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By Dr Bradley Powell , Chartered Clinical Psychologist. When I worked in the UK Parliament, I was struck by the dissonance between what the public sees and what’s really going on behind the scenes. In public, we see poise, polished messaging, and composure. In private, there is pressure, self-doubt, and a fuel tank at risk of running low. The demands on a politician often mirror those experienced by people in high-pressure, high-performance roles; whether they’re senior executives, entrepreneurs, healthcare professionals, or lawyers. At Schoen Clinic Chelsea , we frequently support professionals in these settings, offering tailored mental health treatment for professionals in high-pressure roles. The Hidden Cost of High Performance Nowhere is the mental strain of performance more visible than in moments like Prime Minister’s Questions (PMQs). Take David Cameron, for example; he was known to prepare rigorously for PMQs, rehearsing lines, anticipating attack points, and crafting flawless delivery. What audiences rarely witness is the psychological intensity behind those minutes of performance. The scrutiny, the pressure to appear unwavering, and the knowledge that one wrong sentence could become a headline, all of this takes a toll. Even Rishi Sunak, amidst an unrelenting schedule, found decompression through high-intensity Peloton workouts. This is not just about fitness, it’s about having structured, intentional ways to manage stress. What this reveals is critical: even those at the very top need recovery strategies to avoid burnout. A 2025 report by Mental Health UK found that 91% of working adults experience high or extreme stress levels, with more than a third reporting symptoms of burnout [1]. This highlights a growing need for recovery strategies and therapy for burnout and emotional wellbeing. Common Psychological Challenges Among High Achievers Whether you’re launching a startup, in the media spotlight, or leading a global organisation, the psychological demands are enormous. In my work with high-achieving individuals, I frequently see the following themes: Chronic pressure to perform and maintain composure under scrutiny Cognitive overload with complex decision-making and minimal room for error Public visibility , which can bring both admiration and unforgiving critique Imposter syndrome — even when achievements are clear and accolades abundant [2] Isolation , where expressing vulnerability feels professionally risky Physical and emotional fatigue , with minimal time for true rest These high-pressure careers often reward control and decisiveness, but they rarely reward slowing down. And yet, it is precisely that pause that the nervous system craves for sustainable performance. Insights from Parliament: Burnout and Resilience in High-Pressure Roles My time in Parliament offered a powerful lens through which to understand both the risks and resilience strategies of high-performance roles. Many MPs, advisors, and senior staff were operating in a state of near-constant hyper-arousal. This always-on mentality — an inability to switch off — left many of them feeling disconnected from their sense of self. A particularly common challenge in these roles is identity fusion : where who you are becomes indistinguishable from what you do. Personal values become enmeshed with organisational goals. While this alignment can drive purpose, it also creates emotional vulnerability. When setbacks occur, they’re not just professional; they feel deeply personal. Over time, this fusion can lead to emotional blunting, or even full-scale burnout [1]. We advocate at Schoen Clinic for therapy that helps separate role from identity — enabling sustainable performance rather than costly endurance. Understanding Imposter Syndrome in High-Achievers Imposter syndrome is rampant among high achievers. Despite external markers of success, many individuals in demanding roles live with an inner voice that says, “I’m not good enough,” or “Soon they’ll find me out.” This cognitive distortion often leads to perfectionism, people-pleasing, and a fear of failure [3]. For early-career professionals, especially those entering prestigious or high-stakes environments, this can be amplified. Without adequate support or reflective space, these thoughts can evolve into chronic stress , anxiety , and eventual burnout . But it doesn’t have to be this way. Resilience Isn’t Just Grit — It’s Recovery In psychological terms, resilience isn’t about being unbreakable. It’s about how you respond to setbacks, pressure, and uncertainty. Resilience involves: Cognitive flexibility: the ability to reframe unhelpful thoughts and adapt to challenges Emotional literacy: identifying, naming, and regulating your feelings with compassion Values-based direction: staying connected to purpose and meaning beyond outcomes or applause Intentional recovery: regular, protected time to restore your physical and emotional resources From a clinical perspective, it’s not unrelenting endurance that sustains performance; it’s the rhythm between intensity and restoration. The nervous system, like any finely tuned instrument, requires tuning and rest. Recent research from Queen Mary University of London highlights that workplace support systems and leadership training can significantly reduce burnout among professionals [4]. Practical Strategies for High-Performers Whether you’re a senior executive, politician, founder, or medical professional, the following research-informed strategies can support sustainable high performance: Schedule recovery like a meeting: Don’t cancel on yourself. Carve out time for decompression — whether it’s a Peloton session, a morning coffee without your phone, or a short walk in nature. Separate your role from your identity: You are more than your title. Reconnect with hobbies, communities, and relationships where you’re not expected to perform. Spot the early signs of burnout: Sleep disruption, emotional flatness, or irritability are warning signs. Don’t wait until the engine fails — respond early. Revisit your why: When stress peaks or outcomes feel out of your control, return to the core reason you do this work. Anchoring yourself to your purpose can foster clarity and motivation. Give yourself permission to feel: Emotional suppression is common in high-pressure environments. Create space to process emotions safely — through therapy, reflective writing, or trusted conversations. Check your mental dashboard: Just like a car’s warning light signals something off, your body and mood do too. Tune in regularly to what your mind and body are trying to tell you. Develop micro-recovery rituals: Quick, repeatable practices that signal safety to your nervous system — such as stretching, deep breathing, or stepping away from your screen for five minutes. If you’re noticing early signs of burnout or imposter feelings, our consultants, psychologists and therapists in London can help with tailored, confidential support. Moving Towards Sustainable Success What unites high performers (from the House of Commons to the boardroom) is not ego, but often a deep desire to make an impact. A desire to contribute. But high performance without presence is unsustainable. Sustainable success is not about doing more. It’s about doing differently. Prioritising rhythm over relentlessness, presence over perfection, and creating environments where you can thrive as a whole human, not just as a title. What I learned from Parliament, and what I continue to see in my therapy room, is this: behind every composed leader is someone who also needs space to rest, reflect, and reconnect. References Mental Health UK. The Burnout Report 2025: The Silent Epidemic in the UK Workforce. Mental Health UK, January 2025. Available at: https://mentalhealth-uk.org/blog/burnout-report-2025-reveals-generational-divide-in-levels-of-stress-and-work-absence/ Chamorro-Premuzic T. How to Help High Achievers Overcome Imposter Syndrome. MIT Sloan Management Review, 2023. Available at: https://sloanreview.mit.edu/article/how-to-help-high-achievers-overcome-imposter-syndrome/ UCLA Health. Feeling Like a Fraud? Imposter Syndrome Is Common Among High Achievers. UCLA Health Newsroom, 2024. Available at: https://www.uclahealth.org/news/article/feeling-like-fraud-imposter-syndrome-common-among-high Queen Mary University of London. Study Reveals How Changes in Workplace Support and Leadership Training Can Improve Mental Health and Reduce Burnout. 2023. Available at: https://www.qmul.ac.uk/whri/news-and-events/2023/items/study-reveals-how-changes-in-workplace-support-and-leadership-training-can-improve-mental-health-and-reduce-burnout-in-healthcare-professionals-.html Dr Bradley Powell, Chartered Clinical Psychologist About the author Dr Bradley Powell is a Chartered Clinical Psychologist at Schoen Clinic Chelsea with specialist experience in working with high-achieving individuals, burnout, imposter syndrome, and performance psychology. He previously worked within the UK Parliament, providing psychological consultation in high-pressure political settings.

By Dr Bradley Powell , Clinical Psychologist at Schoen Clinic Chelsea Actor Chris Hemsworth is best known for portraying Thor in the Marvel Cinematic Universe. However, in the National Geographic series Limitless , he explores something much more relatable: the fears, anxieties, and challenges of ageing. In the second season, Hemsworth aims to understand how we can live better for longer and what it truly means to thrive as we age. Credit: National Geographic, Limitless with Chris Hemsworth For men in 2025, this topic is incredibly timely. We’re living longer than ever, yet many of us quietly worry about our health, our future, and whether we’re making the most of our time. Hemsworth’s journey doesn’t provide easy fixes, but it highlights powerful psychological truths that can help us live more meaningfully, with courage and connection. What Limitless Gets Right About Men’s Mental Health In this season, Hemsworth pushes himself beyond the gym and into deeply uncomfortable territory. He climbs a towering dam and performs live on stage with Ed Sheeran. These aren’t just stunts; they’re psychological experiments in vulnerability. As a psychologist, this resonates with me. Fear, whether of failure, ageing, or rejection, often shrinks our world. In therapy, we use a process called exposure to help people gradually face their fears, reducing their emotional grip. “For men, who are often taught to avoid vulnerability, stepping into fear isn’t weakness. It’s strength.” By deliberately stepping into discomfort, we give ourselves permission to grow. Hemsworth shows that courage isn’t about being fearless; it’s about showing up anyway. Ageing and Health Anxiety: Learning to Let Go of Control Credit: National Geographic, Limitless with Chris Hemsworth In season one, Hemsworth revealed that he carries a genetic predisposition to Alzheimer’s . This sparked public conversations about health anxiety , especially among men. It’s common for health worries to creep in as we age. A new ache or a forgotten name can suddenly make our thoughts spiral. From a clinical perspective, this type of anxiety thrives when we fixate on the unknown and try to control the uncontrollable. The Power of Reframing What helps is a psychological shift known as reframing . Instead of chasing the illusion of certainty, we redirect our focus to what’s in our hands: Moving our bodies Nourishing ourselves well Prioritising good sleep ( Research Links Sleep Disorders to Accelerated Brain Ageing ) Investing in relationships As Hemsworth learns, chasing extreme biohacks or trying to “outrun” ageing can actually worsen anxiety. The healthier mindset is balance —caring for your health without turning life into a self-optimisation experiment. Why Connection Matters More Than Biohacking The biohacking world is full of bold claims: longer life through supplements, strict diets, cold plunges, and even plasma infusions. However, one of the most important messages in Limitless is that longevity without connection is meaningless . Credit: National Geographic, Limitless with Chris Hemsworth Psychological research consistently shows that strong social ties are one of the most powerful predictors of health and lifespan. You can eat well, train hard, and do all the right things, but if you’re lonely or disconnected , your mental and physical health will suffer. The Challenge of Maintaining Connections For many men, this is the harder part. As we grow older, friendships can quietly fade. Life becomes busy, and reaching out can feel awkward. But prioritising connection, whether with family, old friends, or community, is just as important as any fitness plan. A Truth Worth Facing Hemsworth puts it beautifully: “Suffering comes from denial of our inevitability of death.” Instead of denying it, we can let the reality of life’s limits bring clarity. Fear and discomfort aren’t stop signs—they’re signals to pay attention. Ageing is inevitable, but anxiety doesn’t have to be. You don’t need a perfect routine or perfect body to live with purpose. You don’t need to climb a dam or share a stage with Ed Sheeran to grow. But you do need to face the fears you’ve been avoiding, care for your health without obsessing, and invest in the relationships that sustain you. That’s the real definition of being limitless . Limitless is streaming now on National Geographic / Disney+. Struggling With Fear, Ageing, or Anxiety? At Schoen Clinic Chelsea, we support individuals facing unique mental health challenges that often go unspoken. These include health anxiety , fear of ageing, loneliness, and emotional shutdown. Our psychologists can help you explore these issues in a safe, compassionate space. We use evidence-based therapies to build resilience and improve wellbeing. Ready to start? Learn more about our therapy services in London or get in touch for confidential support. About the Author Dr Bradley Powell, Clinical Psychologist, Schoen Clinic Chelsea Dr Bradley Powell  is an award-winning Clinical Psychologist at Schoen Clinic Chelsea. He has over seven years of experience supporting individuals of all ages. He specialises in treating anxiety, depression, low self-esteem, and neurodevelopmental conditions such as autism and ADHD. Combining evidence-based therapies with a warm, personalised approach, Dr Powell helps individuals better understand themselves, overcome challenges, and build long-term resilience.

Searches for toxic relationships often begin with a simple question: “Why does this feel so hard?” For many people, a toxic relationship isn’t defined by constant conflict or obvious mistreatment. Instead, it’s a pattern of emotional instability — feeling anxious, unseen, over-responsible, or chronically unsure of where you stand. You may find yourself walking on eggshells, over-explaining your needs, or repeatedly drawn to relationships that leave you feeling small or unsafe. What’s often missing from conversations about toxic behaviour in relationships is context. Many of these patterns are not personality flaws or poor choices, they are learned responses shaped by past experiences , particularly trauma and early attachment relationships. In a recent episode of Schoen Clinic Unscripted , psychotherapists Zoe Laxton and Georgia Mancroft explored how unresolved trauma can quietly shape the way we love, argue, cling, withdraw, and protect ourselves in adult relationships. What do we really mean by a “toxic relationship”? A toxic relationship is not defined by occasional disagreement or emotional intensity. All close relationships involve some level of friction from time to time. Toxicity emerges when patterns of interaction consistently lead to emotional harm , self-erosion, or nervous system distress, even when there is care, attraction, or commitment present. Often, people describe feeling: emotionally dysregulated around their partner responsible for maintaining harmony at all costs fearful of abandonment or rejection trapped in cycles of reassurance-seeking and withdrawal These experiences are deeply distressing, and they rarely come from nowhere. As Georgia explains: “The defences that we use in order to manage our feelings were protective on some level, but over time they become destructive and painful in themselves.” Understanding toxicity through this lens shifts the question from “What’s wrong with me?” to “What happened, and how did I learn to survive this way?” Trauma and the origins of “toxic” behaviour Trauma doesn’t only refer to single catastrophic events. It can also arise from chronic emotional unsafety , inconsistent caregiving, neglect, or environments where needs were ignored, minimised, or punished. In these contexts, children adapt. They learn strategies that increase the chances of connection or reduce the risk of rejection. Those strategies often follow us into adulthood, even when they no longer serve us. Zoe describes how trauma can shape communication styles in relationships: “Sometimes when people have been through traumatic experiences, they can go into people-pleasing and completely neglect their own needs… almost a doormat style.” At the other end of the spectrum is what she refers to as the “bulldozer”: “The bulldozer is kind of like, ‘screw you and the car you came in.’ Again, neither are effective.” Both responses are attempts to meet unmet needs — safety, control, reassurance, or recognition — but they do so indirectly, often escalating conflict or disconnection rather than resolving it. Reassurance-seeking, abandonment fears, and insecure attachment One of the most common trauma-linked relationship patterns is intense reassurance-seeking , particularly when attachment feels threatened. Zoe shares an example from clinical work: “She was afraid that he was going to leave her and felt she needed constant reassurance… calling him non-stop when he was out.” While these behaviours are understandable, they often overwhelm partners and inadvertently push them away — reinforcing the fear that started the cycle. Georgia explains what sits beneath this pattern: “Underneath that need for reassurance is a really painful sense of ‘I’m going to be rejected or abandoned.’ That comes from a very young place.” This is frequently linked to insecure attachment , where closeness feels essential but unsafe, and distance feels intolerable. Even when a partner has done nothing wrong, the nervous system reacts as if an old threat has returned. Subtle trauma patterns that don’t look “obviously” toxic Zoe Laxton, Psychotherapist, Schoen Clinic Chelsea Not all trauma-related relationship difficulties are loud or visible. Some are deeply internalised and quietly exhausting. People may appear functional, calm, or accommodating on the outside, while internally experiencing constant anxiety, hypervigilance, or self-criticism. According to Zoe : “You may not be acting in ways that are obviously problematic, but internally this can be really painful and invalidating.” Examples include feeling panicked when a partner goes out without you, replaying conversations repeatedly in your mind, or feeling ashamed for having emotional needs at all. These patterns often go unnoticed by others — but they take a significant emotional toll. Why we keep choosing the same kind of partner Georgia Mancroft, Psychotherapist, Schoen Clinic Chelsea Many people recognise themselves in the familiar refrain popularised on shows like Love Island : “I always go for the same type," or "I always go for the bad boy." Georgia explains why this often happens: “We repeat what we know. Humans are relationship-seeking beings. What we experience early on, we tend to seek out again and again.” Inconsistent or emotionally unavailable partners can feel intensely exciting — triggering dopamine, adrenaline, and emotional highs. But this “spark” is often a sign of nervous system activation , not safety. " Sometimes we confuse excitement and butterflies with unsafety… and over time, that wears us down.” These dynamics can reinforce deep-seated beliefs such as “I’m not enough” or “I have to earn love” , making the pattern feel both familiar and painfully compelling. Trauma, anxiety, and emotional avoidance Unresolved trauma frequently shows up as anxiety , panic, or emotional shutdown, particularly in people who learned early in life that emotions were unwelcome or unsafe. Georgia describes clients who learned to suppress feelings: “They learn to stick a smile on their face… and then arrive in their late teens or early twenties with huge anxiety and panic.” Avoidance may feel protective in the short term, but emotions don’t disappear when they’re ignored. As Zoe puts it, it’s like “pushing a beach ball under water” — eventually, it resurfaces with more force. Healing involves learning that emotions are not dangerous, and that discomfort can be tolerated without catastrophe. Regulation, mindfulness, and finding “wise mind” A central part of breaking toxic relationship patterns is learning how to regulate the nervous system — especially during moments of perceived threat. Zoe explains: “Mindfulness helps bring the logical mind and emotional mind together — what we call wise mind.” Neuroscience supports this. Research shows that mindfulness practices reduce activity in the amygdala (the brain’s threat centre) while strengthening the prefrontal cortex, which supports reasoning and emotional regulation (Hölzel et al., 2011; Farb et al., 2010). This shift allows people to respond rather than react , creating space for choice rather than repetition — a core principle in DBT-informed and trauma -focused therapies. Breaking free from toxic relationship cycles Healing is not about becoming emotionally numb or “less sensitive”. As Georgia emphasises: “It’s not about taking the anxiety away. It’s about feeling robust enough to manage it.” Change begins with awareness — noticing patterns without judgement — and continues through learning new ways to meet emotional needs, communicate boundaries, and soothe distress internally rather than externally. “Our emotions are information. If we listen to them, we learn more about ourselves and improve our relationships.” When therapy can help If these patterns feel familiar, therapy can offer a structured, compassionate space to explore where they came from and how to change them. Trauma-informed, attachment-focused, and DBT-informed approaches are particularly effective for relationship difficulties rooted in emotional dysregulation and early relational wounds. Support isn’t about fixing something broken. It’s about understanding what shaped you — and learning how to build relationships that feel safer, steadier, and more sustaining. If you need support, our dedicated team of mental health specialists at Schoen Clinic Chelsea , London, is here to help. Reach out to the team today . References & further reading Bowlby, J. (1969). Attachment and Loss, Vol. 1: Attachment. Attachment and Loss. New York: Basic Books. Van Der Kolk, B. A. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin Books. Linehan, M., M., (2014). DBT Training Manual . New York, NY: The Guilford Press.  Hölzel et al. (2011). Psychiatry Research: Neuroimaging Farb et al. (2010). Minding one’s emotions: Mindfulness training alters the neural expression of sadness.

PRESS RELEASE: 19/01/2025 Outpatient addiction treatment programme launches in London at Schoen Clinic Chelsea Schoen Clinic Chelsea, a leading specialist mental health clinic in London, has launched a new outpatient addiction treatment programme designed to support adults experiencing addiction, dependency, and compulsive behaviours, with structured, compassionate and evidence-based care. Created in partnership with Rehubs , the programme combines in-clinic therapeutic support with online support in the evenings and weekends , helping individuals access consistent guidance beyond traditional weekday appointments. The new programme has been developed for people who may be questioning their relationship with alcohol, substances, or behavioural addictions, and who want professional support that fits around work, family life, and existing commitments. Marco Burman-Fourie, Clinic Director “Reaching out for help can feel daunting, especially when addiction is often shaped by shame and secrecy. Our new outpatient programme is designed to meet people with compassion and expertise, providing a clear, supportive pathway forward, backed by evidence-based care and extended support through our partnership with Rehubs.” — Marco Burman-Fourie, Clinic Director, Schoen Clinic Chelsea Outpatient addiction treatment in London — structured support without inpatient admission Addiction often develops gradually, and many people delay seeking help until the impact becomes difficult to ignore. Schoen Clinic Chelsea’s outpatient programme offers a clear pathway forward, with expert clinical input, personalised support, and a focus on sustainable change. Isabelle Wood and Dr Daniel Masud , creators of the programme, said: “For most people, it isn’t a single moment — it’s a gradual realisation that something which once felt manageable has started to cause difficulties. This programme offers structured, compassionate, evidence-based support to help you make meaningful, sustainable changes at your own pace. Progress doesn’t need to be perfect or linear — honesty, openness and engagement are what matter most.” A combined model of support, in partnership with Rehubs As part of the programme, Schoen Clinic Chelsea has partnered with Rehubs , an established provider of online addiction support, helping to extend continuity of care into evenings and weekends. Rehubs offers a modern, accessible model of support designed to fit around real life — including work and family responsibilities — allowing individuals to engage in structured rehab support from home when needed. Nicholas Conn, Founder of Rehubs , said: “We are proud to have a team of highly qualified professionals who are registered with the British Association for Counselling & Psychotherapy (BACP).” Rehubs also provides ongoing aftercare support, with digital tools and continued guidance to help people sustain recovery beyond the initial treatment phase. A specialist team delivering evidence-based addiction therapy The outpatient addiction treatment programme is delivered by a specialist team with experience supporting a wide range of addiction presentations — including alcohol addiction, substance misuse, and compulsive behaviours that may co-exist with anxiety, depression, trauma, ADHD, or burnout. Alex Hayes, Addiction Therapist at Schoen Clinic Chelsea, said: “Addiction cuts right across every community. It doesn’t discriminate.” He added that addiction can be difficult to recognise early on, particularly because of the shame and secrecy it often creates: “Addiction is a disease of secrets… it is defined by people keeping it secret because it is defined by shame.” Richard De Val, Addiction Therapist & Recovery Specialist , emphasised the importance of reaching out and not facing addiction alone: “Therapy enables people to be seen… and explore other ways of behaving and reducing harm.” He added: “Making that first call… it can make a shift. There is hope.” Darja Lee, Integrative Therapist at Schoen Clinic Chelsea, highlighted the importance of treating the whole person — not only the addiction itself: “I work with the whole person… not just addictive behaviour, but also underlying issues.” She also explained that addiction often starts as a coping mechanism, but can become a separate problem that needs specialist support in its own right: “Addiction has a life of its own… and this needs to be addressed separately.” Who the outpatient addiction programme is for The programme may be suitable for adults who: feel their alcohol or substance use has become harder to control are noticing consequences in relationships, work, mood, or physical health are using substances or behaviours to cope with stress, trauma, or emotional pain want structured addiction support without inpatient admission have tried to stop before but found it difficult to sustain change want discreet, professional addiction treatment in London Supporting sustainable change — not quick fixes While many addiction services focus only on stopping a behaviour, Schoen Clinic Chelsea’s outpatient approach is designed to go deeper, helping clients understand why patterns developed, what maintains them, and what meaningful recovery looks like for the individual. This includes building healthier coping strategies, strengthening emotional resilience, and supporting long-term wellbeing — not just short-term abstinence. Referrals now open Schoen Clinic Chelsea is now accepting referrals for its outpatient addiction treatment programme. To learn more, refer a patient, or enquire about suitability, contact the team at Schoen Clinic Chelsea . Learn more: Outpatient addiction treatment programme in London Location: Schoen Clinic Chelsea , London Referrals: Email the Private Enquiries Team

The Traitors is back, and once again it’s taking over group chats, office conversations, and our collective urge to shout “How can you not see it?!” at the television. On the surface, the BBC hit looks like a simple game. A group of strangers live together in a castle, complete missions to build a prize pot, and vote each day to banish someone they suspect is secretly working against them. But psychologically, The Traitors is something else entirely: a pressure cooker that turns everyday social instincts into drama, placing trust, uncertainty, fear and performance under a microscope. And what makes the show so addictive is the uncomfortable truth at its core: most of us believe we’re good at spotting lies. In reality, humans are not particularly reliable lie detectors. Especially when we’re stressed, emotionally invested, or surrounded by other people’s opinions. Image Credit: BBC: The Traitors series 4 cast with host, Claudia Winkleman The psychology behind The Traitors starts with uncertainty The format is deceptively simple. A small number of contestants are secretly chosen as Traitors, while everyone else becomes a Faithful. Each night, the Traitors “murder” someone; each day, the group debates and votes to banish the person they believe is lying. The Faithfuls win if they eliminate all Traitors. The Traitors win if even one makes it to the end undetected. What the show does brilliantly is create a social environment where certainty is almost impossible. Players are removed from normal routines, cut off from everyday support systems, and forced to build relationships at speed while simultaneously questioning whether those relationships are real. Under those conditions, even small changes in behaviour can feel meaningful - and suspicion can start to feel like common sense. Why we’re so bad at spotting lies One of the strongest and most consistent findings in psychological research is that people are surprisingly poor at detecting deception. In a large meta-analysis of deception research, Bond and DePaulo found that average lie detection accuracy sits only slightly above chance, even across hundreds of studies — meaning that, in many cases, we’re barely better than guessing. (Bond & DePaulo, 2006) ( PubMed ) This matters because The Traitors is built around the assumption that the Faithfuls can “read” other people well enough to expose deception. But without concrete evidence, people often rely on social cues that feel meaningful, like tone of voice, eye contact, confidence, hesitation and emotional expression, even though those cues are not consistently reliable indicators of lying. Research suggests we tend to believe there are obvious signs of deception, but the reality is much more complex. (Sánchez, 2020) ( Psicothema PDF ) In other words, The Traitors doesn’t just show us who can lie convincingly, it shows us how easily humans can misinterpret normal behaviour as suspicious when we’re searching for certainty. Stress changes how people behave — and how we interpret them Life inside the castle is designed to be psychologically intense. There’s isolation, sleep disruption, constant social evaluation, and the ongoing fear of being 'murdered' or banished. In those conditions, stress responses become more visible. The problem is that stress can look like guilt. Someone who is anxious may hesitate, become tense, struggle to find words, avoid eye contact, or seem unusually quiet. But those behaviours can be signs of pressure rather than deception. In real life, this is one reason why “gut instinct” can be misleading: we often mistake anxiety for dishonesty, especially when the situation is emotionally charged. It’s a dynamic that plays out repeatedly in the show. Contestants who appear “off” — too quiet, too intense, too emotional, too controlled — can become targets, even when there’s little evidence to justify it. The more uncertain the environment becomes, the more the group tends to rely on behaviour as “proof”, even when behaviour can have many explanations. Photo Credit: BBC/STUDIO LAMBERT/EUAN CHERRY: The latest series of The Traitors sees 'faithfuls' attempt to expose deceitful 'traitors' at the roundtable First impressions are powerful — and hard to undo From the moment contestants meet, first impressions form rapidly. And once the group begins to label someone as suspicious, that narrative can become extremely difficult to shift. This is where confirmation bias becomes a major psychological force. Once we believe something is true, we naturally start to notice information that supports it and discount information that challenges it. The person who is “quiet” becomes “secretive”. The person who is “confident” becomes “controlling”. The person who is “emotional” becomes “defensive”. Even neutral behaviour gets pulled into the story. A pause becomes a “tell”. A laugh becomes “performative”. A calm response becomes “too calm”. The show repeatedly demonstrates how easily perception becomes reality when evidence is scarce. The Round Table isn’t about truth — it’s about influence The Round Table is one of the most psychologically revealing parts of The Traitors . It looks like a logical debate, but it’s often closer to a social negotiation, where people are balancing suspicion with belonging. Classic social psychology research shows that individuals can be influenced by group opinion even when they privately disagree, especially when standing apart feels risky. Asch’s conformity studies remain some of the most well-known demonstrations of this effect, showing that people will sometimes align with a group consensus even when the group is clearly wrong. ( Asch conformity research summary ) More recent experimental research continues to support the same basic idea: group consensus can shape behaviour even when people know, internally, that something doesn’t feel right. (Mallinson et al., 2018) ( PMC full text ) This helps explain why The Traitors often becomes less about evidence and more about confidence. A persuasive accusation can spread quickly. A dominant theory can become “obvious” within minutes. And once a group begins to move as one, it becomes psychologically difficult to challenge the narrative without putting yourself at risk. What it takes to be a convincing Traitor Playing a Traitor isn’t simply about lying - it’s about sustained performance. Traitors have to manage impressions constantly: what they say, how they react, when they speak, when they stay quiet, who they align with, and how consistent they appear over time. This is psychologically demanding because deception increases cognitive load. Maintaining a false story requires mental effort: remembering details, tracking what’s been said to whom, anticipating questions, and staying emotionally consistent under scrutiny. Research in deception psychology highlights how lying can place extra strain on cognitive resources, particularly when someone is under pressure or needs to sustain deception over time. (Blandón-Gitlin et al., 2015) ( PMC full text ) That strain can show up in ways that look suspicious - pauses, over-explaining, reduced emotional flexibility, irritability, fatigue. Ironically, the effort to appear “normal” can sometimes make someone look less natural. At the same time, the most successful Traitors often understand a key psychological truth: trust is frequently built on warmth and familiarity, not logic. In uncertain environments, people are more likely to trust someone who feels emotionally safe than someone who appears dominant or unpredictable. That’s why the most “obvious” Traitors aren’t always the ones who survive. Why Faithfuls become paranoid (and why it makes sense) Being a Faithful doesn’t mean being safe. Faithfuls can still be 'murdered' by Traitors, banished by the group, or socially isolated if their opinions don’t align with the majority. That creates a constant background threat, and when people feel threatened, they become hyper-alert to social cues. In that state, the brain becomes more likely to interpret ambiguity as danger. Neutral behaviour starts to feel meaningful. Doubt becomes intolerable. Certainty becomes comforting - even when it’s wrong. This is why Faithfuls can end up trapped in a no-win social situation. If they speak too much, they may look controlling. If they stay quiet, they may look evasive. If they become emotional, it’s seen as defensiveness. If they stay calm, it’s seen as coldness. Under pressure, people become judged not just on what they do, but on what others assume their behaviour means. Image credit: BBC: The Traitors UK Promotional still. The real reason The Traitors feels so familiar Even though the show is “just a game”, the emotional experience mirrors everyday life more than we often admit. Many people recognise the same dynamics in workplaces, families, friendships and relationships. We all manage impressions to some degree. We all make judgements with incomplete information. We all want belonging and fear rejection. And under pressure, we’re all capable of becoming more rigid, more reactive, and more convinced than the evidence deserves. This is why The Traitors is so compelling. It exaggerates human psychology, but it doesn’t invent it. It turns everyday social instincts — trust, suspicion, conformity, performance — into something dramatic enough to watch, while still feeling uncomfortably real. What the show can teach us about mental health Watching The Traitors through a mental health lens isn’t about diagnosing contestants or labelling behaviour. It’s about noticing what happens to people when they are isolated, emotionally flooded, sleep-deprived, and constantly evaluated. Stress doesn’t just affect mood — it affects judgement, attention, memory and emotional regulation. Over time, chronic stress can contribute to overwhelm, indecision, irritability and burnout . And for many people, the exhausting “performance” element of the show reflects something familiar: the pressure to seem okay, avoid conflict, not be judged, and not take up too much space. The show also highlights a subtler truth: deception isn’t always malicious. In real life, people may hide the truth because they fear rejection, conflict, shame or misunderstanding. But sustained avoidance of honesty can also create distance and loneliness, because it’s difficult to feel close to someone when you’re constantly editing your reality. When support can help If The Traitors resonates because you recognise similar patterns in your own life — persistent anxiety , social stress, relationship conflict, burnout, or the feeling of constantly being “on” — support can make a real difference. Mental health professionals can help people understand their emotional responses, manage stress more effectively, and navigate difficult relationship dynamics with greater clarity and confidence. At Schoen Clinic Chelsea , we support children, teens and adults with a wide range of mental health concerns through evidence-based psychological therapy and psychiatric care. If you’re struggling, you don’t have to manage it alone. More than a game When you look at the psychology behind The Traitors , it becomes clear that the show isn’t really about “good” or “bad” people — it’s about what stress, uncertainty and group dynamics do to human judgement. The Traitors works because it turns everyday psychology into a spectacle. But the patterns it highlights are real human responses shaped by cognitive bias, social influence, and stress. The show reminds us that when the stakes feel high and the truth feels unclear, people don’t become irrational. They become human. And in the real world, unlike in the castle, you don’t have to carry that pressure without support. Sources & further reading (linked) Bond, C. F., & DePaulo, B. M. (2006). Accuracy of Deception Judgments . Psychological Bulletin .( PubMed ) Sánchez, C. (2020). Do people detect deception the way they think? Psicothema .( Full PDF ) Blandón-Gitlin, I., Fenn, E., Masip, J., & Yoo, A. H. (2015). Cognitive-load approaches to detect deception: Searching for cognitive mechanisms .( PMC full text ) Asch conformity research overview (classic social influence findings).( SimplyPsychology summary ) Mallinson, D. J., Hatemi, P. K., & others (2018). Information, social conformity, and political behaviour(experimental evidence of conformity effects).( PMC full text ) The Traitors – a cultural, and psychological, phenomenon ( https://www.bps.org.uk/psychologist/traitors-cultural-and-psychological-phenomenon ) Podcast explores the Psychology of The Traitors ( https://www.chester.ac.uk/about/news/articles/podcast-explores-the-psychology-of-the-traitors/ ) Written by the Schoen Clinic UK Editorial Team, drawing on expertise from our clinicians to provide accurate and up-to-date mental health information.

Christmas can be stressful at the best of times – but Christmas dinner can be one of the biggest obstacles families have to navigate, especially if a young person has an eating disorder. The Christmas season focuses on food and family get-togethers, so supporting a family member with an eating disorder presents multiple challenges. Common problems include having to eat in front of lots of people, being watched and commenting on eating behaviours. Gill Williams, Nurse and Parent Practitioner at Schoen Clinic has this advice for families at this challenging time of year: “For the person coping with  anorexia  at Christmas, there is likely to be raised anxiety about the abundance of food as well as more pressure to eat with other people and to eat food they might otherwise avoid. Parents are also likely to be feeling the pressure to create a happy, or even perfect day (social media can be particularly unhelpful in this respect). However, it is much better to talk through and acknowledge worries of eating disorders and Christmas as early as possible.” Top Tips and Advice on Navigating Christmas Dinner with an Eating Disorder: Before the Meal - Advice for Parents and Carers:  Talk to the young person beforehand about what they think would make the day a little easier.  The contents and serving size of a meal should be decided in advance. Plate up the young person’s and parent’s food ahead, rather than the stress of having to choose food out of a dish or taking food in front of a lot of people.  Try to sit the parent next to the young person. Gill goes on to say:  “It can be helpful to get together with a child, to think ahead about possible strategies that might help enable them to cope with Christmas pressures. The young person feeling they can manage what’s in front of them depends on point of recovery, but they need to be part of the celebration or what the family do traditionally and what matters to them, preserving the personality of the family. The eating disorder is not welcome. For example, at Newbridge, a couple of weeks before Christmas we do a Christmas rehearsal. So, for the whole day, they’ll eat Christmas food, so they feel ready on Christmas Day and it can be incorporated without being ‘extra’ to the diet plan.” During the Meal - How to Prepare: Play music in the background (because they might be too anxious to converse). Curtail the amount of time you spend on the meal. Don’t make any surprises, (no uncertainty). Initiate topics of conversation as there may be anxiety around managing what’s in front of them and also disrupting the day. Short and sweet with the meal is ideal but do challenge food behaviours as this is best in the long run. Gill says: “Parents have this sense that they’ve done something wrong which is why their child has the eating disorder, and they start beating themselves up. They might compare themselves to other parents and have a loss of confidence in their skills as a carer.   After the Meal: It is normal to want to praise a child but refrain as it can make them feel more shame. Try to have an activity planned afterwards such as a game. Gill says: “The importance here is being together as a family, feeling relaxed and feeling confident. This is the time to be together and not time for the eating disorder to hijack the day. As soon as you’ve argued with a young person, the eating disorder has won. By implementing some of tips I’ve talked about, Christmas day can be far more about family, than food.” _________ About Gill Williams Gill Williams is a Nurse and Parent Practitioner and has expertise in helping patients make the transition between the hospital and home. For specific comment and further information, please contact our Press Office at ukmarketingmarketing@schoen-clinic.co.uk

Losing someone or something important can shake the foundations of your life. Grief is a natural response to that loss, not an illness, but it can feel overwhelmingly like depression. For some people, grief and depression happen at the same time, making it hard to know what’s “normal” and when to seek help. This article explains what we mean by depression and grief , how they overlap and differ, and what effective treatment and support can look like. It’s for anyone grieving themselves, or supporting a friend, partner or family member. If you’re struggling with grief, low mood or thoughts of self-harm, you deserve support. This article is information only and not a diagnosis. If you’re worried about your safety, please seek urgent help via 999 or your local emergency services. What is depression? Depression is more than feeling sad or “low” for a few days. Clinical depression is a recognised mental health condition, usually defined by: Persistently low mood and/or loss of interest and pleasure in most activities Lasting at least two weeks Significant impact on day-to-day functioning (work, relationships, self-care). People may also experience: Changes in sleep (too much or too little) Changes in appetite or weight Fatigue and low energy Poor concentration or indecisiveness Feelings of worthlessness or excessive guilt Thoughts that life is not worth living, or suicidal thoughts UK guidelines (NICE NG222) describe a spectrum from less severe depression to more severe depression, and recommend different treatment options depending on severity and patient preference. What is grief? Grief is the emotional, physical and cognitive response to loss, most often the death of someone we love, but also relationship breakdown , serious illness, job loss or other major life changes. Common experiences of grief include: Intense sadness, yearning or longing for the person who has died Waves of emotion that come and go (sometimes unexpectedly) Crying, anger or irritability Difficulty concentrating, forgetfulness, feeling in a “fog” Physical sensations like tightness in the chest, stomach upset, fatigue or aches. There is no “right” way to grieve. Reactions vary widely depending on personality, culture, relationship to the person who died, previous mental health and life circumstances. Many people find that over months, the raw pain becomes less constant, and they’re able to re-engage with life while still carrying feelings of loss and love. Grief vs depression: how are they different? Grief and depression share many features: sadness, crying, sleep problems, poor concentration, and low energy, which is why they are easy to confuse. But clinicians look for several key differences: 1. Focus of thoughts and feelings In grief , thoughts are usually centred on the person who has died or what has been lost – memories, regrets, longing, and questions like “Why did this happen?” In depression , thoughts are often more self-critical and pessimistic: “I’m worthless”, “Things will never get better”, “Everyone would be better off without me.” 2. Emotional pattern Grief often comes in waves or “pangs” triggered by reminders (dates, photos, places). In between, people may still feel moments of relief, humour or even pleasure, especially when supported by others. Depression tends to create a more persistent low mood and loss of interest, with fewer genuine breaks or positive experiences. 3. Self-esteem In grief, self-esteem is usually preserved – you may feel sad, lonely or guilty about specific things, but you don’t necessarily feel fundamentally “worthless.” In depression, feelings of worthlessness and excessive, global guilt are common and often central. 4. Suicidal thinking Grieving people sometimes think “I wish I could be with them” without active plans to end their life. Depression is more likely to involve active suicidal thoughts, plans or intentions, and may not be tied only to the person who died. Importantly, grief and depression can co-exist . After a major loss, some people develop a full depressive episode alongside their grief. In that case, treating the depression can help them engage more fully in grief work and daily life. Prolonged or complicated grief For many people, grief gradually becomes less disabling over months. But a minority experience severe, persistent grief that doesn’t ease with time and significantly impairs their life. This has been recognised in diagnostic manuals as Prolonged Grief Disorder (PGD) . In the latest versions of ICD-11 and DSM-5-TR, PGD involves: Intense, persistent yearning or preoccupation with the deceased Lasting at least 6 months or 12 months after the loss Significant impairment in social, occupational or other important areas of functioning. People with prolonged or complicated grief may feel “stuck”, unable to imagine a future, or unable to engage in life without overwhelming guilt. It is more likely after sudden, traumatic or multiple losses, or where the relationship was very close or complicated. When should you seek help? Grief does not have a time limit, but it is reasonable to seek professional support if: You are struggling to function at work, in education or at home Your grief is not easing at all after many months, or feels like it’s getting worse You avoid all reminders of the loss, or feel numb and disconnected from life You’re using alcohol, drugs, gambling or other behaviours to cope and feel out of control You have persistent feelings of worthlessness or hopelessness You experience suicidal thoughts, plans or self-harm urges. Seeking help is not a sign that you’re “grieving wrong” – it’s a way of looking after yourself in an extremely difficult time. Don't hesitate to reach out to the team at Schoen Clinic Chelsea if you are ready to seek support. Evidence-based treatments for depression and grief For depression NICE guidelines for adults recommend a range of evidence-based treatments depending on severity and personal preference, including: Guided self-help based on cognitive behavioural therapy (CBT) Individual talking therapies (for example CBT, interpersonal therapy or counselling) Group-based therapies Antidepressant medication where appropriate, usually for moderate to severe depression or when psychological therapies alone are not enough Combined approaches (therapy plus medication) in more severe or recurrent depression. More complex or treatment-resistant depression may require specialist interventions delivered within multidisciplinary teams. For grief and prolonged grief Support for grief can include: Bereavement counselling or grief-focused psychotherapy CBT-based approaches adapted for grief Meaning-centred therapies and narrative approaches Group support and peer support, which many people find helpful for feeling less alone. Research suggests that targeted, structured therapies designed specifically for prolonged grief can significantly reduce symptoms and improve functioning. Where grief and depression overlap, clinicians will usually work out an integrated plan – for example, treating major depression alongside grief-focused work, or addressing PTSD symptoms if the loss was traumatic. Self-help and coping strategies While professional support can be vital, everyday strategies also make a difference: Stay connected: keep in touch with people you trust, even if it’s just brief check-ins. Maintain simple routines: regular meals, sleep and movement can provide a basic structure when everything else feels chaotic. Express yourself: talking, journaling, creative activities or rituals (such as visiting a special place) can help process emotions. Look after your body: gentle movement, balanced food and limiting alcohol or drugs can support both mood and physical health. Take grief at your own pace: there is no timetable for clearing cupboards, returning to work or “moving on.” If self-help isn’t enough or you feel stuck, that’s a sign to reach out – not a failure. How Schoen Clinic Chelsea can support you At Schoen Clinic Chelsea in London , our multidisciplinary team of psychiatrists, psychologists, psychotherapists and allied health professionals supports adults experiencing depression, complex grief and other mental health difficulties. We can offer: Comprehensive assessments to differentiate grief, depression and other conditions Evidence-based psychological therapies adapted to your needs Psychiatric input, including careful consideration of when medication may be helpful Support for co-occurring issues such as anxiety, trauma or burnout A compassionate, confidential space to talk about loss, meaning and rebuilding life. If you are struggling with depression and grief and would like specialist private support, you can contact Schoen Clinic Chelsea to arrange an initial assessment or find out more about our outpatient services. Support is also available via your GP and NHS mental health services if you prefer an NHS pathway. You do not have to face grief or depression alone – help is available, and it is okay to ask for it. Written by the Schoen Clinic UK Editorial Team, drawing on expertise from our clinicians to provide accurate and up-to-date mental health information. References [1] NICE Clinical Knowledge Summary – Depression. https://cks.nice.org.uk/topics/depression/ [2] NICE Guideline NG222 – Depression in adults: treatment and management. https://www.nice.org.uk/guidance/ng222 [3] NHS – Get help with grief after bereavement or loss. https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/grief-bereavement-loss/ [4] Mind – What does grief feel like? https://www.mind.org.uk/information-support/guides-to-support-and-services/bereavement/experiences-of-grief/ [5] Zisook S, Shear K. Bereavement and depression – what psychiatrists need to know. Psychiatric Times / Dialogues Clin Neurosci . https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2691160/ [6] American Psychiatric Association – Major Depressive Disorder and the “Bereavement Exclusion” (DSM-5). https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM-5-Depression-Bereavement-Exclusion.pdf [7] American Psychiatric Association – Prolonged Grief Disorder. https://www.psychiatry.org/patients-families/prolonged-grief-disorder [8] Cruse Bereavement Support – Complicated and prolonged grief https://www.cruse.org.uk/understanding-grief/effects-of-grief/complicated-grief/ [9] NHS Inform – Bereavement and grief self-help guide. https://www.nhsinform.scot/illnesses-and-conditions/mental-health/mental-health-self-help-guides/bereavement-and-grief-self-help-guide/ [10] Szuhany KL et al. Prolonged grief disorder: course, diagnosis, assessment and treatment. Focus (Am Psychiatr Publ) , 2021. https://psychiatryonline.org/doi/full/10.1176/appi.focus.20200052 [11] NHS – Mental health services: how to get help. https://www.nhs.uk/nhs-services/mental-health-services/

Why therapy for sexual trauma matters Sexual trauma can have profound, long-lasting effects on emotional wellbeing, self-esteem, relationships, and physical safety. Survivors may struggle with intrusive memories, dissociation, shame, anxiety, hypervigilance, relationship difficulties or identity disruption. Many of these symptoms align with Post-Traumatic Stress Disorder (PTSD) or Complex PTSD (CPTSD), conditions commonly linked with sexual assault or abuse. ( NICE guidance ) At Schoen Clinic Chelsea in London, we provide compassionate, evidence-based therapy designed to help survivors begin healing, rebuild trust, and reclaim control over their lives. Therapy for sexual trauma offers structured pathways to recovery. Working with a trained trauma specialist can help survivors: Understand trauma responses and their origins Reduce the intensity of intrusive memories and triggers Rebuild safety, identity, and trust Process shame, guilt, fear, or self-blame Improve emotional regulation and interpersonal relationships What does effective therapy for sexual trauma involve? Evidence-based trauma treatments According to the National Institute for Health and Care Excellence (NICE), the primary treatments recommended for PTSD — including trauma resulting from sexual assault — are Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) and Eye Movement Desensitisation and Reprocessing (EMDR) . ( NICE guidance ) Trauma-Focused CBT (TF-CBT) A structured psychological therapy that helps survivors understand how trauma affects thoughts, feelings, and behaviour. TF-CBT helps individuals challenge negative beliefs (such as self-blame) and develop coping strategies — and has shown long-term symptom reduction across age groups. ( National Library of Medicine ) Eye Movement Desensitisation and Reprocessing (EMDR) EMDR uses bilateral stimulation to help the brain reprocess distressing memories, reducing emotional intensity and physical reactivity. EMDR is widely used for trauma, with strong clinical evidence supporting its effectiveness. ( NHS ) NHS guidance notes that trauma-focused therapies like TF-CBT and EMDR are typically delivered over 8–12 weeks but may continue longer if symptoms are complex or if trauma occurred in childhood. ( NHS ) A trauma-informed, survivor-centred approach Effective therapy for sexual trauma goes beyond symptom reduction. Survivors often struggle with trust, identity, intimacy, and relational dynamics. A trauma-informed therapist acknowledges how trauma affects body, mind and relationships, avoids re-traumatisation, and works at a pace dictated by the survivor. This approach is central to the treatment philosophy at Schoen Clinic Chelsea. Is it too late to seek help? Absolutely not. Evidence demonstrates that trauma-focused therapies remain beneficial irrespective of how long ago the trauma occurred — including events in childhood or adolescence. ( National Library of Medicine ) Many survivors do not seek support until years later, and therapy can still offer meaningful change, stability, and closure. Schoen Clinic Chelsea is here to help Located in Chelsea, London, Schoen Clinic Chelsea offers discreet, specialist trauma services designed to support survivors of sexual trauma. Our approach includes: Experienced trauma clinicians trained in EMDR, TF-CBT, and integrative approaches Safe, confidential spaces for processing trauma at the right pace Person-centred, evidence-based treatment plans Support for co-occurring difficulties such as anxiety, depression, relational trauma, or dissociation Access to a multidisciplinary private mental health team For individuals seeking therapy for sexual trauma in Chelsea, London, our clinic provides professional, high-quality care grounded in research and clinical best practice. The therapy journey at Schoen Clinic Chelsea Initial Assessment: A clinician explores trauma history, symptoms, coping strategies, and goals. Stabilisation & Psychoeducation: Understanding trauma responses (e.g., hyperarousal, self-blame) and developing grounding skills. Trauma-Focused Work: Using TF-CBT, EMDR or integrative psychotherapy to reprocess traumatic memories and reduce distress. Reintegration: Improving self-esteem, intimacy, relationships, emotional regulation and trust. Aftercare & Relapse Prevention: Planning for triggers and consolidating therapeutic gains. FAQs Is therapy effective if the trauma happened a long time ago? Yes. Research demonstrates that trauma-focused therapy can significantly reduce symptoms even years or decades later [6]. Do I need to revisit traumatic details? Not always. EMDR, for example, supports reprocessing without prolonged retelling. Is this service only for women? No. Sexual trauma affects all genders, and our clinical services are inclusive and confidential. Find support today Sexual trauma can leave deep emotional, psychological, and physical scars — but healing is possible. With safe, compassionate, trauma-informed therapy, survivors can reclaim agency, rebuild identity, and step forward with renewed confidence. If you’re seeking therapy for sexual trauma in Chelsea, London, contact Schoen Clinic Chelsea today to arrange a confidential initial assessment and start your journey toward recovery. Written by the Schoen Clinic UK Editorial Team, drawing on expertise from our clinicians to provide accurate and up-to-date mental health information.

Depression is a complex mental health condition that can affect mood, energy, sleep, concentration, appetite, self-esteem and overall quality of life. For many people, alongside talking therapies and lifestyle support, medication in the form of antidepressants can play a vital role. In this article, we explain what antidepressants are, the different types, when they may be prescribed, and what to know about possible benefits and side effects. Contact us today if you need support for depression. What are antidepressants — and how do they help? Antidepressants are a class of medications designed to alter brain chemistry, often by affecting neurotransmitters associated with mood regulation, to help relieve symptoms of depression and improve emotional wellbeing. They are not a “cure” in themselves, but can help reduce the severity of depressive symptoms, restore interest in daily life, improve energy and motivation, and support engagement in therapy or other recovery strategies. Whether to prescribe an antidepressant depends on several factors, including the severity of depression (mild, moderate, severe), previous history of mental health episodes, personal preference, and response to other interventions. Main types of antidepressants There are several classes of antidepressants. Which one is chosen depends on the individual’s symptoms, medical history, possible interactions, and side-effect profile. Selective serotonin reuptake inhibitors (SSRIs) These are among the most commonly prescribed antidepressants and are often first-line due to relatively favourable tolerability. ( nhs.uk ) SSRIs increase serotonin levels in the brain, which can help improve mood, anxiety , sleep, and appetite regulation. Typical medications in this group include those commonly prescribed for depression and some anxiety disorders. Serotonin–noradrenaline reuptake inhibitors (SNRIs) and other newer antidepressants SNRIs work on both serotonin and noradrenaline systems, which may benefit people whose depression includes low energy, lack of motivation or chronic pain components. ( National Library of Medicine ) Other modern antidepressants may affect multiple neurotransmitter systems or have slightly different mechanisms — selection depends on symptoms and individual factors. Tricyclic antidepressants (TCAs) and older medications TCAs are an older class, less commonly used as first-line now because they tend to have more side effects and less favourable safety profile compared with newer drugs. ( HSE ) They may still be considered in certain cases, e.g., when newer medications are ineffective or if there are specific symptom patterns. When are antidepressants usually prescribed for depression Antidepressants may be recommended when: Depression is moderate to severe, significantly impacting daily functioning or quality of life. Previous treatments (therapy, lifestyle, social support) have not led to sufficient improvement or aren’t feasible on their own. There is a recurrence of depressive episodes or ongoing risk factors that make longer-term treatment more appropriate. Treatment should always involve shared decision-making : the patient and clinician discuss benefits and risks, consider the person's preferences and medical history, and agree on a treatment plan. Once started, antidepressants are usually reviewed regularly. In many cases, they are continued for at least 6 months after symptom improvement; for recurrent depression, longer-term use may be considered. ( NHS ) Specialist Pharmacy Service What to expect — benefits and timeline Some people begin to notice improvements (better mood, sleep, energy, interest) within 2–4 weeks , though full effect often takes longer. Medication can make therapy, daily activities and recovery more manageable by stabilising mood enough that other treatments (talking therapy, lifestyle changes) become more effective. Antidepressants may help reduce relapse risk when depression has recurred, when psychosocial factors remain, or when stressors continue. Possible side effects and risks Because antidepressants affect brain chemistry, they can produce side effects, which vary depending on the class of medication and the individual. Most are mild and may ease over time; some persist or require changing medication. Common side effects include: Nausea, digestive problems, dry mouth, dizziness Sleep disturbances (insomnia or drowsiness), fatigue Headaches, blurred vision, sweating changes Changes in appetite or weight, weight gain or loss Sexual side effects (reduced libido, erectile difficulties, difficulty achieving orgasm) — especially with SSRIs. Less common but more serious risks (which need monitoring) may include: Emotional changes: irritability, increased anxiety, mood changes, in rare cases activation of suicidal thoughts or behaviour, especially earlier in treatment or in younger people. ( GOV ) Withdrawal or discontinuation symptoms if medication is stopped too quickly — so tapering under supervision is often recommended. Rare physiological effects: changes to sodium levels or other side effects depending on the drug class and the person’s health history. Because of varying responses, it's common for prescribers to start with an SSRI and, if side effects are problematic or symptoms persist, adjust the dose or switch to a different class or medication. How antidepressants fit into a broader care plan Medication alone is rarely the full answer. Best practice combines antidepressants with: Psychological therapies (talking therapy, CBT , trauma-informed therapy ) Lifestyle changes: regular exercise, healthy sleep, balanced nutrition , social connection Monitoring and review: regular check-ins with GP or mental health professional , especially when starting, adjusting or stopping medication Person-centred planning: considering patient preferences, history, comorbidities, and risk factors At Schoen Clinic Chelsea , this holistic approach can be tailored to the individual, blending medication, psychotherapy, and supportive care in a confidential, flexible setting. Practical advice if you or someone you know is prescribed antidepressants Ask your prescriber what to expect: likely benefits, possible side effects, average timeline for improvement Keep a simple log or diary for the first weeks: mood, sleep, appetite, side effects — this helps with follow-up reviews Never stop or change dose suddenly without consulting a clinician — gradual tapering may be needed to avoid withdrawal effects Combine medication with therapy and healthy habits — antidepressants are most effective when part of a wider recovery plan If you experience serious side effects (e.g., severe mood changes, suicidal thoughts, physical symptoms), contact a GP or mental health professional immediately Antidepressants: useful tools, not magic bullets Antidepressants for depression can be effective, evidence-based tools to help relieve symptoms, improve mood, and support recovery. They are most helpful when used as part of a broader, tailored treatment plan, ideally combining medication, therapy, lifestyle support, and regular review. They are not a quick fix, and their benefits must be weighed against possible side effects. A thoughtful, shared decision-making process between patient and clinician is vital. If you or someone you know is considering antidepressants, or is already on them and has questions, a professional mental health clinic, such as Schoen Clinic Chelsea , can offer assessment, guidance, monitoring and support every step of the way. Written by the Schoen Clinic UK Editorial Team, drawing on expertise from our clinicians to provide accurate and up-to-date mental health information.

Understanding the differences between autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) is essential for parents seeking clarity about their child’s neurodevelopmental health. Both conditions can affect behaviour, communication and attention, but they present in different ways and require different approaches to assessment and support. It’s also important to know that a diagnosis is not always straightforward. Symptoms associated with autism or ADHD can overlap with each other and can also be caused by other medical, developmental or neurological conditions. In this article, Consultant Paediatrician Dr Joe Datt explains the key differences and overlapping traits of autism and ADHD, helping parents make more informed decisions about their child’s care. What are Autism and ADHD? Autism Spectrum Disorder (ASD) Autism is a neurodevelopmental condition that affects: Social interaction Communication Flexibility of behaviour Sensory processing Children with autism may struggle with social cues, forming friendships, adapting to change or managing sensory input. They may have highly focused interests or repetitive behaviours. Attention Deficit Hyperactivity Disorder (ADHD) ADHD impacts: Attention Impulsivity Hyperactivity Children with ADHD may find it difficult to concentrate, stay seated, follow instructions or control impulses. These challenges often affect school performance and social relationships. Key differences between Autism and ADHD 1. Social interaction Autism: Children with autism often find social interactions difficult. They may avoid eye contact, struggle to read facial expressions or find it challenging to understand others’ emotions. They may prefer solitary activities. ADHD: Children with ADHD usually want social interaction but may find it difficult to maintain friendships due to impulsivity, interrupting others or finding it hard to take turns. 2. Communication and language development Autism: Common features include speech delays, atypical tone of voice, echolalia (repeating phrases) and difficulty understanding non-literal language. ADHD: Children with ADHD typically develop language on time but may interrupt conversations, speak quickly or talk excessively because of impulsivity. 3. Attention and focus Autism: Children may focus deeply on a single interest for long periods but struggle to shift attention to new tasks. ADHD: Attention tends to be inconsistent and short-lived. Children may become distracted easily and move between tasks without finishing them. 4. Repetitive behaviours vs impulsivity Autism: Repetitive behaviours, such as hand-flapping or lining up objects, are common. Changes to routine may cause distress. ADHD: Impulsivity is more prominent—acting without thinking, taking risks, or interrupting others. Overlapping symptoms of Autism and ADHD Some behaviours occur in both conditions, which can make diagnosis more complex: Difficulty concentrating High energy levels Trouble following multi-step instructions Sensory sensitivities or aversions Emotional regulation challenges While the underlying reasons differ, outward behaviours can appear similar. How to differentiate between Autism and ADHD Because symptoms can overlap, a specialist assessment is essential. At Schoen Clinic Chelsea, Dr Joe Datt conducts comprehensive neurodevelopmental assessments that evaluate a wide range of possible explanations—not just autism or ADHD. Dr Joe Datt, Consultant Paediatrician A real case example from Dr Joe Datt “Misdiagnosis can happen when we focus too narrowly on autism or ADHD without considering other possible explanations,” says Dr Datt. “I once assessed a 16-year-old boy who was thought to have ADHD because he was zoned out in class. After a full evaluation, we discovered he had undiagnosed epilepsy and was experiencing absent seizures rather than ADHD symptoms. I’ve also seen children thought to have autism when the real underlying cause was dyslexia. Taking a broad view is essential.” Dr Datt explains that rare genetic conditions, sleep disorders and other neurological issues can also mimic autism or ADHD—highlighting the importance of a thorough assessment. Key questions parents can ask themselves These questions offer a starting point, but they should not replace assessment from a specialist: Does my child struggle with social cues or non-verbal communication? (More likely autism) Is my child impulsive or acting without thinking? (More likely ADHD) Does my child become extremely distressed when routines change? (More likely autism) Can my child focus intensely on one interest for long periods? (More likely autism) Does my child frequently get distracted and switch tasks quickly? (More likely ADHD) Getting a diagnosis in Chelsea, West London If you suspect autism or ADHD, an early assessment can help your child access support sooner. At Schoen Clinic Chelsea, neurodevelopmental assessments with Dr Joe Datt include: A detailed parental interview and developmental history Behavioural observations Standardised assessment tools Collaboration with schools, therapists or other professionals This ensures a comprehensive and accurate diagnosis. Treatment and support options Autism and ADHD require different management strategies, but early intervention helps children develop essential skills and improve long-term outcomes. Autism support strategies Speech and language therapy Occupational therapy for sensory needs and motor skills Structured routines to reduce anxiety ADHD management strategies Behavioural therapy Medication when clinically appropriate Visual schedules and organisational tools Supporting your child’s journey Whether your child has autism, ADHD or overlapping traits, understanding their unique profile is key. With the right support, children can build confidence, develop new skills and thrive in school, friendships and everyday life. If you are in Chelsea, West London or Greater London and are concerned about your child’s development, we offer: General paediatric consultations Autism assessments ADHD assessments Combined assessments with Dr Joe Datt Contact us today to learn more about how we can support your child’s journey to better health and wellbeing. This page was reviewed by Dr Joe Datt on 14/04/2025.

Anorexia nervosa (often referred to as anorexia) is a complex and widely misunderstood eating disorder that affects people of all ages, genders and backgrounds. At Schoen Clinic Chelsea , we provide specialist, evidence-based treatment to help individuals and families navigate this condition with clarity and support. In this article, we answer the most common questions about anorexia, including symptoms, causes, diagnosis and treatment. If you or someone you love needs specialist anorexia treatment in London, our caring team is here to help. If you need specialised treatment for anorexia, please don't hesitate to contact our caring team . What is anorexia? Anorexia is a serious eating disorder involving self-starvation, an intense fear of weight gain and a distorted perception of body shape or size. It most commonly begins in adolescence, but it can develop at any stage of life. People with anorexia often: Believe they are overweight, even when underweight Restrict food intake or avoid eating in front of others Develop strict food rules or rituals Prepare meals for others while refusing to eat themselves Engage in excessive exercise to control weight Early intervention is linked with better outcomes. Without timely support, anorexia can become harder to treat and may lead to significant physical and psychological complications. What causes anorexia? There is no single cause of anorexia nervosa. Instead, a combination of biological, psychological and social factors contribute to its development. These factors can be grouped into three categories: Predisposing factors – increased vulnerability (e.g., family history, personality traits, genetics) Precipitating factors – triggers for onset (e.g., dieting, stress, trauma, social pressures) Perpetuating factors – elements that maintain the disorder (e.g., anxiety relief through restriction) Contributing influences can include: Genetics or family history of eating disorders, anxiety or depression Chemical and hormonal changes Early developmental differences Family dynamics or stressful life events Social pressures around appearance or weight People with anorexia may withdraw from others and often experience co-occurring conditions such as anxiety, OCD or depression . What are the signs and symptoms of anorexia? Signs and symptoms may include: Significant weight loss Restricting food intake or skipping meals Intense fear of weight gain Distorted body image Hair loss, fatigue and difficulty concentrating Feeling cold, dizzy or unwell Irritability, anxiety or depression Anorexia has one of the highest mortality rates of any mental health condition, making early treatment essential. Is anorexia a choice? No. Anorexia is not a choice. It is a complex mental health condition—not a lifestyle decision or a desire for attention. Misunderstandings and stigma can make it harder for individuals to seek help. Many people do not realise they have developed anorexia until the behaviours are deeply ingrained and difficult to change without treatment. Who does anorexia affect? Anorexia can affect: Children Teenagers Adults Any gender, culture, race or background While anorexia is more commonly diagnosed in girls and women aged 12–25, boys, men and older adults can also develop the condition. Symptoms in younger children can be overlooked due to natural developmental changes. Anorexia impacts not only the person experiencing it, but also their family, friends and wider support network. How is anorexia diagnosed? Diagnosis is carried out by a psychiatrist or qualified mental health professional. Because anorexia often begins in adolescence, family members, teachers or peers may notice early signs. A full medical evaluation is essential to rule out other conditions and assess physical health. Early detection and treatment reduce the risk of long-term complications. What is the difference between anorexia and other eating disorders? Eating disorders such as bulimia, binge eating disorder and OSFED involve harmful patterns of eating and exercise. Key differences: Anorexia : restriction of food intake leading to low weight Bulimia : cycles of binge eating followed by compensatory behaviours Binge eating disorder: recurrent binge episodes without purging OSFED: disordered eating that causes distress but doesn’t meet full diagnostic criteria Some people experience more than one eating disorder over their lifetime. Treatment can support recovery regardless of type. What are the long-term effects of anorexia? Without specialist treatment, anorexia may lead to: Loss of menstruation or infertility Bone weakness and osteoporosis Hair, skin and dental issues Seizures Heart complications Kidney problems Organ failure Increased risk of death Early intervention significantly reduces the risk of long-term harm. How can I prevent anorexia from developing in my child? There is no proven method to prevent anorexia, but early awareness helps. You can support your child by: Encouraging a healthy attitude toward food and body image Modelling balanced eating behaviours Seeking help early if concerns arise Prompt intervention can improve outcomes and support healthy development. How can I help my child if they have anorexia nervosa? If you are concerned about your child, speak with your GP or a specialist as soon as possible. You can also help by: Taking part in family therapy Providing reassurance and emotional support Involving their school and healthcare team Seeking counselling for yourself if needed Connecting with other parents facing similar challenges At Schoen Clinic Chelsea, our multidisciplinary eating disorder team includes Consultant Psychiatrists, psychologists, therapists, dietitians and occupational therapists. Your child’s treatment plan will be based on their specific needs and the severity of their anorexia. Support at Schoen Clinic Chelsea At Schoen Clinic Chelsea , we provide compassionate, specialist outpatient treatment for anorexia in both children and adults. Our multidisciplinary teams work closely with individuals and families, offering personalised care every step of the way. If you or your child needs support, our team is here to help you begin the recovery journey.

How do I know if I'm being gaslit? In today's fast-paced and interconnected world, relationships play a crucial role in our mental and emotional wellbeing. Whether it's with friends, colleagues, romantic partners, or family members, all relationships have the potential to experience toxic traits. It's important to recognise that toxic behaviour can manifest in any relationship regardless of sexual orientation, gender, or the nature of the relationship. Gaslighting, for example, is a form of emotional abuse that can occur in any relationship, and it's essential to understand that it's not always easy to recognise. It involves one person manipulating the other into questioning their sanity, memory, or perception of reality. This can lead the victim to feel paranoid, confused, and emotionally drained. Gaslighting tactics can include denying events that have occurred, shifting blame onto the victim, trivialising the victim's emotions, and creating doubt about the victim's memories. In this blog post, we'll delve into some of the typical signs of toxic relationships and offer insights on how to break free should you find yourself in the thralls of a toxic relationship. Identifying toxic traits in your relationship 1. Lack of respect In toxic relationships, there is often a lack of mutual respect between partners. Your partner may demean or belittle you, leaving you experiencing feelings of worthlessness or inadequacy. 2. Control and manipulation Toxic relationships are often characterised by controlling and manipulative behaviours. Your partner may try to control your actions, emotions, or decisions. This creates a sense of power imbalance and dependency. You often feel confused, disoriented, or unable to make decisions, even about simple things. 3. Constant criticism Criticism is a natural part of any relationship, but in a toxic one, criticism becomes relentless and destructive. Constant criticism will eventually make you feel insecure and like you can't ever get things right. You experience a significant drop in self-esteem, often feeling unworthy or incompetent. 4. Gaslighting Recognising gaslighting can be challenging because it's a form of psychological manipulation designed to make you doubt your perceptions, memories, and reality. You frequently second-guess yourself and question your perceptions or memories. You feel like you’re “going crazy” or overly sensitive. The gaslighter dismisses your feelings, thoughts, or experiences, often making you feel that your concerns are invalid or unimportant. The person may frequently contradict themselves or deny saying things you know they said. They might change narratives or events to confuse you. The person may undermine your confidence in your abilities, making you doubt your competence and self-worth. 5. Isolation In toxic relationships, one partner may try to isolate the other from friends, family, and support networks, making it harder for you to get an outside perspective. This isolation can lead to increased dependence on the toxic partner and a sense of alienation from others. Extended periods of isolation from your friends and loved ones could lead you to feelings of depression . 6. Unpredictable mood swings In a toxic relationship, one partner may exhibit unpredictable mood swings and emotional outbursts, creating an environment of fear and unease for the other partner. In these cases, it's natural for you to have a heightened sense of anxiety as you never know what to expect, you always feel as though you're walking on eggshells. 7. Lack of accountability Toxic partners often refuse to take responsibility for their actions and may shift blame onto their partners, creating a cycle of guilt and self-doubt. You find yourself constantly apologising for things you didn’t do or for things that shouldn’t require an apology. 8. Unhealthy communication patterns Communication in toxic relationships is often marked by defensiveness, stonewalling, and a lack of empathy. This can lead to misunderstandings and unresolved conflicts, further deteriorating the relationship. You feel like you constantly need to defend yourself against accusations or criticisms, even if you’re not sure what you did wrong. Breaking Free From a Toxic Relationship 1. Trust your feelings Pay attention to your feelings and instincts. If something feels off, it probably is. 2. Seek professional help It's important to seek support from a mental health professional who specialises in relationships and mental wellbeing. They can provide valuable insights and support as you navigate the process of breaking free from a toxic relationship. 3. Establish boundaries Setting clear boundaries is crucial when trying to break free from a toxic relationship. This may involve limiting contact with the toxic individual and surrounding yourself with a support network of friends and family. 4. Focus on self-care Engaging in self-care activities such as exercise, meditation, and hobbies can help restore a sense of balance and self-worth. Prioritising self-care is essential for rebuilding confidence and resilience. 5. Reflect and heal Take the time to reflect on the relationship and its impact on your mental health. Healing from a toxic relationship may involve processing emotions, seeking closure, and working through any trauma experienced during the relationship. Here at Schoen Clinic, our team of mental health specialists in London understands the complex dynamics of toxic relationships and is dedicated to supporting individuals in breaking free from them. We offer one-to-one mental health therapy for a range of conditions including, resilience and self-esteem , depression , emotional trauma and more . We also provide couples counselling and relationship therapy with a number of our specialists, as well as specialised group therapies for social support. Please don't hesitate to contact our team today if you need support. If you or someone you know is struggling in a toxic relationship, we encourage you to seek professional guidance and support. Remember, your mental wellbeing is paramount, and it's okay to seek help in navigating challenging relationship dynamics.