Crisis: Helplines

In case of a mental health crisis, whether it be you or someone close to you, these helplines should be your first port of call!
Disclaimer:
- Helplines, websites or emails may be out of date. They may not be manned 24 hours. Where possible open hours have been listed. 
- Some helplines may cost more from mobiles or from outside the country. Check the country code before calling.
- Some helplines may be affiliated with companies or have religious backing.
- Where possible, clicking the phone numbers will take you to the source website. Check this for updates if the number is not working. 
- This list is not intended to be extensive. 

Helplines
Europe Wide:
- 116 Hotlines
   - Phone: 116 123 (free from any number)
Argentina:
- Teléfono de la Esperanza
   - Phone: 902 500 002
- Samaritans
   - Phone: +54 (0) 223 493 0430
   - Email: Samaritanosargentina@hotmail.com
- CAFS
   - Phone: (54-11) 4758-2554
Armenia:
- Trust Social Work (Yerevan)
   - Phone: (2) 538194 or (2) 538197

Australia:
- Lifeline Australia
   - Phone: 13 11 14
- Samaritans:
   - Subiaco
       - Phone:
          - All: 08 93 81 5555
          - Frecall: 1800 198 313
   - Lifelink:
       - Phone: 03 63 31 3355
       - Email: Lifelinksam@intas.net.au

Bangladesh: 

- Grameen: 01779554391, 01779554392

- Airtel: 01688709965, 01688709966

- Banglalink: 01985275286

- Robi: 01852035634
Barbados:
- Samaritans:
   - Phone: (246) 4299999
   - Email: Samaritansbdos@yahoo.com

Belgium:
- CPZ
   - Phone: 02 649 95 55
- CHS
   - Phone: +32 (0) 2 648 40 14
Botswana:
- Lifeline
   - Phone: 3911270

Brazil:
- CVV (See more (PDF))
   - Phone: 141
   - Email: Central@cvv.org.br

Canada:
- Suicide Prevention Hotline
   - Phone: 1-800-273-TALK

- CrisisCentre

   - Greater Vancouver: 604-872-3311

   - Lower Mainland + Sunshine Coast: 1-866-661-3311

   - TTY: 1-866-672-0113

   - BC-Wide: 1-800-784-2433

   - Seniors: 604-872-1234

Cayman Islands:
- Government Helpline
   - Phone: (345) 949-0290
Chile:
- Telefono De La Esperanza
   - Phone: (00 56 42) 22 12 00
China:
- Samaritans
   - Phone: (852) 2896 0000
   - Email: jo@samaritans.org.hk
- SPS
   - All: 852-2382 0000
   - Elderly: 852-2382 0881
- Taiwan Suicide Prevention Center (Possibly not active)
   - Phone: 0800 788 995
Colombia:
- Telefonos De La Esperanza
   - Barranquilla
       - Phone: (00 57 5) 372 27 27
   - Bogotá
       - Phone: (57-1) 323 24 25
   - Medellin
       - Phone: (00 57 4) 284 66 00
   - Pasto
       - Phone: 3016326701
Croatia:
- Plavi Telefon (Zagreb)
   - Phone: 01/ 48 33 888
Cyprus:
- Samaritans
   - Phone: 8000 7773
   - Email: Confidential@cyprussamaritans.org
Czech Republic:
- CSS Praha
   - Prague: 02/649 95 55
- CH Ostrava
   - Phone: 596 618 908 or 737 267 939
- Most Helpline
   - Phone: 476 701 444
   - Skype: Idt.most
- Safety Line
   - Phone: 116111

Denmark:
- Livslinien
   - Phone: +45 70 201 201
Ecuador:
- Telefono De La Esperanza
   - Phone: (593) 2 6000477-2923327
Egypt:
- BFS Cairo
   - Phone: 762 1602/3 or 762 2381
   - Email: befrienders@befrienderscairo.com
Estonia:
 - Usaldus:
   - Estonian: Usaldustelefon 126 (19:00 - 23:00)
   - Russian: Usaldustelefon 127 (19:00 - 23:00)
Finland:
- Mielenterveysseura
   - Phone: 010195202
- BA Methodist Lifeline
   - Phone: (0679) 670565
- Wesley Church Lifeline
   - Phone: (0679) 302998

France:
- Suicide Ecoute
   - Phone: 01 45 39 40 00
- S.O.S Amitié
   - Phone: (+33) (0)1 40 09 15 22
- SoS Helpline

   - Phone:
       - English Language: 01 46 21 46 46

Germany: 

- Telefonseelsorge

   - Phone: 0800 1110 111 or 0800 1110 222

- Nummer gegen Kummer

   - Phone: 0800 111 0 550

- British Armed Forces

   - 0800 181 0771 or 0800 181 0772

Ghana:

- Lifeline

   - Phone: 233 244 846 701

Gibraltar:

- British Armed Forces

   - Phone: 55666

Greece:
- OKANA:
   - Phone: 1031
Honduras:
- Telefono De La Esperanza
   - San Pedro Sula
       - Phone: (00 504) 2558
   - Tegucigalpa
       - Phone: 2232-1314 or 2232-2707

Hungary:

- Pharereg

   - Phone: 06 80 820 111
   - Email: Sostelefon@deltav.hu
- T.E.S. Miskolc
   - Phone: (46) 323 888

Iceland:
- Red Cross Crisis Helpline
   - Phone: 1717

India:
- Samaritans:
   - Mumbai
       - Phone: 022 32473267
- Lifeline Foundation
   - Phone: 0332 4637437
   - Email: Reach@lifelinekolkata.org
- Saath
   - Phone: 0091 79 26305544
   - Email: saath12@yahoo.com
- SNEHA:
   - Phone: 04424640050 (24hr)
   - Phone: 04424640060 (08:00 - 22:00)
   - Email: help@snehaindia.org
- Jeevan
   - Phone: 0091 6576453841
- Maithri Kochi
   - Phone: 0091 484 2540530 (10:00 - 19:00)
   - Email: Maithrihelp@gmail.com (10:00 - 19:00)
- Pratheeksha
   - Phone: 0484 2448830
- Thanal Calicut
   - Phone: 91 495 327 9307
- AASRA:
   - Phone: 91 22 27546669
- Sumaitri
   - Phone: 011 23389090
- Roshini
   - Phone: 0091 40 66202000 or 0091 40 27848584
Indonesia:
- Janganbunuhdiri (Possibly not active)
   - Phone: 021 9696 9293
   - Email: Janganbunuhdiri@yahoo.com
Ireland (ROI):
- Samaritans
   - Local rate: 1850 60 90 90 

   - Minicom: 1850 60 90 91

Israel:
- ERAN (Possibly not active)
   - Phone: 1201
   - From abroad: 972-9 8891333

Italy:
- Samaritans ONLUS
   - Phone: 800 86 00 22
- Telefono Amico Italia
   - Phone: 199 284 284
Japan:
- BW Aichia: +81 (0) 568 70 9090 (Sat: 00:00 - 05:00)
- BW Kumano: +81 (0) 597 92 2277 (Fri: 19:00 - 23:00)
- BW Miyazaki: +81 (0) 985 77 9090 (Sun/Mon/Wed/Fri: 20:00 - 23:00)
- BW Iwate: +81 (0) 19 621 9090 (Sat: 20:00 - Sun: 04:00)
- BW Osaka: +81 (0) 6 6260 3232 (Fri: 13:00 - Sun: 22:00)
- BW Tokyo: +81 (0) 3 5286 9090 (Tues: 17:00 - Weds: 06:00, all other days: 20:00 - 6:00)
- Tokyo English Lifeline
   - Phone: 03 5774 0992
- BI Suicide Prevention Centre (Osaka)
   - Phone: +81 (0) 6 4395 4343

Kenya:

- Samaritans:

   - Phone: (020) 2051323

   - Text: - 00254 707 633 692

              - 00254 733 656 262

              - 00254 775 388 222

   - Email: Samaritans.kenya@gmail.com
Liberia:
- Lifeline
   - Phone: 06534308 (Mon - Sat: 09:00 - 17:00)

Lithuania:

- JPPC:
   - Phone: 8-800 2 8888
Luxembourg:
- SoS Distresse
   - Phone: 45 45 45 (15:00 - 23:00) (Fri+Sat: 23:00 - 07:00)
Malaysia:
- Lifeline Association of Malaysia
   - Phone: (063) 92850039 or (063) 92850279 or (063) 92850049
- Johor Bahru
   - 607 3312300
- Malacca
   - +606-284 2500
- Seremban
   - Phone: 606-7653588 or 606-7653589 (19:00 - 22:00)
   - Text: 012-2472580
- Penang:
   - Phone: 604-2811108 or 604-2815161 (15:00 - 00:00)
   - Email: pat@befpen.org
- Kota Kinabalu
   - Phone: +6 088 255788 or +6 088 255788 (19:00 - 22:00)
   - Email: befrienderskk@gmail.com
- Kuala Lumpur
   - Phone: 603-79568145 or 603-79568144
   - Email: sam@befrienders.org.my

Malta:
- SupportLine
   - Phone: 179
Manitoba:
- Southern Health
   - West of the Red River
       - Phone: 1-866-588-1697
   - East of the Red River
       - Phone: 1-888-617-7715

Mauritius:

- Email: befriendersmauritius@gmail.com
Mexico:
- SAPTEL
   - Phone: 018004727835
- Programa Salvemos Una Vida (Possibly not active)
   - Phone: 9453777

Netherlands:
- Phone: 0900 1130113
- British Armed Forces
   - Phone: 0602 222 88

New Zealand:
- Lifeline

   - Outside Auckland: 0800 543 354

   - Auckland: 09 5222 999

   - All: 0800 543354
- National Depression Initiative
   - Phone: 0800 111 757
   - Text: 5626
   - Email: Team@thelowdown.co.nz

Norway:
- Kirkens SoS
   - Phone: 00 47 815 33 300
   - Email: Post@kirken-sos.no
Peru:
- Telefono De La Esperanza
   - Phone: (00 51 1) 273 8026
Philippines:
- Manila Lifeline Centre
   - Phone: (02) 8969191
   - Mobile: 0917 854 9191

Poland:
- Pomoctel (Possibly not active)
   - Phone: +48 527 00 00 or 52 70 988
   - Email: Pomoctel@free.ngo.pl
Portugal:
- Voz de Apoio
   - Phone: 00 351 225 50 60 70
   - Email: sos.vozdeapoio@sapo.pt or sos.vozdeapoio@mail.telepac.pt
Russia:
- Samaritans
   - Phone: 007 (8202) 577-577
Samoa:
- SRCE Novi Sad (Possibly not active)
   - Phone: (+381) 21-6623-393
   - Email: vanja@centarsrce.org.yu
- KOAPS (Possibly not active)
   - Phone: (044) 08080
   - Email: Ltn@ltn08080.org
- SOS Telephone
   - Phone: 037 23 025
Scotland:
- Breathing Space
   - Phone: 0800 83 85 87

Serbia: 

- Centar SRCE

   - Phone: 0800 300 303 or 021 6623 393
Singapore:
- Samaritans
   - Phone: 1800 2214444
   - Email: pat@samaritans.org.sg

South Africa:
- BFS Bloemfontein
   - Phone: 051 444 5000
   - Email: Befrienders@wsinet.co.za
-  LifeLine
   - Phone: 0861 322 322
- SADAG
   - Phone: 0800 567 567
   - Text: 31393
- Durban North Umhlanga Crisis Team
   - Phone: 083 256 5993
   - Email: Joy@crisisteam.co.za
South Korea:
- Love-line
   - Phone: (2) 715 8600 or (2) 716 8600 or (2) 717 8600 or (2) 718 8600
Spain:
- Samaritans
   - Phone: 902 88 35 35
- Teléfono de la Esperanza
   - Phone: 902500002
Sri Lanka:
- SLS
  - Bandarawela:
      - Phone: 00 94 11 572222662
   - Colombo:
       - Phone: 00 94 11 2683555 or 94112692909
   - Rural:
       - Phone: 0094 11 (0) 37-5725815 or 0094 11 (0) 47-5781200
   - Panduwasnuwara
       - Phone: 00 94 11 372291718
   - Kandy:
       - Phone: 00 94 11 812234806
   - Kurunegala:
       - Phone: 00 94 11 374931731
   - Matale:
       - Phone: 00 94 11 662223521
   - Mawanela:
       - Phone: 00 94 11 355788330
   - Negombo (Katunayake)
       - Phone: 00 94 11 312223322
   - Kohuwela (Colombo South)
       - Phone: 00 94 11 2818860
   - Panadura
       - Phone: 00 94 11 382235291
Sudan:
- BFS Khartoum
   - Phone: (249) 11-555-253

Sweden:
- Nationella Hjälplinjen
   - Phone: 020 22 00 60
- NATM
   - Phone: (46) (0) 31 711 24 00

Switzerland:
- Die Dargebotene Hand
   - Phone: 143
   - Email: Verband@tel-143.ch
- PARSPAS
   - Phone: +41 (0) 27 321 21 21
Thailand:
- Samaritans
   - Bangkok
       - Phone: 27136793 or 27136791
       - Email: Samaritans_thai@hotmail.com
   - Chiang Mai
       - Phone: 53225977 or 53225978
       - Email: Samchiangmai@gmail.com
Tonga:
- Lifeline
   - Phone: 23000 or 25144
Trinidad and Tobago:
- CUREPE Lifeline
   - (868) 645 2800
Turkey:
- Emergency Hotline
   - 182
Ukraine:
- Telephone of Confidence (Possibly not active)
   - Phone: 058
- Odessa Confidence Telephone Service
   - Phone: 0487 327715 or 0482 226565

UK: 

- HopeLineUK: 0800 068 41 41

- CalmZone: 0800 58 58 58

   - London: 

            - Phone: 0808 802 58 58

            - Text: 07537 404717

   - Merseyside:

            - Text: 07537 404717

- Samaritans: 

   - Phone: 08457 90 90 90

   - Text: 07725909090

   - Email: jo@samaritans.org

United States:
- Unknown:
   - Phone: 1-800-784-2433 (1-800-SUICIDE)

- Hopeline

   - All: 1-800-422-HOPE

   - Veterans: 1-877-Vet2Vet

   - Espanol: 1-800-SUICIDA

   - Teen: 1-877-YOUTHLINE

   - Grad Students: 1-800-GRADHLP

   - Post-Partum Depression: 1-800-PPD-MOMS
- Suicide Prevention Center
   - All: 001310 391 1253
   - LA County: 877 727 4747
- National Suicide Prevention Lifeline
   - All:
       - Phone: 1-800-273-TALK (8255)
   - Espanol:
       - Phone: 1-888-628-9454
   - Veterans:
      - Phone: 1-800-273-8255 (Press 1)
      - Text: 838255
- Samaritans:
   - Boston-Framingham
       - All: 617 247 0220
       - Toll-free: 877 870 4673
   - Cape Cod & the Islands
       - All: 5085488900
       - Toll-free: 8008939900
   - Keene:
      - All: 603 357 5505 or 603 924 7000
      - New Hampshire: 1-877-583-8336
   - New York City
      - Phone: 212 673 3000

Uruguay:
- Ultimo Recurs
   - Phone: 0800VIVE (19:00 - 23:00)
   - Phone: 095 73 84 83 (24hr)
Venezuela:
- Telefono De La Esperanza
   - Phone: 0241-8433308
Zimbabwe:
- Samaritans
   - Bulawayo
       - Phone: (9) 650 00
   - Harare
       - Phone: (4) 726 468 or (4) 722 000 or 080 12 333 333
   - Mutare
       - Phone: (20) 635 59

For Kids

Australia:
- Samaritans (Subiaco)
   - Phone: 08 93 88 2500
- Kidshelp
   - Phone: 1800 55 1800

Canada:
- KidsHelpPhone
   - Phone: 1800 668 6868
Germany:
- Nummer gegen Kummer
   - Phone: 0800 111 0 333

Lithuania:

- Youth Line

   - Phone: 8 800 28888

New Zealand:
- Youth Line
   - Phone: 0800 376633
   - Text: 234
   - Email: Talk@youthline.co.nz or Parenttalk@youthline.co.nz
Russia:
- Youth Crisis Line
   - Phone: (7) 0942 224 621
South Africa:
- Childline
   - Phone: 08000 55 555
United States:
- Samaritans
   - Boston-Framingham
       - Toll-free Teenline: 800 252 8336
      

Online chat

Canada: 

- www.Crisiscentrechat.ca

- www.youthinbc.com

Serbia:

- www.centarsrce.org/index.php/kontakt

United States
- www.7cupsoftea.com

- https://www.imalive.org/ 

- http://www.113online.nl/
   - Veterans:  http://www.veteranscrisisline.net/ChatTermsOfService.aspx

Read More

In the news: 17/04/13

Wrapping up this week's mental health news, research or otherwise.

Disclaimer: Some of the sources of these articles are suspect or untrustworthy. Some of the research may not be very good quality. Please take that into account when viewing them. 
Some of these links may be triggering to certain aspects of mental health, including, but not limited to, abuse, self-harm and suicide.

Celebrity
L'Wren Scott, girlfriend of Mick Jagger, commits suicide aged 49
White Dee, star of Benefit's Street, speaks about her battle with depression
Hazel O'Connor speaks about the effect of diet on mental health

Research
Fear of 'enjoying the moment'
Difference in effects of stress by gender
Modern society, stress and aggression
'Mollycoddling' and narcissism
Writing about fears eases test anxiety and increases grades
Suppressing unwanted memories reduces unconscious effect on behaviour
Social groups alleviate depression
Binge-eating and obesity connection
Happiness is more important than money
ICU patients may experience mental health problems after discharge

Legislative/Literature
DSM-V: 'Mental retardation' revised to 'intellectual disability' (PDF)
Mental capacity act: Scrutiny after the fact (PDF)

Articles
Ruth Walters speaks out about her Trichotillioma
'The neglected suicide epidemic'
Mental illness diagnoses increasing, why?
11-year-old develops anorexia after warning from school

Other
Minnesota mental health center shuts down, strands patients (North America)
Fukushima: Three years on many deaths are suicide rather than radiation based (Japan)
Native Americans living on reservations and high suicide rate (North America)
1 in 4 lie to NHS about mental health for surgery (United Kingdom)
Student suspended for removing razor from self-harming classmate (North America)
Mental illness and violence on Riker's Island (North America)
Encouraging or advising suicide 'not illegal' according to US court (North America)
A badge in body confidence: Self-esteem badge added to girl guides (United Kingdom)
Woman commits suicide either months after losing husband, sends text to his phone (United Kingdom)
Online store removes glasses named "Anorexxxy" for glamorising eating disorders (North America)
16-year-old commits suicide after being accused of being a rapist (United Kingdom)
TV comic groomed and abused teen boy who committed suicide (United Kingdom)

Seen any news I've missed? Want to talk about any of the articles listed? Post it in the comments!

Read More

Focus: Trichotillomania

In the new this week: Ruth Walters speaks out about her Trichotillomania

What is Trichotillomania (TTM)?

TTM is defined as a compulsive urge to pull out your own hair, including (but not limited to) eyebrows, eyelashes and actual hair. TTM is considered an 'impulse control disorder' but is often related to anxiety disorders.

TTM may also cause people to eat the hair that they pull. 

What triggers people to pull?

How common is TTM?
It is believed that 1 in 50 people will experience some form or degree of TTM at some point in their lives.
It is more common in women than men (although equally so in children) and usually begins during childhood or adolescence.

How is TTM treated?
As with any other psychological disorder, treatment is not as straightforward as it would be for a physical one. Your doctor may want to check you do not have any skin problems in the area you are pulling your hair from, especially if the patient is a child, as this could also cause pulling. Medication, especially Sertraline (Lustra) and Fluoxetine (Prozac) may be prescribed, and therapy may be offered. Psychotherapy and Cognitive Behavioural Therapy are usually the therapies used.
Some people also recommend hypnosis for the treatment of TTM as it can become a habit that is very hard to break.

I think I have TTM. What can I do?
- See your healthcare provider ASAP. This is the biggest, and scariest, step. I have posted some tips for you for your first visit.
- Support from family and friends is very important in most psychological illnesses, but is shown to be especially so in TTM. If you have someone close to you that you feel comfortable telling, it may be beneficial to do so. They may be able to help point out when you are subconsciously pulling and help to reduce the amount you do it.
- Use the internet! There are tons of support forums and resources out there for you to begin helping yourself. I've included a good list at the bottom of this post! Trich.org provide an extremely helpful self-help program (PDF).

I am a long-term sufferer of TTM. What can I do?
- If you have not approached someone for help, now is the time to do it. If you have, and for whatever reason the medication and/or therapy is not working for you, go back to your healthcare provider and ask for a change. It is important you are pro-active.
- In terms of the hair loss, there are a number of practical things you can do to help reduce the effect on your daily life. I greatly recommend TrichWig.com if you are looking for a wig to cover hair loss. You may even be able to get a prescription to cover the price of the wig.
As for eyelashes and eyebrows, there are some great false eyelashes on the market. For eyebrows, you have the option of having them tattooed on, either permanently or semi-permanently, or there are a variety of good pencils, stencils and tutorials to draw them on and make them look more natural.

--------------------------------------------------------------------------------------------------------------------------

Some people with TTM spend a long time thinking that it isn't a "real" disorder, and that they do not deserve, or need, to be treated. TTM is as much as real disorder as any other form of self-harm or anxious compulsions and deserves, and needs, to be treated as such.
Despite 1 in 50 people being effected as some point, many healthcare providers may not know much about the illness, and you may struggle to receive the support you need. If you do, do not give up. There are plenty of people out there who do have experience with TTM and can help you.

I recommend watching the documentary "Girls on the pull" on Youtube. It is a very well made and informative documentary on Trichotillomania, including many case studies.

Resources
Forums
PsychForums
DailyStrength
TrichStop
PsychCentral - OCD and TTM
SocialAnxietySupport - 'Secondary disorders'
Trich.de - German
Reddit Trichsters and Reddit TTM - Trichsters is far more active

Information
Wiki
NHS (UK)
MayoClinic
KidsHealth
Trichotillomania Learning Center
Trichotillomania Support Online
"Doesn't it hurt?" Ebook

In the news (in the past)
Olivia Munn admits she has suffered with Trichotillomania (eyelashes)
Famous people suffering from Trichotillomania
Official ribbon produced for Trichotillomania
Documentary: 'Girls on the pull' - Part 1
Documentary: 'Girls on the pull' - Part 2

Research
Trich.org - Ongoing research summary
Neuroscience and Trichotillomania

Practicalities
Wigs
How to: Eyebrows (TTM specific)
How to: Eyelashes (TTM specific)
How to: Clip-in toppers (TTM/Thinning hair specific)
Self-Help program (TTM specific) (PDF)

Suffer from Trichotillomania? Know someone who does? Have a link to a great resource I haven't found? Comment below!

Read More

MIND: Petition for Mental Health Funding

This is something really important to me that I want to raise awareness of while it's still running.

MIND, the National Association for Mental Health in the UK, are campaigning to end the cuts to mental health services that are being imposed by the current government using this petition.

According to MIND, 30,000 people have lost their social care since 2005, and the current funding cuts have let to a £90m shortfall in mental health services. Next year, hospitals have been asked to save 20% from their mental healthcare budgets.
1 in 4 people, in any given year, will suffer with ill mental health and may need support from these services, which are already stretched.

These cuts will cost lives, will reduce the quality of life for so many people and will cost us more money in the future. 

Sign the petition now!

You do not need to be a resident of the UK to sign this petition, all signatures count. 

References:

BBC: Mental Health charities warn cuts put lives at risk.

The Independent: Mentally ill young people's lives at risk due to cuts

The Guardian: More on the threat to Mental Health services from funding cuts

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Taking the first step: What to expect

So, you've decided to approach a healthcare provider about getting help for your mental illness. This is the biggest and best step you can take, so if you are at this point, congratulations!
This step is scary, and often it's a fear of the unknown. Are they going to lock me in an asylum and throw away the key? Will they judge me?
Here's what to expect from that first appointment.

1) Preparation
Before you go, you may want to write everything down that you might forget or feel embarrassed saying out loud. This can include any symptoms you've experienced, anything that triggers you or anything you think your doctor should know. Don't be afraid to write everything down. Your doctor may not have time to read it through with you if you have limited appointment time, but the more information they have at their disposal, the better for you.

2) Coming out with it
For me, this was the hardest part. How do you say "I'm depressed"? Written down, it's so easy, but to say it to a stranger like that? Not so much.

Credit to Hyperbole and a Half

If this part is really scary for you, write it down. You could even just write down your symptoms and let the doctor work it out from that.Otherwise, the basics work just fine. 

"I have been feeling very down lately"

"I've been having panic attacks and feeling very anxious quite a lot"

"I think I am depressed, can you help?"

My tip here is that the doctors have heard it all before, a LOT of times. 1 in 4 people has a mental illness, they have seen thousands of people who have said something similar, there is nothing to be embarrassed about.

3) The questioning

Your doctor is obligated to ask you some questions at this point which may seem completely irrelevant to you. Your doctor has to ask these questions, so just answer honestly.

Do you drink, smoke or take any illegal drugs? 

This is important because excessive alcohol intake can effect the brain, it is a depressant after all. Illegal drugs can also lead to mental issues and it is important to rule them out, or take them into account as a factor, straight away.

Have you had any thoughts of injuring yourself, or others?

It's quite obvious why they ask this question. Your safety is first and foremost. Saying yes to this question does not mean you will be sectioned. There are plenty of other factors that come into being put into a mental institution and this question alone will not do it. I have personally answered yes to this question before. Being honest just allows them to treat you well.

Do you have any history, or family history, of mental illness? 

This question is especially common if you are suffering from symptoms of schizophrenia or other mental illness that is shown to run in families. You will not implicate your family if you answer yes to this question.

Do you take medication for, or suffer from, any other illnesses? 

Your doctor may not need to ask this if they have your full medical history, but they may check anyway. They mean any illness. They're checking to make sure you don't have a history of, say, thyroid problems, that could cause depression, or are on any medication that can cause mental problems. 

4) The further questioning: Paper edition

At this point, especially if you have mentioned depression or anxiety, your doctor is probably going to produce a GAD-7 (PDF), PHQ-9 (PDF) and possibly a HAM-D (PDF). They may ask you to fill in a CDRS-R (PDF) if you are under a certain age (usually under 12). 

An example of GAD-7 questions

These are short questionnaires that are widely used as diagnostic tools in mental health. Answer these questionnaires honestly, and do not second guess yourself. Often your initial reaction to the question is the most accurate one. The doctor is not judging you on your answers, you do not need to artificially inflate your score to get help, nor deflate it to make yourself seem less 'sick'.

5) Treatment: The options

Before this part, your doctor may schedule you for blood tests. This may seem stupid, since after all you have mental problems, not physical ones, but they are for a good reason. Some illnesses, such as thyroid insufficiency or vitamin deficiency, can cause symptoms that mimic mental illness. It is important your doctor checks for these. However, if you have not said you sleep excessively, or too little, or have trouble eating, they may not feel this necessary. 

By now, your doctor may have mentioned what diagnosis they would suggest for you. They may not. Don't worry too much either way, after all it is just a label and the treatment is most important. Here are some options for what they may suggest:

Medication 

Celexa (Citalopram), Prozac (Fluoxetine) or Lustra (Sertraline) are the most common, in my experience, but any SSRI (Selective Serotonin Reuptake Inhibitor) may be prescribed to you. If you have any queries about the medication, now is the time to ask, or let your doctor know. SSRIs do have side-effects, but mostly I would suggest they are better than the depression and/or anxiety that you may already be suffering. Your doctor may start you on 10mg or 20mg of these drugs daily, or may go straight for a higher dose of 40mg or upwards. 

Prozac effect on CDRS-R score Vs. Placebo (non-medication). Lower is better!

Therapy

In England especially, this is a rarer option. This is a shame because it is very successful, but funding is lacking. You may be offered CBT (Cognitive Behavioural Therapy), counselling, or psychotherapy. Certain types of therapy won't work for some people, and it is important you stick with it, and try other things, if you do find the type of therapy you are receiving isn't working for you.

Research suggests that a combination of both medication and therapy will be most successful in treating depression and anxiety, and research differs for other mental disorders. Personally, I found a combination of Citalopram and CBT worked for me, whilst Fluoxetine and Counselling did not. 

6) Follow-up

Keep in touch with your healthcare provider! I cannot emphasise this enough. If you are in England, try to stay with the same GP and keep them updated on your progress. If you are on medication you will likely be asked to go back for check-ups anyway, but if you aren't, go anyway.

Always stick to what they have provided you as treatment. Do not come off your medication without the help of your doctor, and especially do not do it cold-turkey. SSRI Discontinuation Syndrome is real and quite unpleasant. If you decide you would like to come off, allow your doctor to wean you off slowly. 

If you find that your therapist, or type of therapy, aren't a good fit for you, tell your doctor. Again, try not to just stop going. It is important to stick to a routine with these things.

If you feel your doctor isn't helping you enough, or just isn't for you, try to find a way to change. In England, this is as easy as seeing a different GP at the same surgery, or swapping surgeries. 

Personally, I saw a GP who was quite rude and abrasive, and later saw a different GP at the same surgery who ultimately helped me get the best treatment I have every received. Try not to get disheartened. 

Do you have experience of healthcare providers and mental health? Was it positive or negative? Did anything happen in your first appointment that I haven't mentioned? Let me know!

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Welcome to PsychAware!

PsychAware is a blog dedicated to raising awareness of mental health and mental illness through research, publications, events and much more!

The goal is to remove the stigma of mental health and allow it to become something we can all talk about, openly and freely, without any fear of judgement. Mental health is the same as physical health, at one time or another any of us may need help. Let's empower those people to feel free from shame!

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