The Listening Ear

Counselling

Counselling is a talking therapy that involves a trained therapist listening to you and helping you find ways to deal with emotional issues.

Sometimes the term "counselling" is used to refer to talking therapies in general, but counselling is also a type of therapy in its own right.

What can counselling help with?

Counselling can help you cope with:

  • a mental health condition, such as depression, anxiety or an eating disorder

  • an upsetting physical health condition, such as infertility

  • a difficult life event, such as a bereavement, a relationship breakdown or work-related stress

  • difficult emotions – for example, low self-esteem or anger

  • other issues, such as sexual identity

What to expect from counselling

At your appointment, you'll be encouraged to talk about your feelings and emotions with a trained therapist, who'll listen and support you without judging or criticising.

The therapist can help you gain a better understanding of your feelings and thought processes, and find your own solutions to problems. But they won't usually give advice or tell you what to do.

Counselling can take place:

  • face to face

  • in a group

  • over the phone

  • by email

  • online through live chat services (learn more about online tools for mental health)

You may be offered a single session of counselling, a short course of sessions over a few weeks or months, or a longer course that lasts for several months or years.

It can take a number of sessions before you start to see progress, but you should gradually start to feel better with the help and support of your therapist.



Anxiety

Generalised anxiety disorder in adults

Anxiety is a feeling of unease, such as worry or fear, that can be mild or severe.

Everyone has feelings of anxiety at some point in their life. For example, you may feel worried and anxious about sitting an exam, or having a medical test or job interview.

During times like these, feeling anxious can be perfectly normal.

But some people find it hard to control their worries. Their feelings of anxiety are more constant and can often affect their daily lives.

Anxiety is the main symptom of several conditions, including:

  • panic disorder

  • phobias, such as agoraphobia or claustrophobia 

  • post-traumatic stress disorder (PTSD)

  • social anxiety disorder (social phobia)

The information in this section is about a specific condition called generalised anxiety disorder (GAD).

GAD is a long-term condition that causes you to feel anxious about a wide range of situations and issues, rather than 1 specific event. 

People with GAD feel anxious most days and often struggle to remember the last time they felt relaxed.

As soon as 1 anxious thought is resolved, another may appear about a different issue.

Symptoms of generalised anxiety disorder (GAD)

GAD can cause both psychological (mental) and physical symptoms.

These vary from person to person, but can include:

  • feeling restless or worried

  • having trouble concentrating or sleeping

  • dizziness or heart palpitations

What causes generalised anxiety disorder (GAD)?

The exact cause of GAD is not fully understood, although it's likely that a combination of several factors plays a role.

Research has suggested that these may include:

  • overactivity in areas of the brain involved in emotions and behaviour

  • an imbalance of the brain chemicals serotonin and noradrenaline, which are involved in the control and regulation of mood

  • the genes you inherit from your parents – you're estimated to be 5 times more likely to develop GAD if you have a close relative with the condition

  • having a history of stressful or traumatic experiences, such as domestic violence, child abuse or bullying

  • having a painful long-term health condition, such as arthritis

  • having a history of drug or alcohol misuse

But many people develop GAD for no apparent reason.

Who's affected

GAD is a common condition, estimated to affect up to 5% of the UK population.

Slightly more women are affected than men, and the condition is more common in people from the ages of 35 to 59.

How generalised anxiety disorder (GAD) is treated

GAD can have a significant effect on your daily life, but several different treatments are available that can ease your symptoms.

With treatment, many people are able to control their anxiety levels. But some treatments may need to be continued for a long time and there may be periods when your symptoms worsen.



Grief after bereavement or loss

Most people experience grief when they lose something or someone important to them. If these feelings are affecting your life, there are things you can try that may help.

Support is also available if you’re finding it hard to cope with stress, anxiety or depression.

Information:

Symptoms of bereavement, grief and loss

Bereavement, grief and loss can cause many different symptoms and they affect people in different ways. There's no right or wrong way to feel.

As well as bereavement, there are other types of loss such as the end of a relationship or losing a job or home.

Some of the most common symptoms include:

  • shock and numbness – this is usually the first reaction to loss, and people often talk about "being in a daze"

  • overwhelming sadness, with lots of crying

  • tiredness or exhaustion

  • anger – towards the person you’ve lost or the reason for your loss

  • guilt – for example, guilt about feeling angry, about something you said or did not say, or not being able to stop your loved one dying

These feelings may not be there all the time and powerful feelings may appear unexpectedly.

It's not always easy to recognise when bereavement, grief or loss are the reason you're acting or feeling differently.

Experts generally accept that we go through 4 stages of bereavement or grief:

 1) Accepting that your loss is real

2) Experiencing the pain of grief

3) Adjusting to life without the person or thing you have lost

4) Putting less emotional energy into grieving and putting it into something new

Most people go through all these stages, but you will not necessarily move smoothly from one to the next.

Your grief might feel chaotic and out of control, but these feelings will eventually become less intense over time.



Clinical depression

Depression is more than simply feeling unhappy or fed up for a few days.

Most people go through periods of feeling down, but when you're depressed you feel persistently sad for weeks or months, rather than just a few days.

Some people think depression is trivial and not a genuine health condition. They're wrong – it is a real illness with real symptoms. Depression is not a sign of weakness or something you can "snap out of" by "pulling yourself together".

The good news is that with the right treatment and support, most people with depression can make a full recovery.

How to tell if you have depression

Depression affects people in different ways and can cause a wide variety of symptoms.

They range from lasting feelings of unhappiness and hopelessness, to losing interest in the things you used to enjoy and feeling very tearful. Many people with depression also have symptoms of anxiety.

There can be physical symptoms too, such as feeling constantly tired, sleeping badly, having no appetite or sex drive, and various aches and pains.

The symptoms of depression range from mild to severe. At its mildest, you may simply feel persistently low in spirit, while severe depression can make you feel suicidal, that life is no longer worth living.

Most people experience feelings of stress, unhappiness or anxiety during difficult times. A low mood may improve after a short period of time, rather than being a sign of depression.



Eating disorders

An eating disorder is when you have an unhealthy attitude to food, which can take over your life and make you ill.

It can involve eating too much or too little, or becoming obsessed with your weight and body shape.

But there are treatments that can help and you can recover from an eating disorder.

Men and women of any age can get an eating disorder, but they most commonly affect young women aged 13 to 17 years old.

Types of eating disorders

The most common eating disorders are:

  • anorexia nervosa – when you try to keep your weight as low as possible by not eating enough food, exercising too much, or both

  • bulimia – when you sometimes lose control and eat a lot of food in a very short amount of time (binging) and are then deliberately sick, use laxatives (medicine to help you poo), restrict what you eat, or do too much exercise to try to stop yourself gaining weight

  • binge eating disorder (BED) – when you regularly lose control of your eating, eat large portions of food all at once until you feel uncomfortably full, and are then often upset or guilty

  • other specified feeding or eating disorder (OSFED) – when your symptoms do not exactly match those of anorexia, bulimia or binge eating disorder, but it does not mean it's a less serious illness

OSFED is the most common, then binge eating disorder and bulimia. Anorexia is the least common.

Check if you have an eating disorder

If you or people around you are worried that you have an unhealthy relationship with food that's affecting your eating habits, you could have an eating disorder.

Symptoms of eating disorders include:

  • spending a lot of time worrying about your weight and body shape

  • avoiding socialising when you think food will be involved

  • eating very little food

  • deliberately making yourself sick or taking laxatives after you eat

  • exercising too much

  • having very strict habits or routines around food

  • changes in your mood

You may also notice physical signs, including:

  • feeling cold, tired or dizzy

  • problems with your digestion

  • your weight being very high or very low for someone of your age and height

  • not getting your period for women and girls

It's important to remember that even if your symptoms do not exactly match those for anorexia, bulimia or binge eating disorder, you may still have an eating disorder.

Warning signs of an eating disorder in someone else

It can often be very difficult to identify that a loved one or friend has developed an eating disorder.

Warning signs to look out for include:

  • dramatic weight loss

  • lying about how much and when they have eaten, or how much they weigh

  • eating a lot of food very fast

  • going to the bathroom a lot after eating, often returning looking flushed

  • excessively or obsessively exercising

  • avoiding eating with others

  • cutting food into small pieces or eating very slowly

  • wearing loose or baggy clothes to hide their weight loss

Getting help for someone else

It can be difficult to know what to do if you're concerned that someone you know has an eating disorder.

People with an eating disorder are often secretive and defensive about their eating and their weight, and they may deny being unwell.

Let them know you're worried about them and encourage them to seek help