Healthy Surrey:

Healthy Surrey

First Steps: emotional health and mental wellbeing advice and support guide

The First Steps guide offers a range of advice, information and self-help techniques that we all can use to help support our emotional and mental well-being.

If you are looking for the phoneline, please visit our First Steps to Support phoneline webpage.

Introduction

Emotional wellbeing and mental health

The term 'mental health' means different things to different people but in essence it's about how we think, feel, behave and cope with life.

Emotions are a part of our everyday lives and affect us all. You may feel up and down, but that's normal – we all feel like that at times. It is important to recognise that even if you are not feeling down, looking after your own emotional well-being is just as vital as looking after your physical health.

Feeling happy, excited or full of confidence is accepted as normal and is often in response to positive events or situations. In a similar way feeling stressed, low in mood, anxious or angry is often a normal reaction to challenging or difficult situations in life – you are not alone. People sometimes feel that their distress is a weakness, but this is not the case.

It may be that using some of the self-help tips on this webpage or attending some Virtual Wellbeing sessions or courses run by the Recovery College are enough to help you cope/ feel well again. Or getting some help from the local talking therapy services or Community Connections.

But if negative thoughts and feelings become so frequent and/or severe that they disrupt our ability to cope with daily life, then they can develop into mental health problems.

Mental health problems are very common – approximately one in four adults will have a mental health problem at some point in their life (most commonly anxiety, depression or both), and they can happen to anyone.

Mental health problems can affect our mental and emotional capabilities, relationships, work and overall quality of life. So it's important to recognise when things are getting difficult and interfering with your ability to manage. The earlier you get help, the more likely and better you will cope with difficulties.

With the right advice, support and information, people experiencing mental health problems usually make a full recovery or learn to manage their condition/symptoms and live fulfilling lives.

Signs and symptoms to look out for (in yourself and others) include:

  • Feeling very emotional
  • Unusual mood swings or agitation
  • Poor concentration and decision-making
    ability
  • Social withdrawal
  • Changes in energy levels, sleep
    disturbances
  • Frequent headaches and/or minor illnesses
  • Using alcohol or drugs to cope
  • Thoughts of self-harm or suicide

What this webpage is for

This webpage is for anyone aged 18 years or above who is looking to take the first steps to improve mental well-being for themselves, their friends or family members. There is some information for young people too.

It provides:

  • A range of advice, information and self-help techniques that we all can use to help support emotional well-being
  • Brief information on common emotional and mental health issues
  • Details of local and national organisations that provide support

For more information on local and national services, please visit the mental wellbeing webpage.

If you would like this information in large print, Braille, on CD or in another language please contact us on:

Sight for Surrey

Help and support for people who are blind, vision impaired, deaf, deafblind or hard of hearing.

Who can help me in Surrey

Website and phone line

To help you understand your emotions, thoughts and feelings, and make informed choices to address your mental well-being needs, there are services that you can refer yourself to.

  • Healthy Surrey website
  • Also a confidential phone line, webchat and SMS to guide you to self-help resources and services that can help with your emotional and mental well- being, provided by Surrey Drug and Alcohol Care (SDAC)
    • Telephone: 0808 802 5000
    • SMS: 07537 432 411
    • Email: admin@sdac-helpline.co.uk
    • Open 9am to 7pm Monday to Friday and free from landlines and mobiles. (You can leave or send a message outside these times). If you feel you need more clinical support speak to your GP.

Financial, welfare and wellbeing support

We know that people all across Surrey are feeling the impact of increasing costs and pressure on household budgets. You can access information and advice about the financial and welfare support on offer in Surrey in the County Council's health and welfare support pages online.

If you would like to talk to someone about getting support you can ring the Surrey County Council Community Helpline or complete the community helpline enquiry form.

  • Telephone: 0300 200 1008. Monday to Friday, 9am to 5pm.
  • For deaf and hearing impaired residents online, also Monday to Friday, 9am to 5pm:
    • SMS: 07860 053465
    • VRS: Sign language video relay service

Surrey Virtual Wellbeing Hub

Virtual Wellbeing offers online sessions and classes to support your mental health as we emerge from the COVID-19 pandemic, for example coffee mornings, writing for positive mental health, peer support groups (for example managing fear and anxiety), yoga for all abilities, walking, mindfulness, football and book chat and many more.

Surrey Social Prescribing Services

Advisors help you find local services and opportunities that can help improve your health and wellbeing. Several services operate in Surrey, some require referral from a professional and some you can self refer to. Find out more about social prescribing.

Recovery College

For workshops and courses on emotional and physical well-being. Find out more about the Recovery College.

NHS Talking Therapies

There is a choice of Talking Therapy services available across Surrey for people over 18 years and registered with a GP in the county.

It's for those who are experiencing mild to moderate mental health problems including stress, low mood, anxiety, panic attacks, depression (including pre and post-natal), obsessive compulsive disorder, phobias, post-traumatic stress and eating difficulties.

You can refer yourself or be referred by your GP, and you can decide which service you want to help you.

The services offer a range of treatments including cognitive behaviour therapy both in person and online, other individual therapies, group therapy, workshops and courses (like managing emotions, worries, depression), guided self-help material, book recommendations and employment advice.

The following choice of services are available for all Surrey residents – except those in Farnham – where it is Talk Plus.

Community Connections

Community Connections services offer a range of support, aimed at improving your emotional and mental well-being. You can refer yourself or be referred by a GP or mental health professional.

Services include: one to one support; support groups; drop in services; signposting to local agencies, such as employment support; and activities including walking groups, art groups; mindfulness sessions; social events; peer support; and confidence building courses.

Three different organisations provide services across Surrey.

Visit the Community Connections website to find out who to contact.

Catalyst

Spelthorne, Runneymede, Elmbridge West, Woking, Guildford, Waverley, Surrey Heath, Farnham

Mary Frances Trust

Mole Valley, Epsom & Ewell, Elmbridge East, Banstead

Richmond Fellowship

Reigate and Redhill, Tandridge

Citizens Advice (CA)

Citizens Advice Bureau provides a preventative approach around the stresses of modern life that put a strain on good mental health and well-being including: housing issues; employment problems; and benefits changes. There are several branches in Surrey.

  • Telephone: 0800 144 8848
  • Textphone type: 18001 followed by: 0800 144 8884

The CA has a specialised outreach advice service in four boroughs to help people with severe and enduring mental health issues. You need to be referred by your mental health service. The service is for those due to their illness, are unable to visit or telephone their local CA. Specially trained caseworkers can help with advice and taking action.

Keeping yourself well

Wheel of Well-being

The 'Wheel of Well-being' is a fun and practical tool that's easy for everyone to use. The wheel presents six actions which are proven increase positive feelings and boost well-being.

The actions are:

  • Body: be active – for example go for a walk or cycle ride, or a brisk walk
  • Mind: keep learning – for example visit a museum, read a newspaper or take a course
  • Spirit: give – for example volunteer your time to help others offer a listening ear
  • People: connect – for example catch up with friends and family
  • Place: take notice – for example go out and look at the world around you
  • Planet: care – for example recycle as much as you can and reduce use of your car

Find out more on the Wheel of Well-being webpage or visit National Wheel of Well-being.

Every Mind Matters

The new Every Mind Matters campaign can help you discover simple steps to achieve good mental health. It's full of expert advice and practical tips. It also has a free NHS-approved online tool on the Every Mind Matters website, which helps people build an action plan to deal with stress and anxiety, boost their mood, improve their sleep and help them feel more in control.

Take care of your physical health

Taking care of our bodies is vital for mental and emotional health, as mental and physical health are interlinked. So when you improve your physical health you will automatically improve your mental and emotional well-being.

Eating a healthy and balanced diet and keeping hydrated with plenty of water improves your mood, energy and concentration, and benefits your body and immune system.

Avoiding foods which make your blood sugar rise and fall rapidly, such as sweets, biscuits, sugary drinks, caffeine and alcohol can help you feel better too. Other healthy eating tips can be found on the One You website.

Regular physical activity or exercise is good for us in many ways, it can:

  • Increase our confidence and self-esteem and lift our mood
  • Release tension and frustration
  • Relieve stress and anxiety and can help reduce the risk of depression
  • Boost energy
  • Help us to relax and sleep better
  • Prevent physical illness, such as colds and viruses, as well as heart disease, stroke and cancer.

Choosing physical activities that you enjoy will make them more fun and it easy to fit them in regularly.

Useful contacts

Relationships and social support

Connecting with other people and maintaining positive relationships is vital to our overall well-being and mental health.

Relationships can provide support, reduce stress, add more meaning to our life and encourage personal growth.

When we have a genuine and positive effect on others, we feel like we are making a difference in the world. Positive relationships can fulfil our need to belong in a community, and without this sense of belonging we can feel isolated and disconnected.

Useful contacts

  • Side by Side - a safe and supportive online community where you can be yourself - listen, share and be heard.
  • Community Connections
  • Connect to Support Surrey - lists organisations providing befriending and social opportunities/activities in the Community section and support groups in the Mental Health section.

Self help resources and techniques

As with any new skill, self-help can take time and practice.

In the same way that reading a cookery book will not instantly make you a great cook, simply reading this booklet will not make you instantly happy and healthy. But with time, exploration and practice of self-help techniques, it is possible for everybody to increase their resilience and mental wellbeing. The tips and techniques listed here are proven to manage emotions and help maintain good emotional wellbeing. We are all individuals and respond to situations in different ways, so not every technique will work for everyone.

Self-help alone may not be adequate for everybody. If you feel you need more support, it is important to seek help or talk to your GP.

Tip 1 - controlled breathing

Taking quick and shallow breaths is very common if you're anxious, angry, irritable or stressed.

If you notice you are doing this, try and slow it down and breathe in through your nose and out through your mouth.

Take deeper down, calming breaths (using your diaphragm rather than upper chest muscles). Getting into a regular rhythm of 'in-two-three and out two-three-four' should soon return your breathing to normal.

While you are breathing in, let your stomach expand and feel your ribs move outwards. Imagine that you are trying to inflate a balloon in your stomach as you breathe in and deflate it as you breathe out.

Breathing out a little longer than you breathe in can help to calm you.

Tip 2 - relaxation

Simple relaxation techniques:

  • Take a five minute break alone to clear your head
  • Listen to music
  • Read a book
  • Take a warm bath
  • Exercise
  • Watch TV

Deep muscle relaxation is great for anyone who gets stressed or anxious:

  • Find a quiet, warm, comfortable place
  • Choose your most relaxed time of day
  • Lie or sit down, get comfortable, close your eyes and concentrate on your breathing for a few minutes, breathing slowly and calmly.

Now focus on your body, tensing and relaxing each of the muscle groups in this order:

  • Feet: point your toes away from your body, hold, and then relax
  • Calves: bend your foot at the ankle towards you, hold, and then relax
  • Thighs: push your knees together, hold, and then relax
  • Glutes: tense your bottom muscles, hold and then relax
  • Stomach: pull in your stomach muscles, hold, and then relax
  • Hands: clench your fists, hold, and then relax
  • Arms and shoulders: hunch your shoulders up towards your ears, hold, and then relax
  • Neck: pull your chin forwards on to your chest, hold, and then relax
  • Jaw: clench teeth together, hold, and then relax
  • Forehead: frown hard, wrinkle forehead, hold, and then relax.

Tip 3 - distraction, thinking of or doing something else

Focusing your mind on something other than your symptoms or a stressful event for a few minutes can be helpful.

For example: describing an object to yourself; counting backwards from 100; picturing or describing a safe and happy place or memory; focusing on your senses; or speaking or meeting with a friend.

Tip 4 - challenge your thinking

Sometimes it is better to reflect and challenge how you think.

Think about the situations that concern you, and how you behave and jot down the unhelpful thoughts you have during that time. As we can tend to over generalise or over personalise reasons, try to counter-argue these thoughts by thinking about the following questions:

  • What is the evidence for and against these unhelpful thoughts? What other reasons or explanations could there be for something happening or how someone acts?
  • How many times have you had these thoughts and has your worst fear ever actually happened?
  • Imagine what you would say to a friend if they were having similar thoughts about themselves. Then write it down and try saying these things to yourself
  • Think about and visualise how you could behave or think differently in situations to help you to feel better.

Tip 5 - challenge your fear

Don't always let fear be the reason for putting things off or stopping you doing things you used to enjoy.

As well as challenging your thoughts, you can actually challenge what you do.

For example, gradually test out situations that you fear to see what happens. Instead of escaping from situations that make you
anxious, gradually increase how long you stay. This is probably best done in a planned and controlled way.

Tip 6 - do something creative

Evidence shows that doing something creative can help make people feel better and provides opportunities to meet and connect with other people.

The Virtual Wellbeing Hub has various creative sessions.

Community Connections services run creative activities. Surrey Arts also offer creative activities.

Be kind to and look after yourself

Your general emotional well-being is an important part of how well you feel each day.

  • We often say to ourselves that we will do what we enjoy when we feel better. More often than not we feel better when we do what we enjoy. So try switching it round and do something you enjoy so that you feel better.
  • Be kind to yourself by avoiding harsh self-talk or judgements and incorporate one or two things that make you happy into your day.
  • It is important to try to remind yourself of your positive points. Think about the things that you are able to do and are good at rather than the things that you can't.

Tip 8 - improving communication

Talking things over with friends, family, loved ones or other people that you trust can be helpful – it can help to lift the burden off your shoulders. Good communication with other people is important because it influences all types of relationships, while poor communication can lead to isolation, misunderstandings and arguments / disputes.

There are three key skills in communication:

  • listening to what other people are saying
  • expressing what you think and feel
  • accepting other people's opinions and feelings.

Tip 9 - assertiveness

Being assertive is where our feelings, thoughts and beliefs are communicated in an open, honest manner, without going against the rights of other people. It includes saying "no" to others and expressing personal opinions without feeling self-conscious.

Assertiveness is different to being aggressive – where we do not consider other people's rights, and different to being passive – where we do not consider our own rights. We can improve our assertiveness with practice.

Visit Psychology Today and BBC I Can Do It - Assertiveness to find out more.

Situations or events that can affect our mental well-being

Bereavement and loss

Loss of any kind is something that most people will face at some time in their lives. People's experiences of loss vary, but symptoms can include:

  • Numbness, panic, tearfulness or the inability to cry
  • Difficulty sleeping
  • Physical symptoms, such as heart palpitations
  • Dealing and coping with things calmly, or being completely unable to cope and requiring a lot of support
  • Feeling guilty that more should have been done or things done differently
  • Feeling angry, sometimes directed at the person who has died or the cause of the loss.

Coming to terms with a death or loss can take a long time, but there are services available that can support people.

Useful contacts

Bullying and harassment

Bullying is when an individual or group of people deliberately pick on someone – often again and again – and victims find it difficult to defend themselves. Harassment is unwanted behaviour which you find offensive, or which makes you feel intimidated or humiliated.

Bullying and harassment can be experienced in colleges, workplaces, neighbourhoods as well as online. They can also be done verbally or physically and have a lasting effect on someone's mental and physical health. Bullying and harassment can leave people
feeling sad, lonely, depressed or anxious, or give people physical symptoms such as stomach aches and headaches. Some people may even want to avoid going to college or work. If you are experiencing bullying it is important to take steps to stop it. You can tell a trusted person within your college or workplace – many have anti-bullying policies and systems.

If it is online bullying, keep a record of posts and messages, don't respond and block or delete the person if you can. You may also be able to contact the site administrator or the police if you feel in danger.

Take steps to look after your own mental well- being – find out about NHS Talking Therapies.

Useful contacts

  • Mind - has advice about online bullying. Visit the website and search 'bullying and abuse'
  • National Bullying Helpline - information and advice for anyone dealing with bullying. Telephone: 0300 323 0169 or 0845 225 5787.
  • Get Safe Online - visit the website and search 'bullying and abuse'

Domestic abuse

Domestic abuse is any incident of threatening behaviour, violence or abuse (psychological, physical, sexual, financial or emotional) between adults.

This can take place between people regardless of gender or sexuality, and between people who are or have been in a relationship together, or between family members.

It is abuse if your partner, ex-partner or a family member:

  • Threatens you
  • Shoves or pushes you
  • Makes you fear for your physical or financial safety
  • Puts you down
  • Controls you and takes control of your finances
  • Is jealous and possessive
  • Frightens you

There are a number of organisations that can support you if you are or have been a victim of domestic abuse.

Useful contacts

  • Surrey Against Domestic Abuse
  • Your Sanctuary. Telephone: 01483 776 822
  • Aanchal - support, information, advocacy, phoneline for S.E Asian women affected by domestic abuse (available in different languages). Telephone: 0800 0124 924
  • Childline - for anyone under the age of 19 who feels unsafe in their relationship. Phone number: 0800 1111 (24 hour, calls are free from phones and mobiles)
  • Men's Advice Line - advice and support for men in abusive relationships. Telephone: 0808 801 0327. Email: info@mensadviceline.org.uk

Sexual abuse and violence

Sexual violence is any unwanted sexual act or activity.

Sexual violence can include rape as well as other forms of assault such as sexual abuse of children or adults, sexual exploitation of children or adults, trafficking for the purpose of sexual exploitation, sexual assault by penetration, sexual assault, sexual harassment and female genital mutilation.

If you have experienced sexual violence, you may have experienced some of the following:

  • Recurrent depression or anxiety
  • Panic attacks, phobias and/or flashbacks
  • Anger and feelings of worthlessness
  • Self-blame and feelings of guilt and shame
  • Difficulties trusting others
  • Difficulties with intimacy and relationships
  • Sleep disturbance such as nightmares and insomnia
  • Eating disorders such as bulimia, anorexia and compulsive over-eating
  • Coping through substance dependency, self-injury, or aggressive behaviour

Please remember that you will get through this – you deserve to, and you will. Sexual violence is never acceptable – no one has a right over your body. Guilt, blame and shame belong to the perpetrator, not to you.

Remember, your needs and feelings are important - look after yourself.

The length of time you need to help you recover is personal to you but talking things through with a specialist counsellor is an option for you to consider. There are organisations that offer specialist support if you are experiencing or have experienced sexual abuse or violence at any point in your life.

Useful contacts

Debt and financial problems

Debt and financial problems are very common. They can come about for a number of reasons including delays in being paid, job loss, living on a low income, health problems, ignoring the bills and companies offering you loans and credit cards.

Debt can make you feel stressed, anxious, depressed, out of control, guilty and embarrassed to talk about it.

Debt can both cause and be caused by mental health problems, as poor mental health makes managing money harder. However there are things you can do:

  • It is important not to ignore debt – as it will only get worse
  • Explain your financial problems to someone who you trust
  • Get independent, expert advice from a reputable service
  • Keep track of and take control of your money and spending.

Useful contacts

Problem gambling

Problem gambling or gambling addiction is a repeated pattern of gambling behaviour where someone feels they have lost control;
continues to gamble despite negative consequences and sees gambling as more important to them than any other interest or activity. It can have a negative impact on people's mental and physical wellbeing, their relationships and finances.

There are a range of services that provide support and treatment, including help for families and friends.

Useful contacts

  • Be Gamble Aware - national freephone 24/7 national gambling helpline, live chat and information and advice for professionals. Telephone: 0808 8020 133
  • Gamcare - offers self help, helpline, live webchat, WhatsApp and Facebook messaging, forum, group chat, counselling and cognitive behavioural therapy. Telephone: 0808 8020 133
  • Gamblers Anonymous - a 12 step peer led fellowship group have meetings in Guildford and Staines
  • Gambling Therapy - offers practical advice and emotional support to anyone affected by gambling, by phoneline, text based support groups and self help information. Telephone: 01384 241292
  • Southern Gambling Service - provides treatment including individual psychotherapy and medication. Accepts referrals from individuals and professionals.

Long-term physical health conditions

" Our physical and mental health are very closely linked and people who live with a long-term physical condition— such as diabetes, arthritis or asthma— are also likely to experience mental ill health, such as depression and anxiety." - Mental Health Foundation

Having a long-term health condition* can not only have an impact on your physical health, but can also affect your emotional and mental health.

Many aspects of living with a long-term health condition can be difficult to deal with and you may find you are experiencing more unhelpful thoughts and emotions, such as stress, anger, anxiety, low mood, or depression. It is important to recognise how you are feeling and know that it is normal and common.

It is important to get the help you need for both your mental and physical health. The two are so linked that improving one can also
improve the other. There is more information on our long-term conditions webpage.

The Wheel of Well-being has everyday actions you can take to improve both physical and mental wellbeing.

You can also get support from NHS Talking Therapies.

* Long term conditions include (but are not limited to): arthritis, cancer, chronic fatigue syndrome, chronic pain, coronary heart disease, diabetes, digestive conditions, human immunodeficiency virus (HIV), musculoskeletal disorders, respiratory conditions and stroke.

Useful contacts

Social isolation and loneliness

Social isolation is when you feel alone (even if you are surrounded by people) and not part of social or cultural groups and activities. Feeling isolated can often have a negative effect on a person's mental well-being.

There are many things that can increase feelings of social isolation including shyness, social anxiety, job loss, role change, relationship breakdown, bereavement, having a baby, moving home.

Possible signs and symptoms of feeling isolated are reduced confidence, low self-esteem, depression, anxiety, withdrawal, shortened attention span, increased forgetfulness, general ill health or increased risk of substance or alcohol misuse. Most people need a certain level of social interaction with others to stay healthy, although the amount is different for everyone.

Getting in touch with and spending time with friends and family can reduce your chances of becoming depressed and lonely.
You can also meet and connect with other people, by going to social activities, drop-ins and groups for people feeling low or isolated
– see Community Connections, or look at volunteering opportunities offered by local services below.

Useful contacts

Work and unemployment

Our sense of identity and purpose can often be linked to the paid work we do.

Often when we meet new people, one of the first questions asked is "what do you do for a living?"

However, sometimes it can be hard to find or to stay in work due to a variety of factors such as: lack of available work; redundancy; or being unable to work through ill health. This can have a negative impact on our emotional well-being.

Related issues that may add to stress could be financial worries, responsibilities towards family members, attending interviews and feelings of letting yourself or others down. However there are some self-help strategies and local services that can help listed below:

  • Setting goals can be a helpful way to increase confidence and motivation and help you to feel in control of a situation. Break large goals down into smaller steps
  • Think about your skills that could be transferable to other jobs, like time management, planning, problem solving, communication or project management
  • Think about what benefits you get from work, this could be a sense of achievement or a reason to get up in the morning. Getting up for an exercise class or to get breakfast ready for the family, or to go to a volunteering role could give similar benefits
  • Seek help from Citizens Advice, Job Centre Plus or a supported employment provider. See the services listed below
  • Supported employment services can help you to stay in work if you are experiencing mental health problems, or get back to work if you recovering or have recovered
  • If you notice that you are feeling down or anxious much of the time, then you can get help and support from NHS Talking Therapies and Community Connections.

Useful contacts

People who may be more affected

Carers

Carers are those who provide unpaid support to family or friends who can't manage without help, due to a physical or mental health condition.

It is very common and normal to feel angry, guilty, isolated, stressed or low when caring.

Many carers feel a need to put on a brave face. It can feel that their difficulties are not important compared to those of the person they're caring for and result in the carer neglecting their own needs and health.

Providing care can be stressful and demanding, and can affect your physical and mental well-being, making it difficult to continue to provide that support. 80% of carers see their GP for illnesses which are made worse by the stresses of caring. So it is important to recognise if this is happening and to seek support, from your GP or Action for Carers Surrey – by asking about registering as a carer and the Carer's Prescription Scheme.

Being a carer gives you an additional role and this may affect your other roles such as being a partner, employee, friend, or son/daughter in the case of young carers.

When a role is lost or changes, our sense of identity, purpose and belonging may be affected, which can impact emotional health.

Useful contacts

Men

Men often feel that there is a lot more stigma attached to talking about emotional problems compared to women.

They may be worried that it will affect their career, the respect their friends and family have for them and their image of themselves as 'real men'. For all these reasons, emotional difficulties are often under-diagnosed in men, which can result in men not getting the treatment they need.

Emotional issues do not make you less of a man. They affect everyone at one time or another and are generally short-term, fixable problems if handled correctly. You wouldn't expect a broken leg to heal properly without treatment and it's exactly the same for issues like stress, anger and depression.

Achieving emotional well-being often means acknowledging and facing up to problems, and learning ways to overcome them.

Many people think that feeling sad or tearful is the main sign of depression, but this is often not the case. Feeling angry, frustrated, having regular headaches, muscle pains or digestive problems are all common symptoms of low mood, and for men they can often be what is noticed first. Men may also use different ways of coping to women when they are feeling low or stressed. For example, this might be drinking or smoking, overdoing activities like work or sport, or more risky behaviour such as reckless driving.

Useful contacts

Older people

Older age is a time when there are usually a number of life changes, such as retirement, bereavements, possible changes in physical health or becoming a carer. Adapting to these changes can be challenging and can have an impact on your emotional health.

However, later life can offer many advantages including increased time for hobbies and social activities, increased self-confidence and acceptance, and easing of domestic activities. The most common issues negatively affecting mental health in older age are depression and dementia, with depression being more common. Importantly, neither of these are inevitable. There are many options for talking things through and getting support. If you have any concerns, speak to your GP, Age UK Surrey or NHS Talking Therapy services.

Useful contacts

Parents

Your parenting style can have an effect on your children. Research shows that the most effective parents are those who are loving and affectionate, but who also set rules and challenge bad behaviour. This creates a positive relationship between parents and children and the children tend to be happy and confident.

Being a parent can be hard and even more so if you are experiencing mental health problems.

Sometimes parents can be reluctant to or avoid talking about their own mental health, because they are worried about being perceived as a bad parent or that a child will be taken away from them.

However it is widely recognised that supporting parental mental health also helps the children. So it is important that parents seek help from services to support their own mental health.

Children can also experience emotional distress. Not every child will display the same symptoms of distress, and the symptoms shown will also depend on the age of your child.

Learning self-help strategies to help manage worries as a parent, as well as how to support the emotional health of your child, is helpful. If your child is experiencing emotional distress, this does not necessarily mean that they have a mental health condition. If you are unsure, you may want to seek advice or information from some of the services listed below.

Children can also be affected by mental health problems (research shows that 50% of mental health problems are established by the age of 14), which can be upsetting for their parents. If you notice changes in your child's behaviour which are similar to the symptoms of depression, anxiety or stress, then it is important to seek advice from your GP and/or the services listed below.

Useful contacts

Serving members and veterans of the British armed forces

Serving members or veterans of the British armed forces can experience the same mental health difficulties as the general population, and can also access mainstream services.

Although as serving members or veterans they may also have experienced unique risks in service and so there are specialist services available for them.

Useful contacts

Young people

Being young is an exciting time but it can also be difficult as there can be lots of changes, and uncertainty about the future. Young people can face many issues which can be hard to deal with, for instance:

  • Stress
  • Life changes
  • Relationships
  • Self-esteem
  • Life decisions
  • Exam pressure
  • Addiction to alcohol, drugs, or smoking

The following services offer information and support for difficulties you may be facing.

Useful contacts

Gender identity and sexuality

Some people identify as LGBTQ+ (Lesbian, Gay, Bisexual, Transsexual, Queer, Questioning, non binary), or may define their gender and sexuality in other ways.

People who identify in these ways, can be more vulnerable to and experience higher rates of poor mental health than the general population. Factors that contribute to this include: a sense of 'otherness', the fear of rejection from family, peers and society, experiences of bullying, stigma, discrimination and harassment in day-to-day life, and being the victim of hate crimes and incidents. These can often lead to low self esteem, depression, anxiety and isolation.

Talking about these issues and seeking support are important ways to help manage your emotional and mental health.

Useful contacts

Different ethnic groups

Different ethnic groups have different rates and experiences of mental health problems. This can be due diverse cultures and views of mental health, different socio-economic circumstances, language barriers and access to culturally appropriate treatments.

Mental health problems can also go unreported/untreated or treated later, because some ethnic minority groups are reluctant to engage with mainstream health services (often due to cultural reasons, shame or stigma); and because mainstream services are not always culturally acceptable/ accessible to different ethnic groups – although services are working to improve this.

However, it is important to seek help/support – whether it be self help, or from services, many of which you can self refer to.

Useful contacts

Common emotional and mental health problems

Anger and frustration

Anger is a normal, natural feeling that affects everyone, and when triggered appropriately, can be helpful.

However, for some people anger can get out of control and cause problems with relationships, work and even the law. If anger is not managed or becomes uncontrolled, it can also negatively affect mental and physical health by contributing to: feelings of low self worth, depression, sleep problems, alcohol and substance misuse, self-harm, high blood pressure, colds and flu and gastro-intestinal problems.

Anger can be caused by many different things for example feeling: upset, sad, low, stressed, tired, hungry or in pain, undervalued, misunderstood, threatened or out of control. Anger can also be a symptom of depression, especially in men.

When we are angry we have unhelpful thoughts, for example ('no one listens to me'), unhelpful emotions (anger or guilt), physical reactions (shaking, racing heart or muscle clenching) and unhelpful behaviour (shouting or withdrawing from others). These factors affect each other and can maintain the vicious cycle of anger.

Anger can cloud your thinking and judgment and may lead to decisions and actions that are unreasonable or irrational.

Anger can be expressed in different ways by people and include:

  • Outward aggression and violence, like arguments, shouting, hitting or throwing things and fighting
  • Inward aggression like harsh self-talk and criticism – saying you hate yourself, denying yourself basic needs or things that make you happy
  • Bottling up emotions or feeling withdrawn
  • Passive aggression like ignoring people, sarcasm, deliberately doing things late or badly.

The goal of effective anger control is not to eliminate anger altogether, but to learn to channel it into behaviour that is productive, not destructive.

A good start is to:

  • Look out for warning signs like a racing heart, fast breathing, tension, clenched jaw and fists
  • Buy yourself some time to and calm down by counting to ten or walking away briefly before reacting
  • Try some calming techniques like controlling/slowing your breathing, using some pent up energy safely by exercising, hitting a pillow, or smashing ice cubes in a sink.

You can get help with managing anger from NHS Talking Therapies.

Useful contacts

Anxiety

Anxiety is when we feel worried, tense or afraid – usually about things which are about to happen or we think may happen in the future.

Anxiety is a normal and healthy response experienced by everyone at one time or another when we think we are under threat. Some of the physical signs are the body preparing for action in the face of a threat.

The symptoms of anxiety can include:

  • Physical ones like difficulty breathing, chest pains, feeling faint, racing heart, numbness, headaches, the need to go to the toilet or feeling sick
  • Thoughts and feelings like poor concentration, circling thoughts, fears, unhelpful thinking, thinking irrationally and loss of self-confidence
  • Behaviours like avoiding doing things.

However, anxiety can become a problem if the symptoms are triggered when there is no real threat, or when symptoms become too frequent, last too long or start to affect our ability to function in our daily lives.

The most common type of anxiety is known as generalised anxiety. Other types include panic attacks, phobias, shyness and post-traumatic stress disorder (PTSD).

Panic attacks are characterised by a sudden onset of intense feelings of fear or apprehension.

The reaction may be triggered by a specific situation or come out of the blue. Avoiding the triggering event may bring temporary relief but in the long term makes the condition worse.

Panic attacks are:

  • Not dangerous – although your heart rate is high, you are not having a heart attack. They are quite common and affect people differently
  • Not a sign of serious mental or physical illness
  • Manageable and treatable

Phobias are a specific fear attached to a particular object or situation, like spiders, blood or heights. The fear is out of all proportion to the object or situation and although it's irrational, the person feels powerless to do anything about it.

A phobia is a mixture of fears, anxieties and avoidances, for example agoraphobia is fearing open spaces, and places where escape is difficult.

Shyness and social anxiety is a strong fear or embarrassment in social situations like speaking in public, social events or eating out. It is often based on the belief that others will judge or think badly of you, or that you are not as good as others. It can
lead to avoidance of social situations, and reduce social life and work-related prospects.

PTSD is an after effect of a traumatic event or life-threatening experience that can have a lasting impact on memory and the way a person acts or feels.

For some people this impact comes from experiencing an event first hand, while for others it might be from witnessing or having knowledge of the event.

Some general self-help tips for managing anxiety include:

  • Talk to someone you trust
  • Try to manage your worries – think what can you do to help reduce them or address the causes
  • Look after your physical health – exercise, reduce/avoid excessive caffeine and alcohol, eat healthily, get enough sleep and if you smoke consider quitting – research shows it can improve mood and relieve stress, anxiety and depression
  • Try breathing exercises – generally using your diaphragm to breathe, rather than your chest muscles and breathing out for longer than you're breathing in can be a calming experience
  • Keep a diary or journal – writing worries down can help to stop them circling in your head
  • Complementary and alternative therapies.

Anxiety is common and can be overcome with treatment. You can find self help on Every Mind Matters, refer yourself to NHS Talking Therapies which provide a range of 1-1, group and online, or to Community Connections, or visit your GP.

Useful contacts

Body image

Appearance can play an important part in our self-worth. Symptoms of low body image include:

  • Having a distorted view of what you actually look like
  • Changes in eating patterns
  • Being highly critical of yourself
  • Having self-doubt
  • Blaming yourself if things go wrong
  • Ignoring positive qualities
  • Feeling depressed, anxious, guilty or ashamed

These types of thoughts and feelings may make life more difficult. For example, a person may become preoccupied with their appearance and look for evidence that confirms their unhelpful beliefs, avoid places or situations, try to change their appearance or self-harm through harsh dieting and exercise regimes, or place unrealistic expectations on themselves, leaving them vulnerable to failure which in turn reinforces feelings of low self-worth.

If your body image or relationship with food is having a negative impact on your life it is important to seek advice and help, such as from organisations listed in the Young People section - or speak to your GP.

Useful contacts

Depression and low mood

Everyone can feel down, but it could be a sign of depression if these feelings last more than a few days, recur frequently or start to affect your work, interests or feelings towards your family and friends.

Some of the symptoms of depression include: persistent low mood or sadness, loss of interest or pleasure, sleep disturbances, change in appetite, difficulty concentrating, slowed functioning or agitation (like thinking or talking), less energy, lower sex drive, loss of self- confidence or self esteem, self-harm, feeling guilty, thoughts of death and suicide.

Depression can occur at any age and to anyone and there are many reasons why people get depressed.

It could be due to biology, genes, life events, ongoing stress, traumatic experiences, or unhelpful core beliefs such as 'I'm not good enough'. Depression is often caused by a combination of these factors.

Although depression is common, it can be overcome and treated. Some general self-help tips for dealing with depression include:

  • Look after yourself: eat healthily, get enough sleep, avoid excessive alcohol and caffeine and if you smoke consider quitting – research shows it can improve mood and relieve depression
  • Practice self-care – be kind to yourself (avoid harsh self-talk and judgements), incorporate one or two things that make you happy into your day, create a personal resilience toolkit and treat yourself
  • Keep active – physical activity is proven to improve mood and reduce the risk of depression
  • Challenge your low mood – a mood diary can help you identify what makes you feel better or worse, and try challenging negative thinking
  • Connect with people – friends, family, or call a helpline.

If you think you might be experiencing depression, you can find self help on Every Mind Matters, refer yourself to NHS Talking Therapies which provide a range of 1-1, group and online options, or to Community Connections or visit your GP.

Useful contacts

Drugs and alcohol misuse

Some people may use alcohol or drugs which have not been prescribed by a doctor, to deal with difficult feelings and manage their emotional well-being. While alcohol and drugs may appear to help in the short term, they can actually make you feel much worse. This is known as 'self-medication' and if it becomes a regular tool for coping, a person can become psychologically dependent. This means that you will crave more of the substance, even though it may be doing you psychological or physical harm.

Signs that you may be dependent include regularly:

  • Using drugs or alcohol to block out physical and emotional pain
  • Using drugs or alcohol to distance yourself from problems like loneliness or relationship and family problems
  • Feeling like taking drugs or alcohol is more necessary than anything else in your life.

Useful contacts

Obsessive compulsive disorder (OCD)

OCD is when obsessive thoughts and fears intrude repeatedly into the mind, despite all attempts to banish them.

They can be very distressing, and can include thoughts of contamination, or harm to others. These thoughts can be accompanied by compulsive, repetitive rituals or behaviours/ acts carried out again and again (like washing hands or checking things) in response to the fears created by the obsessive thoughts, even though the person knows that they are irrational.

Most people with OCD recognise that their thoughts and behaviour are irrational, but feel unable to control them. Often people suffering with OCD will delay getting help, this can be linked to feelings of shame.

OCD can be managed with treatment – see your GP or refer yourself to Surrey's talking therapy services.

Useful contacts

Pregnancy, perinatal mental health problems and postnatal depression

Around one in five women will experience a mental health problem during pregnancy or in the year after giving birth (such as anxiety, OCD, depression or more rarely postpartum PTSD or psychosis).

Your midwife or GP is a good source of support for problems during pregnancy. Up to half of new mothers experience a period of sadness called the 'baby blues' in the first few weeks following the birth of their baby. It is usually mild and lasts a few weeks.

However, 10-15% of new mothers experience postnatal depression. This usually begins after four to 12 weeks, but may occur up to one year after the birth. Fathers can also experience emotional distress or depression following the birth of their baby.

Common symptoms of postnatal depression include: feeling unable to cope, sadness, hopelessness, tearfulness, feeling emotionally disconnected to the baby and/or your partner, feeling rejected by the baby or having thoughts or visions about harming the baby.

It can feel difficult to talk openly about how you're feeling when you become a new parent.

You might feel:

  • Pressure to be happy and excited
  • Like you have to be on top of everything
  • Worried you're a bad parent if you're struggling with your mental health
  • Worried that your baby will be taken away from you if you admit how you're feeling.

It's important to ask for help or support if you need it. You're likely to find that many new mothers are feeling the same way.

Your health visitor is a good source of support after the birth. They will know the difference between baby blues and other mental health problems and if needed can refer you to the Parent Infant Mental Health Service. Your GP can also help you and you can refer yourself to NHS Talking Therapies (mothers with postnatal depression are a priority group).

Useful contacts

Relationship problems

Sometimes problems can develop in relationships – often due to one or both partners experiencing challenging life events or situations like debt, redundancy or the birth of a baby.

It is important to keep communicating – make the time to talk and listen to each other.

There are services that offer support with relationship problems including online and face to face counselling and mediation.

Not all relationships are healthy and some can be negative and destructive, leading to stress, anxiety and low mood/depression – read about domestic abuse.

Learning how to identify the difference between a healthy and unhealthy relationship, and gaining skills to develop new, or build upon, positive relationships, can contribute greatly to emotional well-being.

Useful contacts

Self-esteem and confidence

Self-esteem refers to the way we think, feel and value ourselves as a person.

Low self-esteem is having a generally negative overall opinion of yourself, judging and evaluating yourself harshly.

The difference is:

  • Self-esteem is perceived worth and self-worth
  • Self-confidence is perceived ability to do something.

Symptoms of low self-esteem and self- confidence can include: being highly critical of yourself or your actions and abilities, having high self-doubt or only seeing yourself to blame if things go wrong, ignoring positive qualities or finding it hard to accept compliments, predicting that things will not turn out well, feeling depressed, anxious, guilty, ashamed or frustrated.

Here are some self-help tips to boost your self-esteem and confidence:

  • Think about what is affecting your self- esteem: has it been lowered after a difficult experience or series of negative life events? Just recognising and talking about this may help
  • Avoid negative self-talk: notice when you do this and ask yourself 'would I talk to, or think about a loved one in such a negative way?'
  • Connect with people who love and appreciate you: this can help you feel better about yourself
  • Learn to be assertive: if you go out of your way to help others and feel it's the only way they'll like you, try saying no before agreeing to do something you don't want to do
  • Set yourself an enjoyable challenge: achieving it will make you feel better about yourself
  • Focus on your positives: write a list of them, celebrate your successes and accept compliments
  • Take care of and prioritise yourself: make time to relax and sleep, exercise and eat healthily
  • Get support if things get too much: via NHS Talking Therapies or Community Connections

Sleep problems

Sleep is a key part of maintaining good mental and physical health, but research has shown that a third of adults have difficulty with sleeping. Sleep problems can be a key sign of stress and common mental health conditions (like anxiety and depression), and
symptoms include:

  • Difficulty getting to sleep, waking early and not being able to get back to sleep
  • An irregular sleep pattern
  • Tiredness and exhaustion leading to low mood, anxiety, poor concentration, memory problems, irritability and frustration.

Everyone needs different amounts of sleep. You should usually feel refreshed and not sleepy during the daytime. If you feel that you are not sleeping as well as you would like, try some of these tips for a better night's sleep:

  • Keep regular hours. Going to bed and getting up at roughly the same time everyday will help to structure a healthy sleep pattern
  • Deal with worries or a heavy workload by making lists of things to be tackled the next day
  • Create a restful sleeping environment. Your bedroom should be kept for rest and sleep and it should be neither too hot, nor too cool. Try to avoid having a TV or a computer in there
  • Make sure your bed is comfortable. It's difficult to get deep, restful sleep on a bed that's too soft, too hard, too small or too old
  • Regular, moderate physical activity such as swimming or walking can help improve sleep, but not too close to bedtime or it may keep you awake
  • Cut down on stimulants such as caffeine in tea or coffee, especially in the evening as they interfere with falling asleep and prevent deep sleep. Try a hot milky drink or herbal tea instead
  • Too much food or alcohol, especially late at night or just before bedtime can play havoc with sleep patterns. Alcohol may help you fall asleep initially, but will interrupt your sleep later on in the night
  • Stop using electronic devices (for example TV, phone, tablet) half an hour to an hour before going to bed as the blue light they emit keeps you awake
  • Do something relaxing for mind and body before going to bed. Have a warm bath, listen to soothing music, read a book, or try a relaxation exercise or meditation
  • If you can't sleep, don't lie there worrying about it. Get up and do something you find relaxing until you feel sleepy again – then go back to bed.
  • You can also self-refer (through the NHS Talking Therapies provider) to an online platform called Silvercloud, which uses principles of cognitive behavioural therapy (CBT) to support good sleep.

Useful contacts

Stress

Stress can occur when a person feels they cannot cope with their current demands and pressures and/or feels they have no control.

Stress can come from inside ourselves (like wanting to succeed) and from external events (like work pressures, financial problems/debt or being made redundant).

Short periods of mild stress is not always a bad thing, some people enjoy the pressure and are motivated by and gain a sense of achievement from it. However if we do not react well to stress and it is prolonged, it can be damaging to our emotional and mental well-being and can increase the risk of anxiety and depression. Stress can also worsen and be a trigger for other mental health conditions.

Stress is common and affects everyone at some point. Symptoms include:

  • Cognitive symptoms: concentration and memory problems, muddled thinking, racing thoughts
  • Emotional symptoms: low self-esteem, anxiety, loneliness, agitation
  • Physical symptoms: headaches, recurrent minor illnesses and insomnia
  • Behavioural changes: changes in eating and sleeping patterns, and using alcohol, cigarettes or drugs to cope.

We often cannot control stressful events but we can control our reactions to them. The amount of stress we feel is often due to: the importance we place on the event or situation, our beliefs about ourselves, our thoughts about the situation, how we are feeling emotionally and our resilience. It can be helpful to identify your triggers for stress, as a first step in self-help.

The 'stress jug' analogy:

We only have a certain capacity for managing stress. Imagine that all of your stress was in a jug. The fuller your jug is, the greater the symptoms of stress will be. Once the jug is full, your ability to manage any situation that arises is greatly compromised, resulting in feeling unable to manage something that would not normally affect you.

Some of your jug is already filled with the stresses of life that we cannot avoid (for example money, illness or family problems). If you partially empty your jug on a daily basis, you can avoid it over-flowing, which will help you to reduce your symptoms and to feel more in control. It may be that you are unable to change the main contributor to your stress, but if you can do something about your other sources of stress, you will feel better able to cope.

Self-help tips for managing stress (emptying the 'stress jug') include two key approaches:

1. Managing external pressures:

  • Make a list of things you need to do, identify your most productive time of day and start with the most urgent and important items. If needed, ask for help to prioritise them and see if some items can be pushed back to when you are feeling less stressed, or passed to others
  • Focus on one thing at a time and shut out distractions (like phone or email notifications)
  • Take regular breaks, move around, get some fresh air – it will help your concentration
  • Vary your activities, balancing those you find stressful with some easier ones
  • Ask someone to help you with stressful tasks or with daily tasks to give you more time.

2. Developing internal resilience, to help build up your skills to cope with stress:

  • Practice communicating your needs and using relaxation or mindfulness techniques
  • Drink more water, reduce caffeine and sugar intake, and do some physical activity – it can help ease stress
  • Give yourself a break, balance your time not just on stressful tasks but on things you enjoy as well
  • Build your support network and make time for friends, family and colleagues.

Useful contacts

Other more severe mental health problems

The following pages give some information on more complex mental health conditions and sources of support. You can also access Community Connections.

  • See your GP if you have concerns about the mental health conditions below and/or if your mental health symptoms are getting worse. This is important as your GP can refer you to specialist services, including community mental health recovery services, specialist psychological therapies or eating disorders service. Early intervention is essential and can improve long-term results
  • Use family support and other support systems; they play an important part in recovery
  • Develop ways to manage your symptoms so that you can continue with your daily life.

Useful contacts

  • Rethink - offers information, support and webchat for people affected by severe mental illness. Telephone: 0808 8010 525. Email: advice@rethink.org
  • Advocacy in Surrey - services for people with mental health conditions. Telephone: 0300 456 2370. SMS: send the word 'pohwer' with your name and number to 81025. Email: pohwer@pohwer.net

Bipolar disorder (manic depression)

Bipolar disorder is a condition that causes mood swings that alternate between feeling depressed and feeling euphoric/high.

People find themselves alternating between two poles on a spectrum (hence, the term 'bipolar').

These are more extreme than everyday ups and downs and can interfere with work, relationships and everyday life. There can be many different factors that cause episodes of bipolar disorder. Stress or trauma can act as triggers.

The symptoms of depression during low phases are outlined in the depression section, and during the manic or high phases, people may experience one or some of the following symptoms:

  • Excessive energy or movements, sleeping very little
  • Behaving in a bizarre way
  • Grandiose ideas, self-importance, believing one has special powers
  • Talking and/or jumping topics very quickly
  • Making odd decisions
  • Less inhibited behaviour
  • Irritated by those not sharing their ideas
  • May have hallucinations like hearing voices or seeing things others cannot.

During manic periods it may be difficult for the person to see that there is anything wrong, although other people may notice changes in their appearance and behaviour that are very different from how they are normally.

Useful contacts

  • Bipolar UK - provides local support groups, online forum, peer support and an e-community for people with bipolar disorder, their family and friends. Telephone: 0333 323 3880

Eating disorders

Eating disorders are often not just about food and tend to develop as a way of coping with challenging situations and painful feelings that are hard to express, face or resolve.

Anyone can develop an eating disorder and it can affect men as well as women.

Eating disorders can be triggered by a wide range of reasons, including traumatic events, bullying and family problems. Focusing on food can be a way of disguising these problems, even from yourself or of taking back some control. Anorexia nervosa, binge eating disorder and bulimia nervosa are the most commonly known ones. Eating disorders impact a person's emotional and physical health and also impact people close to them.

Body dysmorphic disorder (BDD) is a form of anxiety and shares similar symptoms to eating disorders, such as: having poor body image, worrying excessively about your physical appearance, developing compulsive behaviours to try to deal with these worries.

However, BDD and eating disorders are not the same. With eating disorders, such as anorexia nervosa, concerns focus mainly about body weight and shape. With BDD there are additional concerns around body image like concerns about a particular facial feature or symmetry.

It is important to seek advice and help, such as from your GP and/or other services.

Useful contacts

Personality disorder

Personality disorders are conditions where an individual differs significantly from an average person, in terms of how they think, perceive, feel or relate to others.

Often personality disorders exist alongside other mental health problems, especially depression and substance misuse.

The main symptoms are:

  • Being overwhelmed by negative feelings such as distress, anxiety, worthlessness and anger
  • Avoiding other people and feeling empty and emotionally disconnected.
  • Difficulty managing negative feelings without self-harming (for example, abusing drugs and alcohol, or taking overdoses)
  • Difficulty maintaining stable and close relationships, especially with partners, children and professional carers
  • Periods of losing contact with reality.

Useful contacts

  • Mind - search 'personality disorder'

Psychosis

Psychosis (also known as a psychotic experience or psychotic episode) is when you perceive or interpret reality in a very different way from people around you.

It stops a person from thinking clearly and telling the difference between reality and their imagination.

One might be said to 'lose touch' with reality. The two main symptoms of psychosis are:

  • Hallucinations – where a person hears, sees (or smells) things that are not really there, a common hallucination is when people hear voices in their head
  • Delusions – where a person believe things that, when examined rationally, are obviously untrue.

The combination of hallucinations and delusional thinking can often cause a severe disruption to peoples' perception, thinking,
emotion and behaviour.

Psychosis is a symptom of more severe and enduring mental health conditions such as schizophrenia or bipolar disorder. Psychosis can also be triggered by physical conditions, such as Parkinson's disease, a brain tumour, or a result of drug or alcohol misuse.

Useful contacts

Schizophrenia

Schizophrenia is a long-term mental health condition that causes a range of different psychological symptoms, including:

  • A lack of interest in things, feeling disconnected from feelings.
  • Disorganised thinking and speech
  • Hallucinations – hearing or seeing things that do not exist
  • Delusions – paranoid delusions and strong beliefs that others do not share
  • Changes in behaviour like wanting to avoid people, lack of basic self-care.

The exact cause of schizophrenia is unknown. However, most experts believe the condition is caused by a combination of genetic
and environmental factors. It is important that schizophrenia is diagnosed as early as possible, as the chances of recovery improve the earlier it is treated.

Many people do recover from schizophrenia, although they may have periods when symptoms return (relapses). Support and treatment can help reduce the impact of the condition.

Useful contacts

Self-harm

Self-harm means intentionally damaging or injuring one's own body. Most people self-harm as a way of coping with or expressing overwhelming emotional distress, such a intense feelings of anxiety, anger, sadness, depression, guilt or shame. Reasons for self-harming might be different on different occasions.

Types of self-harm include: cutting or burning, punching oneself, pulling hair out, poisoning, misusing alcohol or drugs, taking part in risky or dangerous behaviours, deliberately starving oneself (anorexia nervosa) or binge eating (bulimia nervosa).

The intention is usually to punish oneself, express distress or relieve unbearable tension – not to die. However, some individuals who self-harm can have thoughts of suicide and it is a known risk factor for suicide.

Useful contacts

Suicidal thoughts and feelings

Suicidal thoughts and feelings can range from abstract thoughts about ending your life – feeling that people would be better off without you, to thinking about methods of suicide, or making clear plans to take your own life. Suicidal thoughts and feelings can make you scared or confused but you are not alone.

Many people think about suicide at some point in their lifetime and the services listed below can help you by listening and offering support or treatment. If you are having thoughts of suicide and don't feel you can keep yourself safe, or someone you know is at immediate risk please seek help immediately – go to A&E, call 999, call the crisis lines or go to one of the Safe Havens. If you are experiencing ongoing thoughts of suicide (intentionally ending your life) it's important to get support and help. Speak to your GP who will be able to prescribe medication and/or refer you to appropriate support such as NHS Talking Therapies or a specialist service.

Crisis support services

Mental health crisis support services

If you feel at breaking point, unable to cope or keep yourself safe, get help as soon as possible.

  • Surrey and North East Hampshire
    • Adult mental health crisis helpline open 24/7: 0800 915 4644 freephone.
    • Children and young people: 0800 915 4644 (select option 1)
    • If you have speech or hearing difficulties: SMS 07717 989024. Dial 18001 0800 915 4644 from your text phone or smartphone app. More information is available at Relay UK.
  • Samaritans - open 24 hours a day, 365 days a year. Telephone: 116 123 (free from any phone). Email: jo@samaritans.org
  • Shout - an anonymous, free 24/7 text service if you feel you're unable to cope. A safe space where you're listened to by a trained Crisis Volunteer and get professional support to create a simple plan of action to manage your crisis. Text 'Shout' to 85258
  • Download the Staying Alive App. An app full of useful information, tools and links to local services to help you stay safe in crisis
  • Surrey Police - If you have a hearing or speech impairment, use the textphone service 18000. Or text on 999 if you've pre-registered with the emergency SMS service.
  • CALM - a national out of hours helpline and live webchat, open 5pm - midnight, 365 days a year. Telephone: 0800 58 58 58
  • NHS 111 medical help 24/7. Telephone: 111. For people hard of hearing/deaf call 18001 111 using text relay, or use nhs111 – InterpreterNow

Safe havens

Out-of-hours friendly help and support to people and their carers who are experiencing a mental health crisis or emotional distress.

You can drop in – doors are open to anyone, and you do not have to be registered with a mental health service, or you can access the virtual safe havens through the links below.

Other non-urgent helplines

  • Mind - the national association for mental health in the UK. Telephone: 0300 123 3393 (daytime, Monday to Friday). Email: info@mind.org.uk
  • SANE - a national, out of hours helpline, text care and online support forum offering emotional support and information to anyone affected by mental illness, including family, friends and carers. Telephone: 0300 304 7000. SMS: 07984 967708. Email: support@sane.org.uk
  • Rethink. Telephone: 0808 801 0525 (daytime, Monday to Friday, webchat am). Email: advice@rethink.org

Support after suicide

If you have been affected by suicide there is support available.