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Seeing the GP: Advice and tips for young people

Talking to the GP about mental health

Here, people talk about the following topics: 

•    what is mental health?
•    when to see the GP about mental health
•    young people’s experiences of symptoms
•    talking to the GP about mental health
•    getting the most out of the appointment
•    getting help and recovering from depression

What is mental health?
Mental health is about our emotional, psychological and social wellbeing, and it affects how we think, feel and act. It also affects how we handle stress, make choices, and relate to other people.

Mental health problems can affect people at any age and can be diagnosed by a doctor. They’re not personal weaknesses, and range from everyday worries to serious long-term conditions. Common mental health problems include depression, anxiety, and panic. Less common are ‘psychotic’ symptoms that interfere with a person’s perception of reality, and may include hallucinations such as seeing, hearing, smelling or feeling things that no one else can. 

When to see the GP about mental health
Feeling low or down now and then is a normal part of life. But when it’s ongoing and stops a person from getting on with their usual routine, it may be a good idea see the GP – whether that’s because of feelings of low mood, anxiety, panic, or depression. Talking to the doctor is the most direct way of finding out what’s wrong and getting help. GP consultations (appointments) are usually short but can still be helpful. Sometimes GPs will offer longer appointments if someone needs to talk. A doctor can help to:

•    diagnose whether someone has depression or another mental health problem
•    give information and recommendations that may help
•    prescribe antidepressant or other medications if necessary
•    refer a patient for counselling
•    refer a patient to other mental health services
 

A GP talks about mental health and when it’s a good time to see the doctor.

A GP talks about mental health and when it’s a good time to see the doctor.

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Can you talk a bit about mental health and when a patient should come and see a GP about it.

Yes. I mean lots of people come to the GP when they’re struggling, when they’re struggling with anxiety, with low mood, with stress. And then they will work with the GP to find out actually what can be done to help. Sometimes that will be in the form of counselling or some other sort of talking therapy, sometimes it might be to help with medication.

Okay because usually, from my understanding, is a GP would refer the patient to an IAPT service or someone else that can actually help them for a longer period because a GP can’t do that, is that true?

Often a patient will be referred on because, as you say, doctors only have usually fairly short appointments and patients may need a longer time, and also some different skills to help them through whatever that psychological problem is.

Lots of people come and see GPs when  they’re struggling, struggling with low moods, struggling with worries. And I guess the time to come is when that’s really having an impact on your life, when it’s difficult to cope getting on with your daily life. Many people will come, sometimes what they need is counselling rather than psychological therapies and usually a GP will refer on to somebody else to do that. Sometimes they may need medication. Sometimes they may need just a break from work because of the situation they’re in makes it difficult for them to continue.

How do GP’s deal with the issue if a patient came in with mental health issues but it actually lead onto physical health problems where a GP would actually have to deal with it.

Yes, it’s sometimes difficult to know how much is a mental health problem, how much is a physical health problem. Some mental health problems lead to very definite physical problems. Things like eating disorders when people can become very ill because of their mental health condition. Sometimes people will have many symptoms, a lot of pain, a lot of headache, and actually the underlying problem may be to do with their mood, and some of those things are often a symptom of depression. So it often takes a lot of working out and many times GPs are having to pay attention both to the mental health and the physical health of their patients.
Young people’s experiences of symptoms
Some people we talked to went to the GP because of feelings of low mood, anxiety or depression which were ongoing and affecting their day-to-day lives. Often a family member or friend had suggested they see the doctor. Aphra, for example, felt very tired, hadn’t slept properly for weeks, and wasn’t eating well. A neighbour noticed that Aphra was very tearful when talking about work so made her an emergency appointment:
 

Aphra’s neighbour helped her realise that she needed to see the GP, who advised her not to go back to work. She was very tearful which was unusual for her.

Aphra’s neighbour helped her realise that she needed to see the GP, who advised her not to go back to work. She was very tearful which was unusual for her.

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I knew I was in a state because it had been a really rough day at work, and I was crying an awful lot. But it was just when I started saying, "Oh I haven’t slept in so long," that she [neighbour] went, "You need to go the GP about this, you can't go back to work, and actually it's not safe for you to go back to work." 

And it's one of those things where it felt almost a bit like I was being silly before, you know; no job could ever be that bad. But it was when the GP, that first GP I saw, went, "It's not safe for you to go back" as well, that I went, "Maybe it's not just me actually, and maybe I'm being a bit hard on myself, and actually there is something really wrong here about how I'm being treated."

So she made the emergency appointment. Was it your GP that you saw then or, do you know who your GP is, or is it different every time?

I have a listed GP, but I rarely see her to be honest. I have the same GP now every time I make an appointment especially if it's about the medication I'm on, and generally how I'm feeling with my depression and my mood, and getting sick notes. 

But for the first few appointments, because they were emergency appointments, I saw different people. But I think they were always really prepared to listen and they could see that, every time I thought about it, I'd start crying again. I'd spent so much time crying at the GP's surgery. And I was never normally a person to cry, so it's one of those things, they're going, "Well this feels a bit silly and this is a bit ridiculous." But it's just one of those things where you go, actually you can't help it. And they must be so used to seeing it, you really can't be the only person who's walked in and gone [crying noise].
When Sophie was around 14, she noticed that she was constantly tired, felt low, lost motivation to see her friends or study, and didn’t enjoy doing things she normally enjoyed. She wasn’t sleeping well, and her sister was having problems with anorexia. Sophie confided in a friend, who told her to see the school counsellor. Later, Sophie went to see the GP, first with her parents and then by herself:
 

Mental health problems affect a lot of people and shouldn’t be seen as embarrassing. It’s important to talk to someone and take time out for yourself.

Mental health problems affect a lot of people and shouldn’t be seen as embarrassing. It’s important to talk to someone and take time out for yourself.

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I just wasn’t really myself; just feeling kind of quite down, that I was very tired all the time and I didn’t have any motivation to go and see my friends or to do any work, or even things like I normally enjoyed I just wasn’t enjoying them anymore. And it was kind of happening for so long. My sister was getting better but it wasn’t going away. 

And so that’s when I kind of realised it wasn’t primarily based on that. I think it just kind of triggered it and actually it was something a bit more than that. And so when I was feeling just really low, and yeah, just not myself, that’s when I thought, 'I'll go and see a counsellor.'

Yeah. Did anyone suggest it or it's something that came to your mind, or did you look on the internet or discuss anything with anyone, or you just didn’t feel like talking about it at that point?

My friends noticed I was really reluctant to talk about it with anyone, but my friends noticed I just like wasn’t really hanging out with anyone and I was…yeah I was just really reluctant to do anything. 

And so like I kind of confided in one of my friends – I was just saying I'm just not feeling good about myself, and she suggested…she said, "Oh I know someone else who's used a counsellor and maybe that will help you out." So, yeah, it was effectively from her who suggested it.

And can you tell me how old you were at that time?

Well I must have been around thirteen/fourteen I think.

Is there any message or advice you would give to someone who's thirteen/fourteen, feeling a bit like that, they don’t know what to do. So, you know, looking back, in hindsight, is there anything that you would suggest to them?

Yeah. I definitely would say like talk to someone about it. It's not embarrassing, you know, and it happens to a lot more people than you think. Yeah go and talk to someone about it, and also like make sure you're making time for yourself because I think it's really easy, in this day and age, to kind of get wrapped up in everything else and to be kind of completely overwhelmed in work and things. 

But make sure, you know, obviously try to do your work but actually make sure you take out time for yourself and you do actually give yourself a break. And try and keep yourself healthy and know that actually it's really important to do that. And kind of recognise that and just take out time for yourself, but talk to someone about it if it's getting bad.
The symptoms of depression can vary but usually include feeling sad, hopeless, and losing interest in things that are usually enjoyable. People can also feel alone and reluctant to talk to others. The symptoms carry on for weeks or months and are bad enough to affect a person’s work, social and family life. 

Aphra made herself carry on with day-to-day life and hadn’t realised that she was probably depressed. Shane, on the other hand, knew quite a lot about depression but it was his family who advised him that he should see the GP:
 

Shane was helping his girlfriend through depression. His mum noticed that he was short-tempered and suggested he should see a doctor.

Shane was helping his girlfriend through depression. His mum noticed that he was short-tempered and suggested he should see a doctor.

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The way I think, I prefer to help others than get help myself. So, because my girlfriend at the time had depression, I didn’t want to off-load what I was feeling onto her because she was struggling with stuff herself. So I sat and helped her rather than try and help myself.

Yeah. Did you talk to anybody at all or no?

No.

No. Did anyone know you were struggling at all then, or they just thought, 'Oh he's doing alright; he seems to be doing alright.'

My mum noticed attitude differences. I was a lot more short tempered and I was doing stuff that I wouldn’t normally have done, so....

Were you…were you at sixth form or school or college?

I was at college, yeah.

College, yeah. So you were…you're doing a course, yeah?

Hm mm. 

And then how did it come about – you mentioned family members said, you know you should go to the doctors. How did all that come about?

It came about just because of…well I… at the time I was having rather frequent nosebleeds, which I'm guessing would have been associated with the stress and anxiety and stuff like that. 

So, with that going on, they went and said that I should go to the doctors to see if anything was wrong. And during that they essentially diagnosed me with depression, anxiety and stress. So, yeah, that’s how that came about and then the counselling started later on.

So, when you went to the doctor's surgery that time did you go with somebody – a family member – or by yourself?

No, with the way my family works, my mum's a single parent who works, and my sisters are at school and college.

So you went by yourself?

Hm mm. 
People like Nikki and Lucy, who were still at school when they started having problems, spoke to a school counsellor first, and it was Lucy’s counsellor who recommended she see a doctor. Nikki had been bullied from a young age but, after a traumatic event when she was 14, she ‘went on a massive downward spiral’. Her step mum took her to the local surgery. Siobhan confided in her brother that she was making herself sick after eating, and she was later diagnosed with depression and anxiety.
 

Nikki didn’t care about anything and didn’t want to be alive. Other people suggested she see the GP but she thought they were trying to trick her into something.

Nikki didn’t care about anything and didn’t want to be alive. Other people suggested she see the GP but she thought they were trying to trick her into something.

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I think it was when I was fourteen I experienced a really traumatic event. And then after that like I just went completely sort of off the rails. And then like…I think it was my step-mum that said, "I'll take you to the GP." But that wasn’t because of the other stuff [bullying], it was just because like it was just a brand new thing. So, the other stuff it was all just like stuff buried inside of me that I just didn’t let out, and now…and there, this was this completely new thing. But there wasn’t a time when I thought, 'Right I can go and get help now.' It was just, yeah.

When the traumatic event happened, did you feel at that point, 'I've got to speak to somebody?' 

No, I didn’t. I didn’t even think of it then. I just thought, 'Do you know what, I should not be here. I clearly…everything is saying to me that I am just nothing here. I should not be here.' That’s all I was thinking. I wasn’t thinking, 'Right I should go and talk to someone.' I was just thinking, 'Right, how can I not be here.' It was other people that said like you need to talk to someone because they could just tell that I was just going completely downwards.

Who were the other people who thought you should speak to somebody?

Friends, different family members. They were just like, "You need to speak to someone."

Did you feel like listening to them or did you not at that stage, it was too difficult to even listen to what people suggest?

I didn’t really care about what they were saying. I was just thinking, 'You lot don’t want me here anyway, you're just trying to trick me into something,' so…but I did it to sort of shut them up. So, like I would go to these things but I would just think, 'Yeah whatever, I'm not interested.' And I would just…I just didn’t care really.
 

Siobhan’s brother found out that she’d been making herself sick. He told her that a doctor could help. Seeing the GP with him was easier than going on her own.

Siobhan’s brother found out that she’d been making herself sick. He told her that a doctor could help. Seeing the GP with him was easier than going on her own.

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About two years ago, I went cos like I was really struggling with my eating and my weight. So I went about like cos I was, after I’d eaten a meal, I was like making myself throw up. So I went about getting help with that. But I hadn’t lost enough weight for him to put me in the system yet. And then a few weeks ago I went with low mood and were diagnosed with depression and anxiety.

And when you went to see him that first time, did you go by yourself or did you go with your mum?

My brother took me.

Your brother took you?

Yeah.

Did you want your brother to come with you?

Yeah, my brother’s like the person I’d go to with anything.

So you felt more comfortable, a bit more reassured going with him?

Yeah.

Is he an older brother or younger?

Yeah, he’s older.

So did you feel comfortable talking to your brother, “I think I need to go to the doctors”? Or did other people say, “Oh I think you need to go”? How did that all happen?

My brother had found out like what I were doing. And he were like, “I think you need to go and do, like just get sorted out and see what they can do for you. Cos there are things that can help to make you better.” So he sort of pushed me to it. But he didn’t like force me. It were more my decision to go.

So he was the only one who knew at the time?

Yeah.

And he came with you?

[mhm]

So that made you feel a bit better, not a huge -

Yeah, not shitting it.
After speaking to the school counsellor, Lucy saw a GP. She’d been feeling very anxious at school. She started missing a few lessons at first but later found it hard to go to most of them:
 

Lucy felt anxious in class and once started shaking. Her teachers told her to see the GP and to tell her dad.

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Lucy felt anxious in class and once started shaking. Her teachers told her to see the GP and to tell her dad.

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I started to feel like really anxious and I wouldn’t go in to my lesson. And at first it just started off with certain lessons. I was like, “Oh, I don’t wanna go in to there.” Then it started to be like most lessons. So I’d just go and hide somewhere.

Cos you felt stressed about the lessons?

Yeah. And then my way of coping with it was like, “Oh, well, I’ll just like do something a bit stupid.” So the school found out about that. They sort of made me tell them.

And then you went to the, did they say, “Oh you should go to the doctor”? Did they say that or?

Well, I’d already had an appointment with the doctor’s but, like I said, it was for something different at the time. But I can’t quite remember what it was. They were like, “Well, you should probably talk to your doctors. Try and get like referred somewhere. And you need to tell your dad, or else we’ll tell him.”

So if someone else was in that kind of situation, where they don’t want to go to the lessons, they’re feeling stressed out about going to the lessons. Is that how you felt? Or feeling stressed and pressured about that? Was there something about the lessons? Or was it the teachers that you didn’t feel comfortable with?

I don’t know. I just, I remember like one day I just went in to school and I was fine. And then it was like after lunch or something and I went in to my lesson, and suddenly I just freaked out and I was like shaking and all this. So I asked the teacher like, “Oh, can I just go to the loo or something?” And she was like, “Yeah, sure.” So I left the room. And as soon as I left the room I was fine. Then as soon as I went back in it was just, “No.”
Psychosis is a mental health problem that can involve hallucinations and delusions. Fran started having problems, which were partly drug-related, when she was a teenager. She said that her teachers at the time saw the illness as bad behaviour and expelled her from sixth form. They later apologised for their mistake. Fran was at home when she had her first major psychotic episode. She wanted to set the house on fire, believing that ‘it was full of devils’.
 

Taking drugs and breaking up with a boyfriend tipped Fran over the edge. She didn’t realise how drugs were affecting her and doesn’t recommend taking them.

Taking drugs and breaking up with a boyfriend tipped Fran over the edge. She didn’t realise how drugs were affecting her and doesn’t recommend taking them.

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I was still living with my mum then and I tried to set the house on fire because I thought it was full of devils. And they rang the doctor. And the doctor just came and he was like, “She’s really, really ill. She needs to go to a psychiatric hospital.” And he was actually really nice. He was a nice man. Cos I wasn’t that nice to him. And he’s still my doctor and he’s still really nice. And he was just calm, but he was shocked I think. He’d never seen anyone quite like that I don’t think. Like somebody who was really trying to burn down the house, yeah.

So he was the doctor. He came to the house?

Yeah, my mum rang him cos she was like, “Something is seriously wrong with my daughter.”

So you said you were getting ill at school but nobody realised what was really happening?

No, they always thought I was being like kind of really cheeky and naughty. And it’s like when you go into school and you genuinely think that people are trying to kill you and stuff, you’re going to be a bit naughty and aggressive. And it got completely misconstrued. And they expelled me and they expelled my best friend as well. And they had to apologise. They had to, like, write a formal apology for it. Which made me feel quite good. They, yeah....

Did you, what did you feel at that time? Did you feel that something’s not quite right? Or did, did it –

To be completely honest, I had the same boyfriend for almost three years. And then we broke up when I got in the sixth form. I just started, I mean I’d always been a person that got wasted, but I just did a lot of intoxicants really. And lots of Ecstasy, stuff like that. And it just tipped me over the edge like properly. I mean I don’t think drugs are good. I think they’re bad for you. I don’t think they’re good for people. But at the time I didn’t really know the severity of what they were doing to my brain.
A GP makes a diagnosis by listening to a patient and then asking questions about their thoughts, feelings and physical symptoms. If someone has severe mental health issues and needs extra support and care, they may be treated in hospital by a psychiatrist (a doctor who specialises in mental health). Auberon, who had depression and was self-harming, was under the care of a psychiatrist. He saw his GP when he needed medication or a repeat prescription.
 

All the doctors Aphra saw listened well and were very good. They reassured her that depression wasn’t ‘a failing’. She’d been in a bad situation for a long time.

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All the doctors Aphra saw listened well and were very good. They reassured her that depression wasn’t ‘a failing’. She’d been in a bad situation for a long time.

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I saw male doctors for the first three emergency appointments. And then it was afterwards that I changed to the female doctor I see regularly now. And I chose to kind of sign up for regular appointments with her, not because she was a woman, but because she'd treated my mum in the past, and so I kind of knew the level of care and I knew she knew the family history. But also just because I knew she was a really good doctor. 

And so…and I knew she was a regular doctor there, she wasn’t teaching or training. And so I didn’t go…I could have this doctor, but maybe only for six months and then have to change again. I know she's going to be there for a couple of years, and so I've got that regular contact that I can have.

Yeah. So the first three emergency appointments it was with different doctors?

Yeah.

Did you feel that they all listened or were one or two better than the others at any…?

I think they all listened really well and I think they were all really compassionate and really kind as well. They were all very good at reassuring me that this wasn’t something that should have happened to me, and it wasn’t kind of a failing within myself. Which is obviously one of the first things you think when it's depression. You go, "I should be stronger, I should be better.” Or “there must have been something that I could do to change it." 

And actually it's one of those things where quite often there's nothing you can do, and it's just you’ve been in a bad situation for a long time, and you just go, "Enough now, I'm going to do something different." And something different isn't always what you want, but it has its own kind of way of working itself out.
 

Auberon had been having counselling and later spent a month in hospital. He had to wait 2 years for therapy when he moved to adult services but feels it’ll help.

Auberon had been having counselling and later spent a month in hospital. He had to wait 2 years for therapy when he moved to adult services but feels it’ll help.

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Regarding my mental health issues, I was in the hospital for a month which is where I was first diagnosed with mental health problems and all my diagnoses took place. And then…But before then I was seen under CAMHS [Children and Adolescent Mental Health Services] just as a counselling service, if you know what I mean; just as like a support and just talking service. But then after I'd been put into this hospital for a month, then I'd been referred to the adult mental health service team, so yeah.

Was there a big difference between that transition to the adult mental health team from the, you know the children's or young people's?

Yes, it was, because I was getting cognitive behaviour therapy at the time, and unfortunately my therapist got ill and unfortunately she couldn’t do it anymore. But they said they would…they said as it was so close to that change…between that period of change over, between the CAMHS and the adult, they said that…they said it would automatically start up again when you come in the adult. But things didn’t work out and I'd been on the…I'd been in the adult mental health services for almost two years and I'm finally getting my first CBT appointment next week.

So you’ve been waiting for a good…?

Two years, almost two years yes.

Have you been able to access any similar services at all in any other way?

I've been …no, not really. I've been…my care co-ordinator's great, but she's not a therapist really. She's just like a care co-ordinator because she gives more practical advice on what to do and how to cope and stuff, but therapy is, I think, everyone says it's a way forward, so yeah, so...

So the care co-ordinator – is this through the GP or the hospital?

It's through… I first start…well I was in a CAMHS mental health unit when I was in hospital, so then I was diagnosed, so I had a formal psychiatrist up there, and when I got out and everything. But then my psychiatrist switched me to adults because I was over eighteen, I was getting to the age of eighteen, and so yeah so....
When Fran had her first major psychotic episode, the GP came to the house and immediately recognised she needed help. She was taken to a psychiatric hospital. For the next ten years Fran spent three and a half years ‘on and off’ in hospital. Other young people had been to hospital overnight when they’d taken an overdose.
 

Fran’s GP called for an ambulance but she refused to go. She was very ill and confused. The police were called and she was taken to hospital.

Fran’s GP called for an ambulance but she refused to go. She was very ill and confused. The police were called and she was taken to hospital.

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I got put in the psychiatric hospital and...

So first your doctor came round?

Yeah, my GP. I just remember I said to him, something like, “You don’t understand. You’ve got to let me burn this house down. We’re all gonna die if I don’t.” And he, and I had a big bottle of pop, a big bottle of lemonade, and I poured it on him. I’d been really ill, yeah, I’d been really ill.

Yeah, yeah. So do you remember what happened after that?

Yeah, the ambulance people came and I just refused to go with them, point-blank refused. And they were like, “You’ll make it like harder for yourself. You don’t understand that we will get you to a psychiatric hospital.” I was like, “No, you won’t. You can’t force me to go to hospital. You’re talking crap, blah, blah, blah.” 

And then after that the police came. And they’d been saying to me, “If you wait for the police, you’ve got no choice. They can handcuff you. They can put you in the back of an ambulance.” And I just thought they were talking rubbish. Cos, because I thought, “Well, I’ve not really committed a crime.” But then they came and they put me in handcuffs and just like proper bundled me into an ambulance and took me to hospital.

In the last ten years for three and a half years I’ve been there overall. The first time I was in, I was in for about three months. And then I came out. And all my friends were either going to university or getting jobs or x, y, z. And I was just unemployed and really, really miserable and didn’t know what to do with my life, yeah.

And you were on and off then, on and off…?

On and off, I was on and off for years and years. Then I got well for about, I’m crap with like time and stuff, but I got well for a really long time. And then I got really, really ill again. Then I got well for about four or five years. And then last winter I came again for two months into hospital.
 

Shane was prescribed a high dose of antidepressants, which he used to overdose on. It was then that he had to tell his mum what he’d been going through.

Shane was prescribed a high dose of antidepressants, which he used to overdose on. It was then that he had to tell his mum what he’d been going through.

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It was a combination of self-harming and the tablets, and I ended up having some friends that I know call me an ambulance and essentially be carted off to hospital for overnight assessment, which wasn’t fun at all, so yeah.

So your friends were around were they or they came over or something?

They drove over just because we were helping each other out with that sort of stuff.

So they knew what you were going through?

Hm mm 

They had gone through something like that as well, or were going through it?

Yeah.

So did you find that they could understand a bit more then? How, you know, having gone through that, or did you find everyone's experience was so different?

It was different in a way because the people, my friends that came round, they had divulged this stuff with their family whereas I didn’t, so it was varied in that respect. But other than that it was mainly the same stuff, and it actually helped having them there because they knew the ambulance crew that came to pick me up, so it was a lot more personal and informal and stuff like that.

So their families knew what was going on with them, but you hadn’t talked to yours, no, because it's something…it's very hard to talk about these things. And you went to the doctor. Was that the first time then that your family kind of realised what was going on or.....

Yeah, because my friends said that they needed to take me…phoned for me and called my mum just because next of kin and stuff like that. So, I ended up with my mum driving to the [name of] hospital, and I had to tell her there and then that…what I was going through because I couldn’t exactly hide it anymore because I was in a hospital bed.

And then you would have…did you…you stayed overnight; you said you had tests and things like that.

Hm mm. 

And that wasn’t a nice experience?

No.

Were you able to come back home the next day or did you stay in for a few days or more than a few days?

I stayed in from six o'clock Friday till four o'clock in the morning on Saturday, so I was home within a couple of hours. But because of the experience that I had with the hospitals it sort of, I guess in a way it haunts me just because I have nightmares of the hospital machines and noises that they make because I had to sleep there. So I guess it affected me psychologically of the noises that the machines made.
Talking to the GP about mental health
It can feel like a big step to see the GP about mental health. People are often unsure how they’ll explain the problem so it’s a good idea to plan ahead to get the most out of the appointment. Sophie, for example, said she found it hard to talk about her feelings to a doctor she hardly knew. It was also hard for her to talk openly with a parent in the room, in case she upset them; Aphra was glad she went on her own.  

Seeing a different doctor every time people went to the surgery was also hard, and it might take several appointments before some people felt they got the help they needed. Sophie, for example, went to the doctors’ six or seven times and, on the last appointment, said she wasn’t leaving until she was given help:
 

It took courage for Sophie to go back to the GP and to say that she wanted a referral. It’s sad that it took so long to get help.

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It took courage for Sophie to go back to the GP and to say that she wanted a referral. It’s sad that it took so long to get help.

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So after six or seven appointments and, you know, you felt that you weren't really listened to and the appointments weren't really helping in that way, what happened after that?

Well I basically [coughs]… well I went back; I left it quite a while. But I did eventually just go back and I did…it took quite a bit of courage but I just went back and just said, "You know what, I’m…" – to be fair I would have been quite an angry patient in their eyes, but I did just say to them, "You know what, I'm actually really upset by how you're treating me." And I said to them, "This may sound threatening but I'm not going to leave here today with you telling me again the same thing you’ve told me, and time and time again." And I said to them, "Look, refer me on to somewhere else because that’s what I've come for and you're not helping the situation by what you're doing." And so I think they kind of like, 'Oh god, we need to do something about that,' so....

So that’s a real…that took a lot of courage.

Yeah, yeah it did, and I think it's, you know, it's sad that it took so long to get to that place because, for a lot of people, I don’t think they'd be able to do that, so yeah.

So can you remember the GP, who it was, you know was it a male GP?

Yeah, it was a male GP, yeah. Yeah, I think he was quite taken aback by it, but...

Did he listen?

[Coughs] Yeah, he said, "OK, I hear you." And so eventually he did do something about it but I don’t think…yeah it's just sad that it took so long to kind of tap into that.
Nikki saw several GPs too. She didn’t like the first few she saw but later found one that she liked. Aphra, on the other hand, found that all the GPs she spoke to were ‘all really compassionate and really kind’. She chose to see one regularly who’d treated her mum in the past.

Getting the most out of the appointment

•    make an appointment well in advance, if possible, with a GP you like
•    think ahead about what you want to say to the doctor 
•    be prepared to talk about how you’ve been feeling. You might be asked about recent sleeping and eating patterns, weight, activity, and mood. 
•    write things down beforehand to help you, including questions you might want to ask
•    think about what help is available and what you might like (e.g. medication, online counselling)
•    don’t give up if your first experience isn’t very good. Try a different doctor.
 

It’s hard to talk about feelings in a short appointment. There’s usually more behind the visit. GPs should give information about helplines and charities.

It’s hard to talk about feelings in a short appointment. There’s usually more behind the visit. GPs should give information about helplines and charities.

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Can you remember how many times you went to see the GP at all?

Oh I've lost count; I don’t know, just loads.

So what could have…what could they do, GPs, to improve the situation there?

They need to realise that people aren’t going to tell you everything in ten minutes. They're trying their best, like it takes a lot of courage to go to a GP and say, "Like this is sort of what I'm experiencing." So I would always say like don’t take like…what they're saying…always assume there's more to it and always provide them with something even if, you know, they're not going to get help through the NHS, then…like helplines, charities, something like…like just never just let someone walk away because that could be…it could be so bad like you just never see them again. Like you cannot ignore anyone.

So a young person comes to see the GP, they might not tell everything that they're thinking or feeling. So you would advise that there may be more behind the appointment?

There always is, yes.

There's always more behind the appointment. How can…what could a good GP do in these situations? Say their ten minutes is coming up and they’ve heard a little bit – is there anything else that they could do? So they could give telephone numbers of helplines; could they follow-up again, maybe phone the person or –

Yeah, I had a really good experience of a GP like a few months ago which was like my first ever good experience of a GP really. She was really, really nice. She spoke to me on my level, on my terms, and what she did was she said which day she worked at the practice. She said that I could go back whatever time if I just want to chat. I think maybe just remind the person that they can come back, like they're not a waste of time, yeah.
Getting help and recovering from depression
Mental health problems can be treated in several ways, including with medication and talking therapies, such as counselling. Sarah was prescribed antidepressants but didn’t want to take them. The doctor also told her that she could contact the university counselling service, which she did, but she found that counselling wasn’t for her. Later, when she was feeling much worse, she saw another GP and started taking antidepressants.
 

Sarah wanted to know about the different medications for depression but felt she wasn’t given all the options by the first GP she saw. She later saw another.

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Sarah wanted to know about the different medications for depression but felt she wasn’t given all the options by the first GP she saw. She later saw another.

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So I was going because I was probably, yeah I was, I think I had depression and I was trying to see a doctor and I didn’t particularly like the doctor that I saw. She was really nice but I, like just she put me on antidepressants which isn’t what I wanted to go on at all. And I’d said that I don’t necessarily want that and she was very much like, “Well the university has a counselling service, that’s separate from the doctors. We can’t really do anything about that apart from recommend that you go to it.” 

But it was very much like we’re here to treat this as a medical problem and give you a drug, which I didn’t really agree with. But then I kind of wanted to keep seeing her because I went back, ‘cos you have to go back, and saw another doctor who had said completely different things to what she’d said and then it got really confusing...
......It was very much like, “Okay,” she explained it was a really common problem, lots of people had it, and this particular drug would be helpful. And I didn’t want to go on that particular drug. And I more wanted a conversation around the possibilities of going on particular drugs in the future and it was very much like, “No, well if you’re here now, we should deal with that now.”

Did you feel you had much choice?

Yeah ‘cos you can always say no. But I didn’t feel like I was being, I knew there were more options out there than what was being explained to me.

So did she write you a prescription?

Yeah.

Yeah. And what did you do with that prescription? Did you –

No, I didn’t take it. I chose not to. But I went back and saw a different doctor who gave me a different prescription for a different drug, and I took that one. I think probably just because I was getting a bit desperate but it was a different situation.
Aphra was prescribed sleeping tablets at first, then diazepam (used to treat anxiety), and later antidepressants. She also had counselling. Siobhan took antidepressants, too, and recalled that the tablets took several weeks to ‘kick in’. The dose was increased a couple of times – the medication didn’t seem to be working at first and made her feel like self-harming more. She also did online CBT (Cognitive Behavioural Therapy).
 

The antidepressants took 6 or 7 weeks to start working. It’s important to be patient and not miss a dose.

The antidepressants took 6 or 7 weeks to start working. It’s important to be patient and not miss a dose.

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For the first four weeks it was one 50 milligram every day. And then a few weeks ago it went to 100 milligram every day.

Did you feel that they were helping at all?

I do now, but not at the beginning. Like when I first went on them I couldn’t notice a difference at all like. But those particular tablets in some people can cause like worse self-harm thoughts or suicide thoughts at first until they kick in properly.

And did you feel that’s what was happening? Or did you feel like --

Yeah, like --

-- changes or?

Before I went on the tablets I was self-harming but it wasn’t really bad. It was sort of capable, copable. Is that a word? Copable, yeah.

Yeah, manageable.

Yeah, manageable. After that like, when I were on tablets for a few weeks, like it started getting worse. But I’d wake up in the morning thinking, “I need to self-harm today.”

And when you were thinking about self-harm, was it like being sick and.... 

Some of it was being sick, some of it was like cutting.

And could you, when you were at home, did you talk much to your brother? Or did you feel you just didn’t wanna talk to other people?

I didn’t wanna talk about it. I just wanted to stay in bed and, not really with anyone, just be left alone to stay in bed and sit and just think.

And if someone else was in that very same situation that you were in, is there any, now, any advice that you would give them?

Just stick it out cos the tablets do kick in eventually. But they do take a while. So you’ve just got to stick with it as long as you can.

And how long did it take in your case?

Six or seven weeks for them to properly kick in. Like they’ve only just started working properly.

So it could be as much as six or seven weeks?

[mhm]

Just be patient with it.

Yeah. Don’t forget a dose either. Cos I have to set reminders on my phone to make me take them, cos I’m crap with remembering stuff. 
Shane was prescribed antidepressants and had informal counselling with his GP, who he saw weekly for about five months. He found her empathetic and related to the fact that she’d had depression herself in the past. She also put him in touch with local counselling services.
 

Shane likes having informal counselling with his GP, which feels more like a chat. He can talk without giving everything away, and it feels that it’s not all about him.

Shane likes having informal counselling with his GP, which feels more like a chat. He can talk without giving everything away, and it feels that it’s not all about him.

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The way it went about was just she ended up introducing herself, not as Dr, it was, "Hi, my name is Ashley [not real name]." I can't actually remember her first name because I know her by sight now. But yeah she set it out very informal, and then instead of it being a table in-between us, it was next to each other looking at the screen to check if there was any options, which eventually there was because, with her help, I got involved with the crisis support team and also [a local service], which is another counselling service. 

Yeah. On the very first appointment that you went to see her, what kind of impression did you get of her?

I could tell that she's been affected by mental health stuff in the past just because of the way that she talks about it, because you could tell that there was empathy with it. So she knew what she was talking about and she's also experienced it, so I think that’s why I got on with her so well.

You mentioned you had counselling with her?

Hm mm 

When did that…how did that all start up?

It was…I guess it wasn’t professional counselling. It was more informal counselling just because we both talked about what was affecting us and stuff, which was good because I could offload what was affecting me with the depression and stuff like that. And she could say like trivial matters because she wasn’t affected by depression at that current time. So it was like I wasn’t just giving everything away. There was some give and take with what was being said and stuff, which helped a lot because it didn’t feel like I was essentially being forced to comply everything that had happened to me.

So it almost felt a bit more like an informal chat?

Yeah, more a conversation than counselling I guess, yeah.
A GP is one of several professionals that people can talk to if they’re worried about their mental or emotional health. If appropriate, the doctor will refer the person for counselling. Young people can also speak to school counsellors, university counsellors, or look online for support. Siobhan and Sophie recommended phoning or texting the Samaritans. Siobhan also felt that it was important for GPs to tell young people about all the options available to them, not just medication.   

Many people have depression at some point in their lives. But with the right support, especially if it’s early on, most recover and get on with and enjoy life again. Sophie, for example, had a hard time for a few years when her sister was ill but felt a lot better after she’d had help.
 

Sophie only goes to the doctors’ occasionally now for minor physical problems. For a while she went regularly until she was referred for group therapy.

Sophie only goes to the doctors’ occasionally now for minor physical problems. For a while she went regularly until she was referred for group therapy.

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I think I used to go a lot because, like now, I used to have like colds all the time and I think my mum thought it was, you know I had some kind of long term cold or something. But yeah I remember going with them. Yeah it was, it like, seemed pretty normal then, so....

And then going forwards can you remember other appointments as you got older?

Yeah I went …I kind of…yeah I use it normally so not that often. And then for a while I ended up going quite a bit because they kept turning me away and I kept going back. But now I'm just kind of using it less regularly, so....

So, at one point, you were going quite regularly and they were turning you away?

Yeah.

Can you remember what was happening at the time?

Yeah basically it was…this must have been about like three years ago – I'd been referred to my GP from the counsellor at school. But they said I didn’t…I wasn’t kind of high up enough on the list to be referred to CAMHS [Children and Mental Health Services]. And so they basically said come back in, I think it must have been about four/six weeks. And so I'd go back and like I still wasn’t feeling well but they kept doing the same thing, like they'd just be like, "No, we don’t think anything's wrong with you" and turn me away. 

It was…I think it was mainly just because I struggled to speak to them about how I was feeling and so they kind of took it as though you don’t really need to come here. So I ended up going about, it must have been about six or seven times before they actually did something.
Fran had mostly stopped taking drugs, was planning to move house, and trying to live as healthily as she could:
 

Fran is trying hard to keep well now. Good family and friends helped. The biggest difference has been keeping off drugs.

Fran is trying hard to keep well now. Good family and friends helped. The biggest difference has been keeping off drugs.

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Since then I’ve been pretty good. Like I’m really, really trying to keep well now. And that makes a massive difference.

What’s helped most?

Quite a lot of things really. The people I love. Had some amazing people just stick by me, like all of my family and my friends. Some friends left, like some friends didn’t, but the ones that stayed, it’s like they’re worth their weight in gold. But good stuff sometimes to a certain extent and self-motivation. But I’d say more than anything not taking drugs. I’m not a person that can take drugs.

So every time you got ill between the years, was it cos of drugs? Or were there different reasons or?

I think there were different reasons. But the different reasons always had an undercurrent of drugs, yeah.
See more young people talk about their experiences of depression and low mood.

See young people talk about their experiences of drugs and alcohol.

See young people talk about their experiences of eating disorders.
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