Who is counselling for and when is it now too urgent for counselling?

(signs of coping and of not coping so well)

"If you do not transform your suffering you will transmit it." – Richard Rohr

Counselling is for anyone who is noticing they are having too little:

• enjoyment of relationships

• satisfaction in work

• desire to go out

• fun from what used to be fun

• desire to connect

• quality sleep.

Counselling is also for peope who notice that too often they have too much:

• anger

• irritability

• sadness

• fighting

• nervousness, anxiety or fear

• 'buzz'/project-drive/in-your-face-ness/'happy'/self-importance (during a manic or hypo-manic phase of a mood disorder).

Signs and symptoms of not coping vary from person to person. Warning signs that things are not working so well can include:

• Feeling sad, down or "empty"

• Losing interest in activities that were once a source of pleasure

• Feeling hopeless, worthless or helpless

• Feeling irritable or restless

• Changes in appetite, and losing or gaining weight unintentionally

• Sleeping poorly or oversleeping

• Feeling tired or having less energy

• Having persistent feelings of guilt

• Having trouble thinking, concentrating or making decisions

• Decreased capability and performance

• Having thoughts of suicide or intrusive thoughts about death

• Abusing alcohol or other drugs

• Calling in sick to work for days or longer

• Avoiding social engagements and missing appointments

• Having trouble following healthy patterns of eating/sleeping/hygiene

• Resorting to avoidance behaviours to mask emotional hurt: e.g. using entertainment, food, chemical addiction, intnentionally staying busy so there is little time to think or feel emotion

• Sacrifice one's own needs and desires to please others; this might be such a habit a person might struggle to know what they want or to put it in words; often long periods of pleasing others will be interspersed with periods of high expressed emotion that might baffle others

Increased frustration and venting high levels of emotion more often (e.g. expressed hurt; anger; tears)

• Staying stuck in the 'familiar' and not communicating about how things hurt or are no longer ok

• Listening to what others say to do rather than thinking about and deciding the best option one's self

• Preferring to stay in denial that things are not working well, just plodding on even though not fulfilled

• Fear of conflict keeping one silent

• Using others for need fulfilment rather than coming to terms with old hurt and anxiety about unmet needs

(Source:  Several points adapted from Mayo Clinic)

Whilst Mayo Clinic lists many of these as signs of depression several of these symptoms can also match a number of other mental health concerns; e.g. they may also be symptoms of grief after an important loss, post-traumatic stress disorder, a complex trauma history or another anxiety condition.

Some people may think these symptoms are just normal or that they feel ‘just a bit blue’ so they might need your prompting to let them know how they could benefit from professional treatment to discover more ways to understand their symptoms and to cope better. It is tricky doing this without sayng to a person "you need counselling," a line that is very likely to offend the person.

If you or the person about whom you care a great deal are not sure some online self-scoring tests that assess strength of symptoms can be found here. If you decide to make an appointment please print the results and bring them to the appointment to see a GP or when you see the counsellor.

Identify Warning Signs of Worsening Symptoms

Everyone experiences periods of not coping differently.  It would pay to learn how depression and other mental health concerns affect your family member or friend — and learn what to do when it gets worse. Mayo Clinic recommends you observe your family member or friend and consider these issues:

What are the typical signs and symptoms of not coping in your family member or friend?

What behaviours or language do you observe when the pattern of not coping is worse?

What behaviours or language do you observe when he or she is doing well?

What circumstances trigger episodes of more severe symptoms?

What activities are most helpful when a period of not coping worsens? 
(Source: Mayo Clinic)

Things you might do to support your friend or family member cope better include:

Urge the friend or family member to see a GP (request a ‘long appointment’ so the GP has time to listen and make recommendations; reception staff will normally accommodate this request).

Make a booking to visit a service like Counselling, Career and Consultancy Services for at least 6 visits and come with your friend or family member to the first visit if they want your support (for things that built up over a long time it may take more than 6 visits to improve quality of life).

Take more self-care steps together including better diet that contains a lot of unprocessed food, getting out in the sunlight for short periods every day (ask the GP to check for a vitamin-D deficiency if the person does not get much sun), improve sleep (including no use of light-emitting screens in the hour before bed or use the night-shift mode on your device), do something physical as many days a week as possible.

Worsening symptoms may mean it is time to get more treatment before things go too far.  Sometimes some great things can come from what looks bleak.  Appointment details are listed above (to the right).

You're Gonna Be Ok (Lyric Video) // After All These Years // Brian and Jenn Johnson