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When Should You Speak To Your Doctor About Your Mental Health?

mental health
(Image credit: Unknown)

Mental health conditions like depression and anxiety can have devastating effects on your life, but it’s still not always easy to speak to a medical professional about them. Whether that’s because you struggle to recognise the condition, or simply don’t feel confident about going to speak to a doctor about your mental health, a lot of people end up suffering in silence.

A good first step, as frontline NHS doctor Emeka Okorocha explains, is talking to people you trust and discussing how you’re feeling. They can help you get assistance from professionals, which can make a world of difference.

“It’s extremely important to go [and seek help], because chronic conditions always have a better prognosis if caught early,” says Okorocha. “Anxiety and depression get worse as they progress. If you’re digging a hole, the more you dig the harder it is going to be for us to fill in that hole. If you’ve only dug three spadefuls, we can fill in three spadefuls in a short space of time. But a lot of people keep digging and before you know it it’s been years.

“When it’s been years, your lifestyle, habits and thinking are different. Changing all of that takes time and work. It does happen, but it will perhaps take just as long to get you back to normal. If you’re noticing these signs, come see us earlier rather than later, when you have cemented habits and a way of thinking.”

We spoke to Okorocha, who is an ambassador for home workout app Freeletics (opens in new tab), for more information on what to look out for, and what you can expect when you do go and visit a doctor.

What are the symptoms you should look out for?

There are a few red flags. One is distancing yourself – if you’re not engaged in activities with your friends, not seeing your family, and find yourself alone most of the time. Alone not just in the physical sense, but also no communication. No calls, no texts. When you find yourself alone with your thoughts, that’s when it gets very dangerous.

Another thing is lack of interest in activities. We call this anhedonia. Stuff that you would have liked before, like going out with mates, watching football, going shopping. You don’t do that any more. You just don’t have the urge or desire to do it.

Sleep patterns are a big one. A lot of people suffering from depression or anxiety find it difficult to fall asleep or stay asleep. Early morning waking is something we look for and we look at a span of two weeks at least and see if it’s not triggered by any personal acute life changes. If you have just had a bereavement and you’re very low, we wouldn’t class that as chronic depression, because that’s a life event which has a normal trigger and a normal social response. However, with depression there’s not an obvious trigger. It can just happen and people often don’t understand why.

Another thing is a lack of eating. People who are suffering depression have a poor diet. And chronic illness is another risk factor for depression. If you have a chronic illness you’re suffering with, that can get you low.

Those are the kind of things we look for. Changes in personality, changes in behaviour, and changes in sleeping and eating, without any obvious triggers.

What should you do when you first spot these signs?

I tell people to try not to focus on the stigma, but on how you’re feeling. You don’t need to go telling people “I’m depressed” – people don’t want to be labelled. Open up about how you’re feeling to the people closest to you. Speak more about your symptoms and what you’re experiencing, rather than saying, “I might have depression or anxiety”. Just getting that out, and talking to someone about how you’re feeling can make you feel better. The people closest to you can give you advice, and also watch out for these trigger signs.

It’s sometimes difficult to come to a doctor’s surgery and talk about it. It can feel very daunting to book an appointment. It’s easier to talk to people around you, the loved ones you speak to every day. They can give advice, or even flag it up to the doctor and go with you. Obviously with COVID protocols that’s difficult, but they can help set it up.

What can you expect at an appointment with a doctor?

The doctor is basically going to ask you a lot of questions. Generally we don’t need to run blood tests, or do X-rays or scans – although sometimes we do, because a lot of these symptoms can be masking a chronic disease such as underactive thyroid disease, say if you’ve been feeling very lethargic or gaining a lot of weight. We also know depression is linked with Parkinson’s disease and early onset Alzheimer’s.

We aim to exclude all the medical clinical diagnoses, and after that we will ask questions. Everyone who has been to medical school will know the questions to ask. Based on the answers they’ll be able to say when a person may have depression, or anxiety. From there the doctor will talk about lifestyle management before you go on any treatment. If there are any triggers, the doctor will suggest a lot of stuff. Usually there will be follow-up consultations.

We prefer to leave medication as a last resort. There are a number of different things we can try, like cognitive behavioural therapy and behavioural group therapy, before going on medication. When you are on medication it is quite difficult to get off. It’s not something you can start and stop like antibiotics.

If you don’t have a great relationship with your doctor, where else can you get help?

A lot of people find it difficult to get an appointment with their GP, and not everyone has a great relationship with their GP. It’s very difficult to see someone else once you’re assigned to a GP in your practice. And some people don’t have the time, or don’t want to be stigmatised. But there are loads of organisations you can contact. If you go on the NHS website (opens in new tab) there are links to organisations like Mind (opens in new tab).

How can exercise help your mental health?

I’ve been advocating exercise as a therapy to combat depression. During lockdown, when a lot of us haven’t had access to gyms, I’ve been doing a lot of home workouts, which I found really good for me, for my energy and keeping my mental health up. I’ve been encouraging others to do the same.

A lot of my colleagues have struggled with mental health over the past year. There were a lot of dark months, especially when we were working during the second wave in winter time. At the end of a day, I didn’t want to think about COVID or work, and what helped me get over it was exercise. I always loved team games, but we didn’t have access to any of that, so I needed to find a way to keep active and get my mind off what we were seeing at work. I started doing a lot of home workouts. I got the resistance bands like everyone else! It kept me fit, for one, plus it kept my mind active and busy, and not thinking about the terrible things we were seeing at work.

Nick Harris-Fry is a journalist who has been covering health and fitness since 2015. Nick is an avid runner, covering 70-110km a week, which gives him ample opportunity to test a wide range of running shoes and running gear. He is also the chief tester for fitness trackers and running watches, treadmills and exercise bikes, and workout headphones.