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University is an exciting time, but it can also exacerbate mental health problems Going to University is a major life transition and such transitions, although often exciting, can also come with understandable feelings of stress, fear and anxiety. Starting university is typically at a time when we’re developing into adulthood and taking on new roles and responsibilities. This can be a challenging time alongside the pressures to perform both academically and socially, and many can find it hard to adapt. If you need support, please don't hesitate to contact our team today. 37% of first year students showed moderate to severe symptoms of depression It’s understandable that students may be more vulnerable to experiencing difficulties with their mental health and well-being given they’re likely for the first time living away from home and dealing with the stresses of adult life, pressures that have been added to with the pandemic and restrictions. One survey conducted by the Office for National Statistics (ONS) in the summer of 2021 found that 37% of first year students showed moderate to severe symptoms of depression. The majority of mental health disorders have been found to develop before the age of 24 years old (Kessler et al., 2005), and students are a group at high risk of developing mental health difficulties. Getting support early is important to help prevent and alleviate longer term mental health problems. If you’re noticing experiences like withdrawing from your lectures or from seeing friends and family, struggling with motivation and concentration, struggling with sleep and eating, feeling low in mood, lacking in energy, tearful, on edge, feeling bad about yourself, having thoughts about harming yourself, using alcohol or drugs to feel better, then these may be signs to reach out for support. It can be helpful to find out support your university has available. Outside of university, you can speak to your GP and it can be helpful to let friends and family know what you’re experiencing. There are a number of charitable organisations that offer advice and support, including Student Minds, SHOUT,CALM, SANE, Papyrus, and Samaritans. Why am I so stressed at university? There could be any number of reasons as to why you might feel stressed at university. For many new students living on campus, the transition might be the first time living away from home. For others, the freedom and self-sufficiency might feel overwhelming. Building your own daily structure around courses or lectures, managing your time efficiently, meeting so many new people and trying to make friends can all be incredibly daunting. Where some people thrive in situations like these, others can find the experience hectic and struggle to adapt to the change. Students can put a lot of pressure on themselves to fit in with their peers. It's a time for expression and self-exploration, and along with the freedom of living away from home, you're also opened up to situations or environments you may not be used to. In trying to fit in, there's the potential to succumb to peer pressure, but it's important to note that if you aren't comfortable with something you can always say 'no'. University is of course also about learning. Students need to apply themselves, deliver coursework and commit to deadlines. The amount of work required will be a large step-up from previous education and the pressure to keep on top of your workload will have an impact on your stress levels. Signs and symptoms of anxiety Feeling restless, wound-up, or on-edge. Being easily fatigued. Having difficulty concentrating. Being irritable. Having headaches, muscle aches, stomachaches, or unexplained pains. Difficulty controlling feelings of worry. Having sleep problems, such as difficulty falling or staying asleep. If you feel you need further support, then it can be helpful to consider psychological treatments. At Schoen Clinic Chelsea we offer an intensive treatment programme, consisting of a range of therapy groups, individual therapy and medical reviews if needed. Students who have been through our treatment programme have typically sought help for difficulties around low self-confidence/self-esteem, relationship difficulties, anxiety and worry, low mood, self-harm, eating problems, procrastination, and perfectionism. They have often had these difficulties for several years but they have been exacerbated with the pressures of student life. An intensive treatment approach can benefit by supporting people to make further or faster progress, help them to understand how their life experiences have shaped their current difficulties and what’s keeping the problems going, and develop a wide range of coping skills. “The way the groups are organised is brilliant and the many different topics we cover means that just about every issue I have had has been addressed in at least one of the groups.” - Patient feedback, Mental Health Treatment Programme at Schoen Clinic Chelsea Find treatment for anxiety and mental health conditions in London Following an assessment to find out about your current problems and what you want to gain from treatment, you can expect to meet regularly with a key worker, who will work with you to develop a treatment plan and support you as you progress through your therapy. Learn more about our mental health treatment programme here, alternatively you can call and speak to our Private Enquiries Manager at no obligation, on 020 3146 2300, or send an email to che-privateenquiries@schoen-clinic.co.uk Written by Dr Sarah Perkins, Clinical Psychologist at Schoen Clinic Chelsea If you or someone you care about is experiencing a mental health problem, our specialists are here to help. Contact us today.

In recent years, we’ve seen a rise in conversations about eating disorders and whilst raising awareness is a good thing, there is one aspect that too often gets ignored – men. Men are suffering from eating disorders too, yet these issues are often dismissed as a ‘girl thing’ or even passed off as ‘a phase’. In reality, toxic body standards can have serious consequences for men just like they do women: intense anxiety around food and exercise, obsessive thoughts about weight-loss or gaining muscle mass (known as muscle dysmorphia or ‘bigorexia’), disordered eating behaviours, substance use, depression from comparing oneself to images on social media and fitness accounts… the list goes on. If you need support, please don't hesitate to contact our team. When discussing men, boys and eating disorders, it’s hard to ignore the massive impact the fitness industry has had. The rise of “gym culture” over the past few decades has been accompanied by an explosion of social media accounts dedicated to posting photos of muscular physiques and weightlifting videos, which often lead to comparisons in body ideals and strength. Such content is usually made with the purpose of inspiration and help but can feed into body standards and pressure for individuals to look a certain way. Such societal attitudes often trigger harmful or obsessive behaviours. Boys and men are more likely to suffer from ‘bigorexia’ or muscle dysmorphia, with studies suggesting around 25% of adolescent males are worried about not having enough muscle. The term “Adonis Complex” has been coined to describe these circumstances, where men experience body image distress in the pursuit of obtaining the “ideal” male physique. Many men may not even realise their workout routine has drifted towards obsession, nor that their body image has become dysmorphic (i.e. they see themselves differently, often smaller and less muscular than they actually are). If you’ve found yourself spending more and more time in the gym, or have become increasingly concerned with building muscle, you may be developing a problem. What are the signs and symptoms of muscle dysmorphia? 1. You spend long hours lifting weights with little or no rest days Whilst everyone’s workout length and rest days vary, more than 5 full workout sessions a week could be too much. Remember, your body needs time to rest too and pushing your body too far could end up causing problems. 2. Excessive attention to diet Those preoccupied with building muscle will often be concerned with protein intake, which is fine, but obsessively counting macros and/or calories, along with anxiety and stress when certain figures aren’t met, could be a cause for concern. It’s okay to use food to fuel your body but it’s also okay to enjoy food and meal times. If your diet is causing you anxiety, you may need to talk to a specialist. 3. The use of performance-enhancing drugs to meet muscle goals Studies have shown that men are more likely to take steroids or other performance-enhancing drugs than women. However, such drugs bring a whole new range of health issues. Steroids can cause behavioural problems such as mood swings and aggression and health problems such as liver damage and heart disease. 4. Missing out on social or recreational events which may interfere with diet, exercise or cause anxiety A healthy relationship with exercise often means a balanced lifestyle i.e. you take time away from the gym and specific diet plans. Spending time with friends and family, eating out or missing the occasional workout shouldn’t cause stress, anxiety or guilt, nor should you feel restricted by such events. 5. Feelings of guilt, disappointment and not being good Whilst actions are a great way to pick up on potentially harmful mindsets towards exercise, diet and the gym, how you actually feel is key. Exercise and a healthy balanced lifestyle should make you feel happy and calm and spark positive emotions. You shouldn’t feel anxious, guilty, agitated and down about your workout routine, diet and body. Seek help We want to stress that weightlifting, exercising and setting goals in the gym isn’t a bad thing. Exercise and weightlifting provide great benefits for mental as well as physical health. For many people, exercise is a form of self-care which provides time to focus during a busy life and can be a great way of socialising and making friends too. What is important, however, is that you monitor how you feel when in the gym and eating. Is it making you feel anxious, or overwhelmed or have your thoughts around the gym become obsessive? Have thoughts of working out harder and building more muscle become constant and unavoidable? Schoen Clinic UK specialises in helping children, young people and adults with eating disorders and mental health conditions. If you think you might be experiencing muscle dysmorphia or a form of disordered eating, speak to your GP or get in touch with our team.

Eating disorders can affect anyone, of any age, and often don't have one single cause – as multiple factors usually play a role. Recovering from an eating disorder often requires more than just dietary intervention, and at Schoen Clinic, our specialists work to identify underlying causes through an integrated treatment approach. Here we clear up some of the most common misconceptions about eating disorders. Get in touch with us today. 1. Eating disorders are only about food and weight. An eating disorder, at its root, is the expression of emotional distress and means of managing difficult and painful feelings. 2. People with eating disorders are always underweight. A person doesn't need to be underweight to have anorexia. Due to the cultural stigma associated with being overweight, they might not receive a diagnosis as often. In addition, a person can be underweight without having anorexia. 3. Recovering from an eating disorder is as simple as “just eating more.” Eating disorder recovery isn't as simple as "just eating more". The process of recovering from an eating disorder takes time, continuous support, and specialised, efficient care. It is important to recognise eating disorder recovery is achievable. 4. Eating disorders are caused by a lack of willpower or self-control. There will always be a number of factors in the development of an eating disorder and each individual will be affected by a unique combination. There is never one simple, single cause of eating disorders, although sometimes there may be one factor in a person’s life which plays a particularly prominent role in his or her eating disorder. 5. Only women can have eating disorders. Eating disorders can affect anyone, of any age, gender, sexual orientation or ethnicity. 6. Eating disorders are uncommon. Eating disorders are more common than you think. According to Beat, the UKs leading eating disorders charity, around 1.25 million people in the UK have an eating disorder. 7. Men cannot have eating disorders. Men can and do suffer from eating disorders. Recognising this, raising awareness of it, and ensuring that men also receive treatment for eating disorders can help to end the stigma. 8. Eating disorders are a result of bad parenting or a dysfunctional family. As mentioned previously, there could be any number of factors that could play a role in developing an eating disorder. Families are an essential part of the recovery from eating disorders. 9. Anorexia nervosa is the most common type of eating disorder. According to recent statistics, the most prevalent eating disorder is binge eating disorder. Binge eating disorder (BED) is more complex than just overeating from time to time. Although overeating plays a role in this condition, there are other factors as well. It may possibly pose a life-threatening situation if left untreated. Need support for an eating disorder? Reach out to our caring team today Please reach out to our caring team at Schoen Clinic if you need support for yourself or a loved one. Our specialists in London, Birmingham and York offer highly specialised treatments for children, teens and adults.

April is National Stress Awareness Month, an annual observance to raise awareness about the negative impact that stress can have on our physical and mental health. Stress is part of our daily lives and it’s important to understand how it affects our overall well-being so we can manage it effectively. In this article, we’ll look at some of the causes and cures for modern-day stress in relation to both mental health problems and eating disorders. Need support? Get in touch with our caring team today. If you need support for a mental health or eating disorder, get in touch with our team today. What causes stress? Stress can be caused by a variety of factors, including work, relationships, financial issues, and health concerns. While it’s relatively common to experience some levels of stress in our daily lives, when left unchecked, stress can lead to a range of mental and physical health problems (1), including the development of more complex mental health difficulties such as depression, anxiety and in some instances, eating disorders. When under stress, our bodies release adrenaline, a hormone that increases heart rate, blood pressure, and breathing rate - this is often referred to as our “fight or flight” response. Dr James Woolley, a Senior Consultant Psychiatrist at Schoen Clinic Chelsea says, “You will recognise it as the sensation we all have when afraid of something real or imagined. These changes can lead to physical symptoms such as headaches, fatigue, and muscle tension as well as escalating up to a fear that we are about to suffer some sort of catastrophic event such as a heart attack or a stroke. It can be so terrifying that people sometimes check themselves into Accident Emergency or even call an ambulance.” At Schoen Clinic, we're committed to improving the lives of people affected by mental health problems and eating disorders. Learn more about the highly specialised treatments we offer across three UK mental health facilties today. Stress can affect eating patterns Additionally, to maintain a state of high alert after releasing adrenaline, our bodies also then release other stress-hormones such as cortisol, which causes the liver to release glucose (sugar) for a quick energy boost to fuel the body during stressful situations (2). Stress can disrupt an individual's regular eating patterns, leading to excessive or restrictive eating behaviours indicative of some eating disorders. Cortisol is known to increase appetite and the desire for sugary or high-fat foods. Therefore, when individuals experience stress, they may turn to food to cope with their emotional discomfort. Those who have eating disorders like anorexia nervosa are also more likely to experience chronic stress. Research conducted on stress and eating disorders (3) supports the claim that stress is a significant contributing factor to the development and exacerbation of eating disorders. Some researchers argue that eating disorders could be a maladaptive coping mechanism that individuals develop to manage their stress and anxiety, so the way a person copes with stress has a bearing on the link between stress and disordered eating: Active coping: When a person attempts to discover useful or active ways to relieve stress, this is a healthy coping mechanism. When someone is actively coping, they are aware of their trigger and find solutions to minimise undesirable outcomes. ‍ Avoidance coping: The individual engages in destructive or harmful behaviours as a kind of maladaptive coping to avoid dealing with the root of their stress. Those who use avoidance as a coping mechanism may be more susceptible to disordered eating. (4) Stress and mental health treatment options There is no single cause for eating disorders, but they can have a profound effect on an individual's physical, emotional, and mental health, leading to social isolation, depression, anxiety, and other psychological disorders. Stress alone can also have a significant impact on our mental as well as physical health. Chronic stress is linked to depression, anxiety, and other mental health disorders (5). Dr Woolley adds, “Physically it is also associated with higher rates of cardiovascular disease (strokes, heart attacks), higher levels of inflammation and impact on the immune system and even risk of cancer.” People who are under prolonged stress may also have difficulty concentrating, making decisions, and regulating their emotions. So, what can we do to manage stress in our daily lives? One of the most effective ways to manage stress is to develop healthy coping mechanisms. The first step is to identify the sources of stress in our lives. By recognising what triggers stress, we can develop strategies to cope with it. This may include talking to a friend or therapist, journaling, or engaging in hobbies that we enjoy. Some common stress management techniques include relaxation techniques such as deep breathing or meditation, regular exercise, getting enough sleep, cutting down on alcohol and caffeine, and eating a healthy diet. National Stress Awareness Month is an opportunity to start a conversation about stress and mental health. By raising awareness about the negative impact of stress on our wellbeing, we can encourage others to seek help when they need it. We can also take steps to prioritise our own mental health and wellbeing, develop strategies to manage stress including taking breaks when we need them, setting healthy boundaries, and seeking support when we feel overwhelmed. It’s important to remember that stress affects everyone differently, and there is no one-size-fits-all solution. If you’re finding it difficult to cope with stress it’s important to seek help. At Schoen Clinic we’re committed to improving our patients’ lives by offering a range of individualised treatments and therapies for stress. We also provide highly specialised treatment for individuals experiencing disordered eating at three specialist eating disorder centres across the UK. References This article was reviewed by Dr James Woolley, Senior Consultant Psychiatrist at Schoen Clinic Chelsea on 3rd April 2023. Dr Woolley is a specialist in mental health conditions and welcomes privately insured and self-funding patients to his clinic. (1) Yale Medicine. (2019, November 15). Chronic stress. Yale Medicine. (2) Physiology, cortisol - statpearls - NCBI bookshelf (no date). Available at: https://www.ncbi.nlm.nih.gov/books/NBK538239/ (Accessed: April 3, 2023). (3) Brewerton, T. D. (2018, February 21). Trauma, post-traumatic stress disorder, and eating disorders. National Eating Disorders Association. (4) MacNeil, L., Esposito-Smythers, C., Mehlenbeck, R., Weismoore, J. (2012). The effects of avoidance coping and coping self-efficacy on eating disorder attitudes and behaviors: A stress-diathesis model. Eating Behaviors, 13(4), 293-296 (5) The links between stress and depression: Psychoneuroendocrinological ... (no date). Available at: https://neuro.psychiatryonline.org/doi/10.1176/appi.neuropsych.15030053 (Accessed: April 3, 2023). Please reach out to our caring team at Schoen Clinic if you need support for yourself or a loved one. Our specialists in London offer highly specialised treatments for children, teens and adults with mental health conditions.

Recovery from an eating disorder is possible. Get in touch with our specialist team today. Eating disorder recovery Recovery from an eating disorder is a long process which requires specialist, effective treatment, consistent support and time. It is important to recognise eating disorder recovery is achievable. Many people recover fully from anorexia or bulimia and feel their eating disorder is firmly part of their past. For others, some difficulties remain, but to a lesser extent than the original eating disorder. In this article, we consider the key elements of sustained, long-term eating disorder recovery. We consider some of the specific features of an anorexia recovery and bulimia recovery, together with work such as a relapse prevention plan which are essential for all forms of eating disorder recovery. We consider how long it may take to recover from an eating disorder, discussing the different stages involved and key elements of treatment. Anorexia treatment and recovery In anorexia treatment, the first stage will focus on stabilisation and weight restoration. If an individual is severely underweight, they will not have the cognitive capacity to undertake the psychological or educational work involved in anorexia treatment. The first phase of treatment must focus upon re-feeding and weight restoration, together with early motivational work. More complex parts of treatment, such as body image work and psychological therapies, can only effectively commence when weight is restored, or close to being restored, so an individual is better able to think, process information and start to manage emotions. This second stage is where treatment can be challenging, for example work to help the individual accept their body at a normal weight and reduce body image distress. One-to-one therapy will seek to understand the different causes of an individual’s anorexia and how this understanding can be built into treatment and relapse prevention. The third stage of anorexia treatment is focused on maintaining a healthy weight and developing a relapse prevention plan. A study by Berends et al (2016) shows that a personalised relapse prevention plan does reduce levels of relapse after anorexia treatment. With a personalised relapse prevention plan, they found that 11 per cent of the participants experienced a full relapse, 19 per cent had a partial relapse and 70 per cent did not relapse. This compares with reported general relapse rates of 35 to 41 per cent. When we consider these statistics around eating disorder recovery, it is important to keep in mind other known parameters: the sooner an eating disorder is diagnosed and effective treatment commenced, the greater the prospects of a full, sustained recovery. Eating disorder relapse rates tend to be higher in adult populations than in child and adolescent patients (Carter et al, 2012). Bulimia treatment and recovery Unlike anorexia, which may require inpatient treatment, bulimia is almost always treated without hospital admission, in community services.  Broadly, recovery from bulimia may occur more quickly than anorexia (programmes are typically 20 weeks, with therapy for one or two hours per week), using a Cognitive Behavioural Therapy approach. Treatment is based on building an understanding of the triggers for the binge, purge cycle and developing healthier ways of managing difficult feelings. It is perhaps surprising then, that some studies suggest similar relapse rates for bulimia as for anorexia (30 to 40 per cent, two years after treatment). However, there is ongoing debate about the definition of a relapse in bulimia. This is sometimes defined as two episodes of binge and purge within a month. Some experts argue this is too narrow and patterns would need to be repeated over three consecutive months to equate to a full relapse. The importance of a relapse prevention plan For all types of eating disorder recovery, a relapse prevention plan is essential. A relapse prevention plan will consider what are the particular risks and triggers for the individual and how might these be addressed. It will consider their personal support network and environment, for example, how to address risks if the individual is moving away to university. An effective relapse prevention plan needs to be highly personalised: for example, an individual may enjoy sports, but compulsive exercise may have become a symptom and maintaining factor in their eating disorder. Their relapse prevention plan would need to encompass how they can enjoy exercise safely and enjoyably and recognise if their exercise pattern is becoming unhealthy and compulsive again. A relapse prevention plan needs to consider what actions need to be taken if triggers are identified. This needs to recognise personal circumstances: for example, a teenager who has been treated for anorexia may avoid talking to parents about concerns because of fear they will worry they are becoming ill again; they may be tempted to hide any difficulties they are experiencing. However, it is important to plan who they will talk to and what they would do if they experience a recurrence of anorexic feelings or behaviours. Recovering from an eating disorder Studies suggest that the time of greatest relapse risk is four to 18 months after treatment. As a specialist hospital group treating children, teens and adults, at Schoen Clinic, we recognise that for our patients, once they are discharged, they enter the increased risk of relapse phase at the time when they may also be leaving home to go to university. What this means, for each individual, will vary according to their needs and risks, but in some cases, a gap year may be helpful, or certainly planning which recognises the relapse risk in this early phase after treatment. There can also be a long period between treatment and recovery, with symptoms returning at a much later stage. For example, a person who developed and recovered from bulimia during their twenties. In bulimia recovery, an individual may experience no symptoms for many years but find a stressful life event, such as the death of a partner or friend, triggers a return to the binge-purge cycle. Vigilance, therefore, is important, even at a stage when an individual may feel their eating disorder is a thing of the past. In common with the initial development of an eating disorder, anyone experiencing a relapse, or symptomatic feelings, should seek help as soon as possible so that support and treatment can be put in place. References: Carter et al, (2012). A prospective study of predictors of relapse in anorexia nervosa: implications for relapse prevention. Psychiatry Res. 2012; 200:518–23. Berends et al (2016)  Berends et al. (2016) Rate, timing and predictors of relapse in patients with anorexia nervosa following a relapse prevention program: a cohort study BMC Psychiatry 16:316 DOI 10.1186/s12888-016-1019-y Please reach out to our caring team at Schoen Clinic if you need support for yourself or a loved one. Our specialists in London, Birmingham and York offer highly specialised treatments for children, teens and adults.

Schoen Clinic UK Group are delighted to announce this appointment which will strengthen and enhance our group governance structures, improve oversight and visibility of all clinical and medical outcome data and ensure compliance and regulatory requirements are consistently met. Dr Woolley was one of the founding clinicians at Schoen Clinic Chelsea and has been instrumental in driving their quality agenda as well as being influential in setting growth aspirations. Dr Woolley is dual-qualified in general medicine and Psychiatry, training in London at the Maudsley Hospital. He has been a Consultant Psychiatrist since 2007, specialising in psychosis and anxiety and mood disorders alongside liaison psychiatry at a variety of London teaching hospitals. In addition to 15+ years of NHS Consultant experience, he has extensive knowledge of the private healthcare market having worked with the largest UK private mental healthcare provider for over a decade. Dr Woolley most recently worked at the Royal Brompton and Royal Marsden Hospitals, running their psychiatry service and is increasing his commitment to Schoen Clinic during an exciting period of growth. Andy Davey, UK Managing Director says “This appointment is a significant one for us, as specialisation, patient safety, clinical governance and quality outcomes for our patients are of paramount importance. Dr Woolley strives for exceptional standards in the delivery of healthcare and will be leading on the next stage of our quality agenda.” Dr Woolley will remain treating patients and involved in the medical leadership of Schoen Clinic Chelsea, simultaneously driving clinical, quality and governance standards at all Schoen Clinic UK sites. --ENDS-- For specific comment or further information, please email our Press Office at ukmarketing@schoen-clinic.co.uk

Anxiety is a common mental health condition that affects a significant portion of the population, with 22.5% of people reporting high levels of anxiety during 2021 and 2022. While some individuals may experience more noticeable symptoms, others may exhibit high-functioning anxiety - a form of anxiety characterised by the ability to perform well in various areas of life, despite feeling anxious. So how exactly does high-functioning anxiety develop in the workplace and what symptoms should we be on the lookout for? Dr Tara Tofiq shares some insight Dr Tara Tofiq, Consultant Psychiatrist (below) at Schoen Clinic Chelsea says “People with High-Functioning Anxiety (HFA) are able to accomplish tasks and manage themselves in various settings across the professional and social spheres. Nevertheless, they will internally experience the same symptoms as those with Generalised Anxiety Disorder (GAD). These symptoms could include physiological manifestations of anxiety, such as increased heart rate, headaches and stomach upset as well as the psychological aspect which includes an impending sense of doom and racing thoughts.” The difference between HFA and GAD is that in HFA, people can manage the daily demands made on them and therefore do not meet the criteria to be formally diagnosed with an anxiety disorder. In presentations of GAD, there is an impairment in being able to take care of one’s self, being so anxious at night that it disrupts sleep patterns contributing to fatigue and not being able to complete tasks during the day. People with HFA often feel trapped in a vicious cycle of self-doubt and uncertainty and the coping strategy is often to do more and keep the mind occupied. This leads to exhaustion and feeling depleted. Going above and beyond is often commended in workplace cultures without looking at the personal cost to the individual. It is a common misconception held by high achievers that hustling is the only option for success, often this is exacerbated by the workplace culture leading to anxiety in the workplace. What causes HFA? The causes of high-functioning anxiety in the workplace are multifactorial and can be a product of internal or external factors. The development of anxiety in the workplace will also vary from person to person. Some potential causes include: Perfectionism:  high achievers often set exceedingly high standards for themselves, leading to constant self-imposed pressure to excel. The fear of failure can trigger anxiety symptoms even when the person appears to be performing well. Workload and deadlines: an excessive workload, tight deadlines, or a fast-paced work environment can create high levels of stress and trigger anxiety symptoms. This pressure to consistently meet expectations can contribute to anxiety in the workplace. Work-life balance: difficulty maintaining a healthy work-life balance can significantly impact an individual's mental health. The inability to disconnect from work-related stressors can perpetuate anxiety symptoms, even outside of working hours. Fear of judgment: a constant fear of being judged by colleagues, superiors, or subordinates can contribute to high-functioning anxiety. This fear may stem from a desire to maintain a positive image and may result in overthinking and self-doubt. How does HFA present? Now we’ve looked into some of the causes, let’s take a look at how high-functioning anxiety presents in individuals. It’s important to note that due to its very nature, high-functioning anxiety may often go unnoticed by others, manifesting in subtle ways. Common symptoms may include: Excessive worrying:  individuals with high-functioning anxiety may constantly worry about work-related matters, including minor details or future projects, leading to persistent feelings of unease. Perfectionism and overachievement: striving for perfection and constantly seeking approval can be common characteristics of high-functioning anxiety. While this drive for excellence can lead to success, it can also cause significant stress and anxiety. Difficulty with delegation: people with high-functioning anxiety may struggle with delegating tasks, fearing that others may not meet their standards. This can result in an excessive workload and increased anxiety levels. Physical symptoms: anxiety can manifest in various physical symptoms, such as headaches, muscle tension, gastrointestinal issues, fatigue, or difficulty sleeping. Treating high-functioning anxiety (HFA) Addressing high-functioning anxiety in the workplace requires a comprehensive approach that combines self-care strategies and professional support. Cognitive-Behavioural Therapy (CBT) can be highly effective in managing anxiety by helping individuals identify and challenge negative thought patterns, develop coping mechanisms and learn relaxation techniques. In addition to therapy, there are many stress management techniques such as mindfulness, deep breathing exercises, and regular physical activity that can help reduce anxiety symptoms and improve overall well-being. High-functioning anxiety in the workplace is a significant concern which can impact an individual's well-being and performance and it is important to recognise the signs early. Schoen Clinic Chelsea is a leading London private mental health clinic specialising in offering group and one-to-one therapies for adult mental health conditions. If you’re struggling, please speak to your GP or contact our clinic by calling 020 3146 2300 or email che-privateenquiries@schoen-clinic.co.uk This page was reviewed by Dr Tara Tofiq, Consultant Psychiatrist at Schoen Clinic Chelsea on 18th May 2023.

Mental health problems can affect anyone at any stage in their life. Research shows that approximately 1 in 4 people in the UK will experience a mental health problem each year* and 1 in 6 people in England will experience a common mental health problem (like anxiety or depression) in any given week*. But what triggers mental illness? What are the risk factors leading to a mental health condition? Can a mental health problem go away on its own? Research suggests that lesbian, gay, bisexual, trans and queer (LGBTQ+) people are at higher risk of developing serious mental health problems, so this Pride Month, we’re focusing on some key questions and applying them to the LGBTQ+ community to see what we can find out. LGBTQ+ people and mental health It’s important to note that being LGBTQ+ doesn’t necessarily mean someone will have mental health problems, but it may put them at higher risk of experiencing them. Whilst we know there are many aspects and experiences which contribute to a deterioration in someone’s mental health, one aspect which may play a significant role early in life can be bullying during school years. According to studies, anti-LGBT bullying is still a problem, with 52% of students reporting hearing homophobic insults regularly at school (Stonewall School Report; 2017). Research shows that childhood experiences of bullying can have long-lasting effects on an individual's mental health well into adulthood*. People who have been bullied during their childhood years are more likely to experience depression and anxiety in later years. Bullying can lead to feelings of low self-esteem, shame, social anxiety and the inability to establish trusting relationships. A 2018 study by Stonewall found that over the previous year, half of LGBTQ+ people had depression and 3 in 5 have experienced anxiety. These figures are significantly higher than the general population (1 in 4 people each year, or 1 in 6 people each week). So we should ask the question: what issues do LGBTQ+ people face to put them at higher risk of developing a serious mental health problem? We’ve already discussed bullying and shame as factors, but LGBTQ+ people also regularly face discrimination or prejudice. One aspect can sometimes be accessing healthcare. Research has found approximately 1 in 8 LGBTQ+ individuals encountered discrimination from healthcare personnel due to their identity and 1 in 7 even avoided seeking healthcare out of concern for discrimination*. Additionally, a 2021 survey found that 70% of trans people reported being impacted by transphobia when accessing general health services.* Schoen Clinic UK Group is proud of its inclusive culture, where our hospitals and clinics welcome patients of all beliefs, backgrounds and orientations and foster safe environments, free from judgement. “At Schoen Clinic Chelsea, we see people from all walks of life with mental health conditions, including those within the LGBTQ+ community,” says Adam Bloor, Clinic Director. “We understand our LGBTQ+ patients may have gone through experiences unique to their community, which may have contributed to developing a mental health condition or eating disorder. That’s why we ensure a safe space for everyone, to talk freely about their experiences without fear of judgement or discrimination.” The Minority Stress Model (MSM) and mental health The Minority Stress Model (MSM) is frequently used to explain why sexual and gender minority groups have varying levels of mental health problems. According to MSM, LGBTQ+ people are more likely to experience stressors like internalised homophobia or transphobia and concealing their sexual orientation or gender identity, as well as external stressors like stigma and discrimination, increases their risk of developing physical and mental health problems.* It’s not just accessing healthcare which might be a problem for LGBTQ+ people. Their community are also at a higher risk of experiencing 'hate crimes’ which can create and exacerbate mental health issues. Hate crimes are those committed against someone because of a protected characteristic, i.e. their race, sexual orientation, religion, gender identity or disability. It is documented that members of the LGBTQ+ community are more likely to experience hate crime. Gay men, queer youth, transgender people and members of the black, Asian and minority ethnic (BAME) communities are among the LGBTQ+ groups who are known to be most at risk. Whilst discussing discrimination, it’s also possible to highlight ‘equality disparities’ and transphobia within the LGBTQ+ community itself. Trans people can face prejudice from gay, lesbian or bisexual people. Forums have even been created to campaign for the removal of ‘Trans’ from the LGBTQ+ umbrella. In addition, femme-presenting gay men regularly face homophobic remarks from other gay men within the community. Much of this is believed to stem from greater societal expectations of what men and women should be, or how they should behave. LGBTQ+ people and eating disorders Mental health isn’t only about depression, anxiety or internalised shame as many instances can lead to a decline in physical health and wellbeing. It’s important to also discuss LGBTQ+ mental health and the link with eating disorders. According to research by the National Eating Disorder Association (NEDA), more than half of LGBTQ+ youth between the ages of 13-24 have been diagnosed with an eating disorder at some point in their life. Gay, lesbian and bisexual youth may be more likely than their heterosexual counterparts to binge eat and purge as early as age 12. LGBTQ+ individuals experience unique challenges which may increase their likelihood of having an eating disorder. Potential risk factors which may play a role in the development of an eating disorder in an LGBTQ+ person can include: the fear of being rejected or having been rejected by friends, family and co-workers negative self-perceptions because of sexual orientation, non-binary gender presentation or transgender identity exposure to violence and the experience of post-traumatic stress disorder (PTSD) are major risk factors for developing an eating disorder discrimination based on gender identity or sexual orientation being a target of bullying because of gender or sexual orientation inner conflict between biological sex and gender identification inability to conform to certain LGBTQ+ cultural norms about appearance The Minority Stress Model (MSM) and eating disorders It is possible that eating disorders can present in LGBTQ+ people in response to external stressors (as previously mentioned in the MSM) as a form of coping mechanism. Internalising negative messages/being unable to be openly oneself, living in fear of being harassed, stress related to discrimination and living as a runaway or being homeless, can all play a part in the development of an eating disorder. Another factor to consider when discussing eating disorders in LGBTQ+ people is body dissatisfaction. This links to one of the potential risk factors as the inability to conform to some LGBTQ+ cultural appearance norms. Research has found a link between the high representation of the ‘ideal physique’ and increased body dissatisfaction. Although diversity in queer representation has improved over the years (with shows like the BBC’s “I Kissed a Boy” successfully highlighting a diverse range of body types and cultures), LGBTQ-specific media has historically portrayed gay people as young, heteronormative (straight presenting) white men with lean, muscular physiques. These representations create an ‘appearance ideal’ and a pressure to look or act a certain way, damaging not only to the community as a whole but also to individuals. Body dissatisfaction is a proximal risk factor for both eating disorders and disordered eating behaviours within the LGBT community*. Ending the stigma of mental health in the LGBTQ+ community The stigma of mental health remains a problem in the LGBTQ+ community and indeed the world. One of the best ways to address this is through education and raising awareness. By providing information about mental health and encouraging open discussions about it, we can help to dispel negative attitudes and move towards a more accepting and supportive society for everyone. Healthcare organisations can play their role in helping to end discrimination towards LGBTQ+ people reaching out for help. This means ensuring staff are trained in providing appropriate care to LGBTQ+ people, using inclusive language and tailoring treatment to the specific needs of each individual. It’s also essential that healthcare organisations create safe and affirming spaces for everyone to seek help. This can include training staff on the specific mental health issues which affect certain communities and offering support groups which focus on the unique challenges faced by them. Treating LGBTQ+ people with mental health conditions You can’t make a gay person straight and you can’t make a straight person gay. Not understanding this, or trying to deny LGBTQ+ youths from expressing themselves can lead to internalised shame. Accepting people for who they are is the first step toward a brighter future, no matter what their identity or sexual orientation. Understanding the potential causes of mental health problems in LGBTQ+ people goes a long way to helping treat them. Whilst there is a higher risk of sexual or gender minority people developing anxiety, depression or an eating disorder, help is available from people who truly care. Adam Bloor says, “We recognise the significance of tailored treatment and are proud to offer personalised mental health and eating disorder services for everyone. Our priority is to provide a welcoming and inclusive environment for all our patients and we’re committed to supporting everyone on their journey to recovery.” Where can LGBTQ+ people find help for mental health or eating disorders? If you’re LGBTQ+ and need support for anxiety, depression, stress, trauma or any other mental health problem, please reach out for help. If you’re experiencing an eating disorder, it’s always best to begin treatment as early as possible for the best chance of a full recovery. If you need support for a mental health condition or an eating disorder, Schoen Clinic UK Group is the home of highly specialised treatments, with a wonderfully diverse team of healthcare professionals available to help. Our locations across the UK provide caring, inclusive environments free from judgement. Reach out to our caring team today. This page was reviewed by Adam Bloor, Clinic Director at Schoen Clinic Chelsea on 27th June 2023. References McManus, S., Meltzer, H., Brugha, T. S., Bebbington, P. E., & Jenkins, R. (2009). Adult psychiatric morbidity in England, 2007: results of a household survey. The NHS Information Centre for health and social care. McManus S, Bebbington P, Jenkins R, Brugha T. (eds.) (2016). Mental health and wellbeing in England: Adult psychiatric morbidity survey 2014. Leeds: NHS digital. Parker LL, Harriger JA. Eating disorders and disordered eating behaviors in the LGBT population: a review of the literature. J Eat Disord. 2020 Oct 16;8:51. doi: 10.1186/s40337-020-00327-y. PMID: 33088566; PMCID: PMC7566158. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4552909/ https://jeatdisord.biomedcentral.com/articles/10.1186/s40337-020-00327-y https://www.stonewall.org.uk/lgbt-britain-health Trans lives survey 2021: Enduring the UK’s hostile environment https://static1.squarespace.com/static/5e8a0a6bb02c73725b24dc9d/t/6152eac81e0b0109491dc518/1632824024793/Trans+Lives+Survey+2021.pdf https://www.nationaleatingdisorders.org/learn/general-information/lgbtq

Combining short-term coping and long-term treatment options Anxiety is a common mental health problem faced by many in the UK and around the world today. Data from the Office for National Statistics (ONS) revealed that in 2022/23, an average of 37.1% of women and 29.9% of men reported high levels of anxiety, a significant increase from data collected only a decade ago. Anxiety can manifest in many different ways including excessive worry, fear, restlessness, and physical symptoms such as a rapid heartbeat and perspiration (sweating). Fortunately, there are various techniques available to help manage anxiety and this article offers 5 effective strategies for reducing anxiety, encompassing both short-term coping techniques and long-term treatment options. 5 top tips for helping to reduce anxiety: 1. Cognitive Behavioural Therapy (CBT): CBT is a widely recognised, evidence-based approach for treating anxiety as it focuses on identifying and challenging negative thought patterns and beliefs that contribute to anxiety. By altering cognitive distortions, individuals can reframe their thinking and develop healthier coping mechanisms. CBT also includes exposure therapy, where individuals confront anxiety-inducing situations gradually, helping to de-sensitise and reduce their fear response. 2. Mindfulness and meditation: Mindfulness and meditation practices have gained significant attention for their effectiveness in reducing anxiety. Mindfulness involves paying attention to the present moment without judgment and allows individuals to observe their anxious thoughts and emotions objectively, without becoming overwhelmed by them. Regular meditation can cultivate a sense of calmness, enhance self-awareness and build resilience to anxiety triggers. Incorporating mindfulness into daily life can also provide lasting benefits for anxiety management. 3. Relaxation techniques: Engaging in relaxation techniques is an effective way to alleviate anxiety in the short term. Deep breathing exercises, progressive muscle relaxation and guided imagery are among the techniques which can help activate the body's relaxation response. These practices promote a state of physical and mental calmness, reducing the intensity of anxiety symptoms. Integrating relaxation techniques into daily routines or using them during stressful situations can bring immediate relief and restore a sense of control. Get in touch with our team at Schoen Clinic Chelsea to find out more about highly specialised treatments for anxiety and other common mental health problems in London. 4. Regular physical exercise: Physical exercise not only benefits physical health but also plays a vital role in managing anxiety and mental health overall. Engaging in regular exercise releases endorphins, which are natural mood-boosting chemicals that promote a sense of well-being. Exercise can also act as a distraction from anxious thoughts and provide a healthy outlet for stress and tension. The great news is you don’t even need to set foot in a gym if you don’t want to! Activities such as walking, jogging, swimming, or yoga can be incorporated into your routine to reduce anxiety symptoms and improve overall mental well-being. Getting out in nature has been proven to be beneficial for mental health and may even help to spur creative thinking. 5. Social support and self-care: Building a strong support network and practising self-care are crucial aspects of anxiety management. Sharing concerns and feelings with trusted individuals can provide emotional support and help reduce anxiety levels. Additionally, engaging in self-care activities, such as maintaining a balanced diet, getting sufficient sleep and participating in hobbies or enjoyable activities, can significantly contribute to anxiety reduction. Find help for anxiety in London While short-term strategies provide immediate relief during anxious moments, long-term approaches, such as Cognitive Behavioural Therapy, help to address the root causes and promote sustainable anxiety reduction. It’s important to remember that each individual's experience with anxiety is unique and what works for one, may not work for another. Consulting with a mental health professional or your GP is an important first step to getting the support you need. At Schoen Clinic, we’re committed to improving people’s lives by offering a range of easy-to-access, personalised treatments and therapies. If you’re struggling with anxiety and would like professional support to help combat the challenges brought on by it, our anxiety specialists in London can help. We offer a variety of group and individual therapies for mental health conditions. Just get in touch with our friendly team at Schoen Clinic Chelsea by calling 020 3146 2300 or completing our online contact us form.

The festive season, often synonymous with joy and celebration, can be an exceptionally challenging time for those grappling with bereavement and loss. Whether you have experienced a bereavement or are navigating complex emotions due to the loss of a relationship or friendship, this particular time of year (or other significant birthdays or celebrations throughout the year) has a way of amplifying these feelings. Understanding that grief doesn't take a holiday, let's explore ways to cope with the impact during this time of year. The unique challenges of grief during the festive season: Grief, in response to loss, manifests differently in each individual. Whether mourning the passing of a family member, the end of a relationship, or other significant life changes, the holiday season can trigger a range of emotions. Shock, overwhelming sadness, fatigue, anger, guilt and loneliness are common companions during this time. Recognising that there is no "right" way to feel, it's essential to acknowledge and honour your emotions. Navigating the 5 stages of grief Experts often describe grief as a journey through five stages: Denial Anger Depression Bargaining Acceptance. While these stages offer a framework, it's crucial to remember that everyone's experience with grief is unique. Progression through these stages may not follow a linear path, and the intensity of emotions may ebb and flow. Acceptance, the final stage, doesn't imply liking the situation but signifies readiness to move forward. Coping strategies for grieving at Christmastime Recognising the complexity of grief, there are practical strategies to help navigate this challenging time: Seek support: Share your feelings with friends, family, or professionals who can provide a listening ear. Our mental health specialists at Schoen Clinic Chelsea can offer highly specialised bereavement support. Prioritise self-care: Getting enough sleep each night is essential. If sleep is elusive, try to set a specific time to switch off electronics and wind down to bed. If you're really struggling with sleep we have a team of specialists who could help with therapeutic approaches. It's also important to avoid using alcohol or drugs as a way of coping. Explore peer support: Engage with peer support groups where individuals share their experiences, fostering a sense of understanding and connection. We offer a variety of therapy groups throughout the week at Schoen Clinic Chelsea which you may find beneficial. Utilise mental wellbeing resources: Access free mental wellbeing audio guides and resources online. There are a number of apps on the AppStore or Google Play Store to aid in coping with grief and promoting self-care that may also be helpful. Get in touch with our team at Schoen Clinic Chelsea if you need specialised support regarding loss. 5 tips for navigating grief during the Christmas season As the festive season approaches, considering your plans and envisioning how you'd like to spend this time can offer a sense of grounding. However, there's no one-size-fits-all approach. Feeling pressured to adhere to traditional celebrations isn't necessary. Instead, aim for a Christmas that feels comfortable to you, granting yourself the liberty to adjust traditions or create new ones aligned with your emotional needs. Planning with sensitivity: As the festive season approaches, considering your plans and envisioning how you'd like to spend this time can offer a sense of grounding. However, there's no one-size-fits-all approach. Feeling pressured to adhere to traditional celebrations isn't necessary. Instead, aim for a Christmas that feels comfortable to you, granting yourself the liberty to adjust traditions or create new ones aligned with your emotional needs. Managing emotional energy: Grief encompasses various emotions, from profound sadness to fleeting moments of joy. Understand that these emotions consume energy. Allow yourself breaks amidst the hustle, whether it's a solitary walk, quiet moments with a cup of tea, or personal reflections through journaling. Try to avoid overextending yourself and refrain from feeling guilty about things you think you should be doing. Recognise that it's okay not to be okay during this period. Open communication and setting boundaries: Engaging in open conversations with loved ones about your feelings and plans for the holidays can foster a supportive environment. Sharing your wishes and boundaries allows others to offer sensitive support tailored to your grief. Adapting traditions: Many holiday traditions may hold memories intertwined with the person you're grieving. While some might feel too painful to continue, exploring ways to adapt or create new traditions can be a healing process. Consider starting fresh traditions like crafting a memory ornament, lighting a candle in their honour or making a donation to a cherished charity they supported. Coping with the first Christmas after loss: Your first Christmas or significant date like a birthday or anniversary following a loss can be particularly challenging. Unpredictable emotions and a mix of old memories and new realities may surface. Grant yourself the grace of taking each day as it comes. Understand that it's okay not to have all the answers or to feel differently each day. Allow yourself the freedom to prioritise self-care and put your needs first during this time. Guidance moving forward As you navigate grief during Christmas, remember to set realistic targets, channel energy into positive endeavours, and avoid relying on unhealthy coping mechanisms like alcohol or substance use. Most importantly, understand that you are not alone—many individuals experience grief during the holiday season, and support is available. By acknowledging your emotions, seeking support, and embracing self-care, you can find a path through grief during the holidays. While the journey may be challenging, it's an opportunity for personal growth, resilience, and finding light even in the midst of loss. Author information This article was developed with and reviewed by Dr Sumi Ratnam, Consultant Forensic Psychiatrist at Schoen Clinic Chelsea on 12th December 2023. With nearly 30 years of experience, Dr Ratnam specialises in providing expert care to adults with mental health conditions. She has a particular interest in women's mental health but also offers specialised mental health support and treatment for men. Next review date: 12th December 2024

When it comes to mental healthcare, each individual's journey is unique, marked by personal trials and triumphs. Isabelle's story at Schoen Clinic Chelsea stands as a testament to the power of holistic care and compassionate support in the face of mental health challenges. In this blog article, Isabelle shares her experience in her own words in the hopes that her story can help others who may be considering specialised mental health support or may be apprehensive about beginning mental health therapy. Reflecting on group therapy "My experience with the Schoen Clinic was truly transformational. I've spent many years trying to navigate the mental health system, so having a clinic that incorporated every aspect of mental healthcare was a godsend. They are true professionals with a humanistic approach and will work as a team to help you heal. During my time there I received individual therapy, group therapy, and psychiatric help, and can highly recommend all of them." For Isabelle, the comprehensive approach of the clinic, encompassing individual therapy, group sessions, and psychiatric support, became a beacon of hope in her quest for healing. She embraced group therapy despite initial hesitations, discovering an unexpectedly supportive environment where shared experiences nurtured a sense of camaraderie and growth. "At first, I was hesitant to try group therapy but it turned out to be a wonderful experience. The groups are open and friendly and meeting other people going through similar experiences helps one feel less alone in one's struggles." My experience with individual therapy "For individual therapy, I worked with Jahanara Khatun, who is by far the best mental health therapist I have ever had. In addition to her knowledge and expertise, she is incredibly insightful and compassionate." Isabelle's one-to-one therapy sessions with Jahanara became the cornerstone of her transformational journey. "Throughout our sessions, I gained a depth of understanding I never thought possible and felt a real shift within myself that I've never experienced when trying therapy in the past. After our time together, I have truly concrete tools to live my life to the fullest and the clarity to deal with anything that may arise in the future." I received exceptional psychiatric support from Dr Woolley Dr James Woolley's guidance as a psychiatrist left a lasting impression. Isabelle highlighted his ability to simplify complex mental health aspects and empower patients through informed decision-making. "Dr James Woolley is an exceptional Consultant Psychiatrist who helped me during my time at Schoen Clinic Chelsea. I have been in and out of psychiatric care in the past and Dr Woolley was the first psychiatrist who took the time to explain the more complex aspects of mental health in a way that was easy to understand. He went above and beyond to truly listen and always took my concerns seriously. He contains the rare combination of an exceptional mastery of his field and the ability to make it accessible in such a way that empowers you to make informed decisions as a patient." Would I recommend Schoen Clinic Chelsea for mental health support? "Throughout the whole process I felt empowered to choose the direction of my care and the team was utterly transparent and communicative with me at all times. It was the most collaborative experience I have had with regard to my mental health and I never felt 'out of the loop' on any decision. In addition to their professionalism, Schoen Clinic Chelsea also has a really friendly atmosphere that is very reassuring when you are dealing with such vulnerable matters as mental health. I'm so grateful for my time working with the specialists at the clinic. I cannot recommend Schoen Clinic enough." Get in touch with our mental health team in London today We'd like to extend our heartfelt gratitude to Isabelle for generously sharing her experience with us. At Schoen Clinic Chelsea, our commitment to comprehensive mental health care is bolstered by a team of highly specialised experts. Whether it's group therapy, one-to-one counselling, or tailored psychiatric support, our dedicated multidisciplinary team of professionals embodies expertise and compassion to guide individuals through their unique mental health journeys. We understand the urgency of support, which is why many of our specialists are readily available within days for self-funding patients. To begin on your own journey, the quickest way to get started with mental health support is by completing our online pre-screening questionnaire. This accessible tool is available 24/7, 7 days a week, designed to initiate your path towards the specialised care you deserve. Isabelle's story resonates deeply with the ethos of Schoen Clinic Chelsea - our private outpatient clinic in the heart of Chelsea, London, where individuals find support, guidance, and personalised care.

Positive mental health is critical to overall well-being during pregnancy and after childbirth. It includes a wide range of emotional and psychological issues which may be experienced during and after pregnancy, such as stress, anxiety, depression, and mood disorders. The most common form of maternal mental health issue is postpartum depression, also known as PPD, which affects more than 1 in 10 new mothers. PPD is a condition which lasts longer than two weeks and can significantly impact the ability to function in day-to-day life as well as bonding with the newborn child, so early recognition is really important. Is PDD the same as baby blues? PPD and baby blues might share the postpartum phase, but they're distinct experiences. Baby blues are common, fleeting feelings of sadness, anxiety, or irritability that many new parents experience within the first two weeks after childbirth. These emotions often arise due to hormonal shifts, sleep deprivation, and the adjustment to parenthood. Symptoms include mood swings, weepiness, and trouble sleeping, yet they tend to fade on their own. In contrast, PDD involves more intense and persistent feelings of sadness, hopelessness, or emptiness that can interfere with daily life and bonding with the baby. These symptoms endure beyond the initial two weeks and might exacerbate over time if left untreated. Seeking help or treatment becomes crucial when these feelings persist for longer periods, impacting one's ability to function. Unlike baby blues, PDD often requires professional intervention, such as therapy or medication, to support the individual's mental health during this challenging postpartum period. Postpartum depression symptoms Postpartum depression (PDD) manifests differently for each individual, but certain symptoms are commonly observed, affecting mental, behavioral, and self-perception aspects: Mental symptoms: PDD often triggers overwhelming feelings of sadness, despair, or emptiness that persist beyond the initial weeks after childbirth. Some experience severe mood swings, irritability, or constant crying without a clear cause. Anxiety, excessive worry, or feeling disconnected from the baby are prevalent. Thoughts of harming oneself or the baby may also occur, though these are serious and require immediate attention. Everyday/behavioural symptoms: Individuals with PDD might struggle with sleep disturbances, either sleeping excessively or facing insomnia even when the baby is resting. Appetite changes, whether an increase or decrease in eating habits, are common. Difficulty concentrating or making decisions, along with a loss of interest in activities once enjoyed, can also be observed. Fatigue or a lack of energy, despite adequate rest, is pervasive. Changes in self-perception or baby perception: PDD often leads to negative thoughts about oneself as a parent, feeling incompetent or unworthy. Some may experience a lack of attachment or bonding with the baby, despite efforts to connect, fostering guilt or shame. It's essential to recognise that these symptoms might vary in intensity and duration for each person experiencing PDD, emphasising the importance of seeking professional help to address these challenges effectively. Not only is good mental health essential for overall wellness, but it can also impact the child’s mental and emotional wellbeing. For example, studies have shown that postpartum depression can negatively impact a child’s cognitive and social development if not treated promptly. What causes postpartum depression? We’re not exactly sure what causes PPD. It can happen to any woman after having a baby. Possible causes include hormonal changes, genetic predisposition, stress, lack of support, prior mental health issues, and the adjustment to new parenthood, all contributing to the complex onset of postpartum depression. Hormonal changes: After childbirth, hormonal fluctuations occur as estrogen and progesterone levels, which surged during pregnancy, swiftly return to baseline within the initial 24 hours. This sudden decline in hormone levels post-birth is associated with the onset of postpartum depression (PPD), potentially impacting mood regulation and contributing to its development. Genes: Genes, the body’s instructions for growth and function, can influence postpartum depression (PPD). When depression runs in the family—a family history of depression—there’s a higher likelihood of experiencing PPD due to inherited genetic predispositions passed from parents to children, making it more prevalent among those with familial depressive tendencies. Lifestyle changes: Sleep deprivation post-childbirth can exacerbate postpartum depression (PDD). Women struggling to achieve restful sleep often experience physical symptoms like body pain and exhaustion, intensifying the risk of PDD. Additionally, the loss of freedom and "me time" in the transition to parenthood can be challenging and contribute significantly to feelings of depression. Adjusting to this loss of personal time and independence might amplify the emotional strain and vulnerability to postpartum depression. Are some mothers more at risk of postpartum depression? There are many risk factors for postpartum depression, such as a history of mental health issues, lack of social support, unforeseen circumstances during pregnancy, and complications during childbirth. However, it can also appear without any obvious risk factors. Increased risk factors for postpartum depression include: Prior or during pregnancy depression Family history of depression Childhood abuse or adversity Challenging or traumatic childbirth Previous pregnancy/birth complications Limited support from family, friends, or partners Current or past experience of domestic violence Relationship issues, financial stress, or significant life stressors Being under 20 years old Difficulty breastfeeding Premature birth or a baby with special health needs Unplanned pregnancy Certain factors, from past experiences to current circumstances, may heighten the likelihood of postpartum depression. Can men have PPD? Recent studies reveal that postpartum depression affects nearly 1 in 10 fathers, a largely overlooked phenomenon. A comprehensive study delved into this under-recognised issue, outlining factors influencing its manifestation in men. Similar to women, men experience comparable symptoms of postpartum depression. However, these signs might be less conspicuous, given men's tendency to mask their emotions. Remember, seeking help is crucial regardless of gender, and openness about these feelings can lead to effective support and treatment. Treatment for postpartum depression Fortunately, several effective treatments are available for PPD. The choice of treatment, considering symptom severity, personal preferences, and various factors, offers hope for recovery. Remember, never let worrying or shameful thoughts deter you from seeking the support and care you deserve during this challenging time. Some treatment options for PPD include: Psychotherapy One of the most effective treatments for PPD is psychotherapy, also known as talk therapy. A therapist can help to explore  feelings and concerns and provide tools to better cope with the challenges of parenting. Cognitive-behavioural therapy (CBT) is a particular type of psychotherapy that has been shown to be effective for PPD. Medication Antidepressants can also be helpful in treating PPD. Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant that is often prescribed for PPD. These drugs can take several weeks to start working and may cause side effects such as nausea, dizziness, and changes in sexual function. However, they have been shown to be effective in improving mood and reducing symptoms of PPD. Self-care Engaging in self-care activities such as exercise, yoga, and meditation can also help alleviate symptoms of PPD. Women with PPD should aim to get enough sleep, eat a healthy diet, and make time for themselves. A supportive network of family and friends can also be beneficial during this time. Support groups Participating in a support group for women with PPD can help reduce feelings of isolation and provide a supportive environment for women to share their experiences. These groups can be found through healthcare providers, community centres, or online. Find help for postpartum depression in London It’s important to seek treatment for PPD as soon as possible, as symptoms can become more severe if left untreated. Women with PPD can talk to their healthcare provider about their options for treatment, who will work with them to find the best approach for their individual needs. At Schoen Clinic Chelsea we’re committed to providing highly specialised treatment for a range of mental health problems. We also offer a variety of helpful group therapies which may be beneficial to those experiencing PPD. If you’re experiencing depression or another mental health problem and need support, please feel free to get in touch with our team. Can you prevent postpartum depression? Supporting mental wellbeing during pregnancy involves various proactive steps, including maintaining a healthy lifestyle, nurturing a robust support network for open conversations, attending antenatal classes to connect with peers, and seeking guidance from healthcare professionals. However, despite these efforts, developing postpartum depression (PDD) isn't indicative of failure. PDD can arise irrespective of preventive measures. It's crucial not to perceive it as a personal shortcoming. Factors contributing to PDD are multifaceted and can't always be prevented, even with diligent preparation. Instead, view seeking help and support as a proactive step toward managing PDD should it occur. Prioritising mental health throughout pregnancy is commendable. Remember, seeking advice and guidance from specialists in the area, particularly if there's a history of depression or mental health issues, is a responsible approach. Acknowledging that PDD can occur despite efforts empowers individuals to focus on effective coping strategies and seek assistance without self-blame. References This page was reviewed by Dr James Woolley, Senior Consultant Psychiatrist at Schoen Clinic Chelsea on 4th May 2023. https://www.maternalmentalhealthalliance.org/about/perinatal-mental-health/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2724169/ https://www.cambridge.org/core/journals/psychological-medicine/article/inperson-1day-cognitive-behavioral-therapybased-workshops-for-postpartum-depression-a-randomized-controlled-trial/E729E7D8385D87779FED7548CA36E39C https://www.sciencedirect.com/science/article/abs/pii/S0165032713006939