Mental health – your questions answered

21 March 2017

For this topic, Nurse Nikki Porges from AXA PPP healthcare’s dedicated Health at Hand team, answered your questions about mental health, in one of our monthly Live Chats.

Questions asked were:

I’m down at the moment – could it be depression? When do you need to see a doctor?

Nikki answered:

Feeling down can be a normal reaction to life situations, but if it’s affecting aspects of your life like your sleep, appetite and concentration, and lasts longer than two weeks then generally it's a good idea to have a chat with your GP.

If you have depression, is there anything you can do or take other than take prescribed anti-depressants to help yourself feel better?

Nikki answered:

Depending on how your symptoms are affecting you. i.e. if you’re still able to work and your sleep is not too badly disturbed, there are some things you can do that should help to lift your mood.

Possibly one of the most important one of these is to seek help through counselling or therapy, this is where you will find a safe space to explore how you are feeling and why, and learn how to deal with these issues successfully. People often can’t see an obvious cause for their depression and this can be because it may be related to some deep buried issues and incidents that only come to the surface once life is at a settled place.

Good counselling and therapy can help to address and overcome these issues and help you to move on. Other activities that have been found to be helpful include exercise, which is probably at the top of the list. Whether you take up walking, running, cycling, or a regular gym routine, being more active has a positive impact on your mental health and can help to bring about positive change. If depression has been brought on by stress or anxiety then we would usually recommend taking up activities such as yoga, meditation or Pilates - all of which can help and provide a space for you to carve out a time for yourself. If you’ve tried these things and depression is still a problem then don't be shy about discussing this with your GP.

Why do I feel the added pressure when caring for an elderly parent?

Nikki answered:

You may be experiencing 'carer' stress. It’s not unusual to find yourself meeting the needs of elderly parents experiencing failing health, as well as coping with your own immediate family needs and a busy working life, these can often come together to create a 'perfect storm' of stress. If you find you’re experiencing feelings of frustration or anger, or even rage then you may be experiencing a degree of overload. Just know that it’s very normal to feel like this at times, given the circumstances.

There are organisations that can offer both help and support which may in turn take the pressure off of you. If, however, these feelings are affecting you in a way that you’re unable to sleep, or lose your appetite and if you’re experiencing frequent mood changes ,or are just feeling unable to relax, then you may like to seek either counselling or a chat with your GP, who will be able to refer you for more support.

Do you know what Fluoxetine is good for? Are there any side effects?

Nikki answered:

Fluoxetine is Prozac and is a selective serotonin reuptake inhibitor (SSRI) antidepressant medication. It works by boosting one of the neuro chemicals that is responsible for our mood and, in this case, serotonin, a hormone that helps stabilize your mood. It does come with side effects, which you should discuss with your pharmacist and bear in mind that while all medication can cause side effects this does not necessarily mean you will experience them. There are also many other forms of SSRI antidepressants available and if you were to find the fluoxetine didn't agree with you then just have a chat with your GP, who will be able to talk you through the options.

I had a relationship which ended badly and I had some sort of breakdown as a result. I’ve been having some counselling and wondered how long before I typically start to get over it?

Nikki answered:

I'm so sorry to hear you have been going through this, things have obviously been very hard - well done for getting the counselling, it’s certainly a step in the right direction. Unfortunately it's not possible to put a time on recovery as each and every one of us is unique.

There’s no right or wrong here, things will take as long as they need. If you are finding the counselling has helped then it's sensible to continue with this. Being physically active is known to improve stress, anxiety, as well as resilience, which is your ability to bounce back from life’s challenges.

If you feel your symptoms and the effects of the relationship breakdown are still affecting you very badly with little relief then you may like to consider looking at medication to support you while you heal from this which your GP will be able to help with. If you’re already taking medication then it may also be worth asking for a review as to how well this helping. Above all, give yourself time - emotional healing is a process that can take several years.

I have anticipatory anxiety and this heightens the anxiety when I do anything. Do you have any tips to overcome this? Cognitive Behavioural Therapy (CBT) isn't helping all that much.

Nikki answered:

Anticipatory anxiety is fairly common. While some people find CBT very helpful it doesn’t always suit everyone who tries it; sometimes it may be worth considering finding another CBT practitioner who you work with better. Alternatively, you may like to look into a deeper form of therapy, such as Psychotherapy, as this would help to reveal where the anticipatory anxiety is stemming from and help to identify and then treat this underlying cause. Other techniques that may be helpful include mindfulness, meditation and introducing some relaxation techniques, such as Yoga or gentle exercise into your every day life.

What is the best way to find a psychiatrist who is properly qualified and approved?

Nikki answered:

Your GP should be able to suggest someone suitable for you to see, but qualifications for a Psychiatrist are ‘RCPsych’. All psychiatrists have to train as Drs first, so the letters RCPsych will be displayed after their name, i.e. ‘Dr Smith RCPsych’.

Further reading

Experiencing mental health challenges is a normal part of many people's lives, but it’s vital to RECOGNISE when you need help, TALK to someone, and then ACT to make changes. Our mental health centre has a wealth of articles aimed to help you cope with stress, anxiety and depression.

Useful resources for help and support


Royal College of Psychiatrists