep in contact by email.

5.     Volunteering is also a great way to meet new people and feel good about helping others. It will not only allow you to give something back to your community but will also help you to feel more connected, involved and needed. There are lots of volunteering roles that need your skills and experience. It can also have a positive effect upon your mental health through helping others.

6.     Pride comes before a fall. Don’t be afraid to reach out to people and ask for help, companionship or just a chat. They may be feeling lonely too!

7.     Take it slow. If you’ve felt lonely for a while, or experience anxiety around new social situations, throwing yourself in at the deep end could only act to exacerbate the problem. Instead, dip your toes into the water first by going to a local café or sports event where you are surrounded by people, and just enjoy sharing their company. Or try a class where you can dive into the activity itself to distract you from the pressure of introducing yourself to people straight away. With loneliness, slow and steady often wins the race.

If you think you might be struggling with symptoms of loneliness, find more tips and advice at AXA PPP healthcare’s Mental Health Centre.

The best way to support a friend or family member through anxiety and depression.

~ Eleanor Segall ~ 1 Comment

I have been asked by my friends to write an article about how best to support someone through a mental health issue. There is not a one sized fits all answer, due to the fact that every illness and person is unique with their own brain chemistry and life experience. However, I am  going to offer a few tips on what you can do if someone is suffering from an anxiety disorder or depression (for this article I am going to leave out other illnesses eg bipolar, schizophrenia, psychosis, addictions but will speak about them at a later date)

So what can you do if your loved one is suffering from  an anxiety disorder/ depression?

Anxiety disorders are a group of multi faceted disorders which can include things like generalised anxiety, social anxiety, health anxiety, OCD, PTSD and more. Your loved one may be suffering from lack of sleep, nightmares, inability to sit still, palpitations, racing or obsessive thoughts, panic attacks and hyperventilation. They may feel more on edge, or in the case of OCD- be checking and analysing everything. Anxiety disorders run in certain patterns and all are unique to the individual- what one person with anxiety may have will be different to another, however there are some general patterns to anxiety.

When a person is suffering from anxiety, they may also have physical health symptoms as above due to the increase in adrenaline and the stress hormone, cortisol.

Depression or depressive disorders are sometimes caused due to a chemical imbalance in the brain (not enough seretonin) and can require medication to return the brain to its usual state. Some are a mixture of chemical imbalance and challenging life experiences or brought on from a period of stress eg divorce, moving house, losing a baby, having a baby, being unemployed etc . Symptoms typically can include loss of motivation, feeling tearful, low and hopeless, not wanting to engage socially or be involved with activities one enjoys.

If your loved one is suffering from anxiety or depression the best way you can help is by speaking and interacting with them calmly- not judging them or accusing them of anything bad, but simply being a laid back, supportive friend or partner. If someone can’t socialise, its best to just text once in a while and check up on how they are doing- or send a hand written note or card. Most importantly, do not pressure the person to see you, talk to you or go out.. but just be there for them calmly as a listening ear and encourage them to do small achievable things for themselves.

It is good to encourage your friend to go out with you but not to pressurise. Similarly, getting a bit of fresh air can help. If your friend or loved one is at crisis point ie threatening to take their own life, feeling suicidal, not eating or sleeping and being involved in self harming or risk taking behaviours, it is very important to do the following:

1) If a friend is suicidal, listen to them but do not promise to keep it a secret. You must tell their nearest relative/ best friend/ someone they trust if you believe they are in danger of a suicide attempt or at harm to themselves . Encourage them to see their GP immediately or speak to a help line and the GP will be able to tell you if a psychiatric referral is needed. A psychiatrist and team known as the Crisis Team will then  step in to help.

2) If a loved one you live with is suicidal, go with them to the Doctor or get a doctor to come out to you. There is stigma around this BUT if your loved one is really ill and their brain is effectively temporarily ‘broken’ much like a broken leg, it needs fixing. Your loved one needs help and support to recover whether its medication, counselling or more support at home. Do not blame yourself. This is an illness- not something you have done.

Ultimately, be loving, caring and supportive and CALM- however angry or frustrated you feel. Being frustrated to someone who is unwell can cause them to have feelings of guilt, low self esteem or worthlessness which the depression/ anxiety may perpetuate.

Be there as a support and listening ear but make sure you have a break and take time for you too.