What is agoraphobia?
Agoraphobia often goes hand in hand with panic problems. If you experience agoraphobia you will have an intense fear in situations such as being far from home, being alone or far from help, being in crowded public places including streets, shops, buses, trains or tubes, lifts and motorways.

If you have agoraphobia, you probably avoid a whole range of situations and day-to-day activities resulting in your life becoming severely restricted and housebound and dependent on others.

Agoraphobia is a very common problem and it can occur with or without panic. It is not connected with serious mental illness of any kind, nor is it connected with any known physical illness. You are NOT going ‘mad / insane’.

Treatment for Agoraphobia
CBT is the treatment most doctors recommend for agoraphobia. The treatment process involves changing how you feel (bodily sensations), how you think (associated thoughts) and how you behave (avoiding / coping).

The central feature of effective CBT treatment is helping the sufferer to face their fears in a focussed, gradual, prolonged and repeated manner. This is also known as ‘exposure therapy’. By gradual practice the fear is overcome.

This means that you will have to practice facing the feared situations over and over again until your fear disappears and your confidence returns.
The basis of exposure therapy is, ‘if you stay in the feared situation for long enough and repeat the process systematically in a focused way, the anxiety and fear will fade away’.

Fortunately, once panic has come and gone, it is unlikely to come back for a while. Self-help is the most important component in the process of CBT.

What is Stress?
Stress is the feeling of being under too much pressure, which may cause you feeling unable to cope. People have different ways of reacting to stress, so a situation that feels stressful to one person may not feel stressful to another.

Many of life’s demands can cause stress, particularly work, relationships or money problems. And, when you feel stressed, it can get in the way of sorting out these demands, or can even affect everything else you do. Whilst sometimes it is easy to spot what’s causing you stress, at other times it may not be as obvious.

Remember that positive events in your life such as getting married or buying a house can also be causes of stress.
Stress can affect how you feel, think, behave and how your body works. In fact, common signs of stress include sleeping problems, sweating, loss of appetite and difficulty concentrating. You may feel anxious or irritable, and you may have racing thoughts, worry constantly or go over things in your head. You may notice that you experience headaches, muscle tension or pain, or that you drink or smoke more. Stress causes a surge of hormones in your body. These stress hormones are released to enable you to deal with pressures or threats – the so-called “fight or flight” response. Once the pressure or threat has passed, your stress hormone levels will usually return to normal. However, if you are constantly under stress, these hormones will remain in your body, leading to the symptoms of stress. Recognizing the signs and symptoms of stress early will help you figure out ways of coping and will help you prevent it getting worse.

Why do these things happen, and what can help?
Although there may be little you can do to prevent stress, there are many things you can do to manage stress more effectively. Self-help techniques such as learning how to relax or taking regular exercise can all help to reduce your symptoms of stress, and some forms of counselling and Cognitive Behavioural Therapy can also assist you in reducing your stress levels.

Sometimes things happen that are extremely upsetting and distressing.

Between 20 – 40% of people who experience a traumatic event have problems for more than one year, and about 15 – 20% have problems for more than two years.

After trauma, it’s normal to experience worry about the incident and to make efforts to avoid situations that bring back memories of the incident, at least for a while, but if this goes on for a long time it can become a problem.

The painful memories pop into your mind without you wanting them to, and can make you feel as if you were back in that situation. You may also experience ‘gaps’ in memory where you can’t remember parts of the incident. This is known as Post

Traumatic Stress Disorder or PTSD
You may have developed PTSD after experiencing or witnessing an event where you felt intense fear, horror or helplessness, believing that either your life or the life of someone else was in danger.

Many different kinds of events can cause PTSD, such as motor vehicle accidents, physical or sexual assault or abuse, witnessing accidents, torture, accidental injury, witnessing disasters or war.

What are the signs of PTSD?
There are a number of signs indicating that you may have PTSD and you may find you experience any or all of them, including flashbacks, constant remembering the event, nightmares often accompanied with feelings of intense fear, helplessness or horror, and avoidance of situations that are linked to the trauma, a feeling of numbness, symptoms of anxiety and panic such as being easily startled, difficulty sleeping and increased irritability.
PTSD can interfere in other areas of your life, for example increased use of alcohol or drugs to manage your difficult feelings, financial problems, feelings of shame or guilt, unemployment, low mood or depression, pain, anger and / or violence and disruption to family life making it hard to move. These can make the PTSD more difficult to manage.

What will help with PTSD?
CBT (Cognitive Behavioural Therapy) can help you to reclaim areas of life that you may have given up since the traumatic incident. This is called ‘graded exposure in real life’ and is done gradually starting with the easiest situation to tackle. The decision where to start is left to you.

Also you may find you have changed the way you think of yourself since experiencing the trauma. Confidence in yourself and trust in others are knocked and can cause shame, guilt and/or anger. CBT can help to examine your thoughts, look for alternative ways of thinking, and help you come to terms with the traumatic event.

CBT can also help you to reduce anxiety and flashbacks by ‘updating’ your memory of the incident, by ‘cooling down’ your traumatic memory so that you can recall the event without the high levels of distress that you previously experienced. This makes the memories less likely to ‘pop in’ or be triggered ‘out of the blue’.

What is postnatal depression and anxiety?

The birth of a child can trigger off a number of very strong emotions. Coming to terms with these new experiences may not be easy. We can help.

Symptoms of Postnatal Difficulties include:

• Overwhelming feelings of sadness and low mood
• Loss of interest or pleasure in doing things you would normally enjoy
• Excessive feelings of tiredness and low of energy
• Feeling inadequate and unable to cope
• Regular tearfulness
• Blaming self unnecessarily when things go wrong
• Feeling anxious or worried for no particular reason
• Problems concentrating and making decisions
• Significant changes to appetit
• Feeling agitated, irritable or that you “can’t be bothered”
• Feelings of guilt and hopelessness
• Isolating yourself
• Difficulty bonding with your baby with a feeling of indifference and no sense of enjoyment in his or her company
• Fearful of being left alone with your baby
• Difficulty adjusting to life changes accompanied by having a new/another baby
• Thinking about harming yourself or ending your own life

Why do these things happen and what can help?
Many women feel a bit down, tearful or anxious in the first week after giving birth. This is often called the “baby blues” and is so common that it’s considered normal. The “baby blues” don’t last for more than two weeks after giving birth.

If your symptoms last longer or start later, you may benefit from further support.

What is the treatment for postnatal depression and anxiety?
The therapy that most doctors recommend for the above difficulties is CBT (Cognitive Behavioural Therapy). We offer an 8 week Wellbeing in Motherhood course which will teach you tools and strategies, within a safe non-judgemental setting, to help improve your mood and reduce your anxiety levels.

…like fear of spiders, needles, dogs, dentists, blood, etc.

What is a phobia?
A phobia is an intense, unrealistic fear of an object, an event or a feeling. Many people suffer from some kind of phobia to a greater or lesser degree, and there are many different phobias — lifts, clocks, mushrooms, closed spaces, open spaces, animals, needles. Being in the presence of these will trigger the rapid breathing, pounding heartbeat, and sweaty palms of panic.

No one knows for sure how phobias develop. There may have been an event or trauma – such as being chased by a dog – that triggered the phobia but often, there is no clear explanation for the fear. What puzzles experts is why some people who experience such an event develop a phobia and others do not.

The cause probably lies in a mix of genetics and social causes. Dogs, snakes, dentists…

You could develop a specific phobia of pretty much anything. Animal phobias – cynophobia (dogs), equinophobia (horses), zoophobia (all animals) – are common. So are arachnophobia (spiders) and ophidiophobia (snakes) and, of course, there’s the fear of flying (pterygophobia), heights (acrophobia), and confined spaces (claustrophobia). One of the more common phobias is the fear of dentists (odontiatophobia). People who suffer with this phobia will literally let their teeth rot because they are afraid to go to a dentist.

Most specific phobias do not cause a serious disruption in a person’s life, and if you have a phobia you’ve probably found ways to avoid whatever it is that triggers the panic, or simply endure the distress felt when you encounter it. Some people go to their doctor requesting medication to help them through a situation, such as an unavoidable plane trip for someone who is phobic about flying. Some phobias cause significant problems that need professional help. People usually seek treatment when their phobia interferes in their lives, such as someone who must travel frequently but who is afraid of driving, or a woman who wants to have children but who has a fear of pain or blood or injections.

What helps?
While anti-anxiety medication sometimes may be prescribed, Cognitive Behavioural Therapy or CBT has also been found to be effective. This treatment works on the theory that the more a person is exposed to the object of his phobia, the less they will fear it.

First, you and your therapist will work together to establish a hierarchy or ladder of feared situations, from the least to the most feared. For example if you had a fear of lifts, stepping into a lift would cause a certain level of anxiety; the doors closing increases the anxiety, going up one flight causes another level of anxiety. With each additional flight the anxiety increases until it becomes intolerable.

Therapy begins with you practicing the least feared step, riding out the anxiety until the symptoms subside. This step is repeated until you can do this step without any anxiety or until the anxiety level is acceptable to you. You then move up the ladder to the next step. Each successive step is repeated until the physical reactions and anxious mood decrease to the point where you can step onto an elevator and ride to the top floor without panicking.

The most important thing for people with phobias to remember is that phobic disorders respond well to treatment. It’s not something they have to continue to suffer.

What is Panic?
Panic is an intense feeling of utter terror / fear that comes on very suddenly and it seems ‘out of the blue’, causing extreme bodily discomfort and a strong fear, as if something really awful is about to happen.

People who get panic attacks experience some very unpleasant physical feelings like heart pounding, feeling short of breath or breathing faster, gulping air, chest pain, numbness / tingling in fingers, toes and lips, pounding in the head, sweating, wobbly legs and shaking, dizziness, feeling sick or nauseous.

When you are in a panicky state it’s likely you think of the worst, that the physical feelings mean that something very bad is happening to you. For example, you might believe you are having a heart attack and dying because of the palpitations, or that you are going to faint, or run out of air, or go mad, choke, or lose control or make a fool of yourself in some way.

However, the fact is that panic is NOT dangerous/harmful and nothing awful is going to happen. This is your body reacting to a situation as if it were dangerous/frightening.

If your panic attacks are associated with a particular situation, you most likely try to avoid it, but if you can’t, then you will try to get away as soon as possible, or try to prevent the worst by doing something to make you feel better or safe. You may try to get others to help, or distract your attention. Other things panicky people do include sitting down, going to bed, carrying water/medicines at all times, seeking reassurance, or taking drugs or drinking alcohol to deal with the problem.

Sufferers of panic disorder become very nervous, anxious, irritable and easily annoyed, and sometimes things feel unreal, they may even feel depressed. All of these can lead to severe disruption in your day-to-day life.

Treatment for Panic
CBT is the treatment most doctors recommend for panic attacks. The treatment process involves changing how you feel (bodily sensations), how you think (associated thoughts) and how you behave (avoiding / coping).

The central feature of effective CBT treatment is helping the sufferer to face their fears in a focussed, gradual, prolonged and repeated manner. This is also known as ‘exposure therapy’. By gradual practice the fear is overcome.

This means that you will have to practice facing the feared situations over and over again until your fear disappears and your confidence returns.

The basis of exposure therapy is, ‘if you stay in the feared situation for long enough and repeat the process systematically in a focused way, the anxiety and fear will fade away’.
Fortunately, once panic has come and gone, it is unlikely to come back for a while. Self-help is the most important component in the process of CBT.

What is OCD?
Most people worry sometimes that they haven’t done important things like locking the door, turning off the cooker or cleaning their hands properly, and may experience anxiety about this occasionally. Concerns like these are normal and actually helpful because they help us to remember to do important things.
A small number of people will have a much bigger problem with these types of worries. They worry about things so much and spend hours trying to get things right that it can really interfere with a person’s life. This is called Obsessive Compulsive Disorder or OCD.

OCD is made up of obsessions and compulsions:
Obsessions are repetitive unpleasant thoughts or mental pictures. Obsessions include fears about hurting others or yourself, either deliberately or by accident, thinking very upsetting things about your religious beliefs, or worries about getting things just right.
Compulsions are things we do mainly to manage the worrying thoughts. Compulsions include repeatedly checking, doing lots of cleaning or trying to make things ‘just right’ at home or work.
Both obsessions and compulsions are unwanted, hard to get rid of and come back again and again. They are very upsetting and can often affect your day-to-day life in a big way.

Fictional example:
Jane was a new mum of a little boy when she began to have worries that she would hurt him at bath time. She worried that just by having these thoughts, it meant that she would hurt him. She began to bathe him only when her husband was at home and gradually began to avoid bath time completely. She was afraid to tell anyone in case they took her son away and she worried about it for most of the day.

How does OCD affect peoples’ lives?
Checking and worrying take up a lot of time and sometimes it can take up so much time that people stop working, going out with friends or looking after themselves, others or their home. OCD is very tiring. You might find that because of all the anxiety, you hardly have any energy for other things.

You may also think that no one would understand if you told them, and you may have feelings of guilt or shame, and wonder what others would think about you if they knew what you were doing or thinking. When it gets very bad, you might get very low in mood and tearful. You might even think of taking your own life. These worries are often the complete opposite of what you would normally do. Jane loved her son very much and was a great mum, but her OCD became a big problem for her, until she got some help.

What keeps it going?
People who are most likely to develop OCD have a lot of worries about responsibility. They think there is a danger when in fact there isn’t. If you are worried that you might not have locked the front door properly, you’d go back and check, this would be ‘normal’, but if you have OCD you might check many times, only stopping when the anxiety goes away. This may get to the point where it stops you leaving the house altogether.

What can help?
Cognitive Behavioural Therapy (CBT) is a talking therapy that has been shown to be good at helping the person get over their OCD. It helps a person look at their thoughts and behaviour. CBT teaches them how to deal with difficult thoughts and upsetting behaviour. The aim is to teach the person to take charge of their own lives.

What is depression?
Depression is a very common problem which affects most people at some time in their lives. We all feel fed up, miserable or sad at times, but usually it doesn’t last longer than a week or two, and won’t interfere too much with our lives. Sometimes there is a reason; sometimes the feelings just seem to come out of the blue. Normally, and with support and time, our problems will become easier to deal with. However this may not happen and you may feel unable to carry on with everyday life but not understand why.

Symptoms of depression include:

• Loss of interest in life, not enjoying the things you used to
• Finding it harder to make decisions
• Not coping with things like you used to
• Feeling exhausted all the time
• Losing confidence
• Losing interest in sex
• Losing your temper more often at the smallest things
• Feeling useless, inadequate and hopeless
• Problems with sleep
• Feeling restless and agitated

Having just one of the above symptoms for a day or two would probably mean that it is not serious, but if it carries on for more that a few weeks you may be depressed.

What is low self esteem?
Depression and low self esteem can go hand in hand. Low self esteem involves thinking about yourself in a consistently negative way. For example, you may think you are useless, or never quite good enough, or compare yourself with others, and think you are are inadequate or that others are in some way better than you.

People with low self esteem often spend a lot of time and energy trying to cover up these feelings, or overcompensating by trying to do things perfectly, so that other people won’t ‘find out’ how ‘useless’ they are.

They may also get very upset when things don’t go perfectly, and blame themselves when someone else might see that there was nothing they did wrong.

Why do these things happen, and what can help?
Sometimes there is an obvious reason for becoming depressed, sometimes not. There is normally more than one reason, and these are different for different people. No one has the complete answer as to why some people become depressed and others not. What is important is to recognise if you have a problem and get help as soon as possible.

It is also important to remember that depression can be successfully treated – there is hope for recovery.
Depression can make you feel bad and upset about yourself, making it hard to talk to anyone about how you feel. This is a part of being depressed, and talking to someone such as a close friend or family member about your problems may help you see things clearer and help lift your mood.
Eating properly, sleeping well, finding time for yourself, socialising and exercise can also help you feel better about yourself but if you feel that nothing is working and you just can’t manage, then the next step may be to get some professional help.
The therapy that most doctors recommend for depression is CBT (Cognitive Behavioral Therapy). This therapy will help you get back to your previous activities, or begin some new ones if you think you might like to. For example many depressed people stop doing things that used to give them a sense of pleasure and meaning.

CBT would help you to slowly restart these as a way of bringing pleasure back into your life. CBT can also help you look at and change the ideas you may have that make you depressed.

Working with people with long-term health conditions
Having a physical health problem like diabetes, a lung condition (eg COPD/asthma), a heart condition, chronic pain and IBS can affect the whole of your life.

People who have recently been diagnosed with a long term condition and those who have lived with one for some time often find that these long-term conditions also have an effect on their emotional health. Feelings of depression, sadness and anger are very common.

Sometimes you are troubled by a persistent physical symptom but doctors don’t seem to be able to help. They can tell you what you haven’t got but are not able to alleviate the symptoms you are experiencing.

Daily activities, work, relationships and your social life can be affected by your illness/condition and in turn negative thoughts can make it even more difficult to look after oneself.

Sometimes people find it difficult to cope with taking their medication every day. Stress and anxiety are common and people tell us that thy can become irritable and moody – especially with their loved ones. They may feel that no-one understands how hard it can be to live life with a long term condition.

Talking to a psychologist can help you understand what is going on in your life and to find new ways of coping. This is a list of topics we commonly discuss with clients:

• Coping with change, loss and uncertainty
• Learning to live with and manage your condition
• Support and techniques to help you make the lifestyle changes that you want to (e.g. weight loss, stopping smoking, healthy eating)
• Feelings of failure or guilt when self-care isn’t working
• Managing stress, depression and feeling overwhelmed
• Worries about needles, blood and other procedures and treatments
• Coping with the impact of health on your relationships and/or sexual functioning

The team works to help people with a long-term condition overcome the challenges that it brings with it. We run a range of programmes for affected people aimed at improving quality of life, reducing psychological distress and improving ability to cope.

There is some more information on this part of our programme in the following explanatory leaflets.

Long Term Conditions Program Information, Strategies for Better Living Information, Mindfulness Based Stress Reduction Information

What is health anxiety?
Most people at some time in their lives will be concerned about their health. Often these worries will go away after a few days or they will reduce when their doctor has reassured them.
But for some people these fears can grow until they become very frightening and can significantly interfere with normal day-to-day life. Health anxiety becomes a problem when you develop a fear that you have a serious illness, despite your doctor saying that everything is okay.

You probably notice changes in your body which you believe means you have a serious illness. Understandably, this can be a very frightening thought. The changes you have noticed are real but there are other explanations for them.

The most common fears are heart disease, HIV/AIDS, cancer, multiple sclerosis, Parkinson’s disease or becoming mentally unwell. If you spend a lot of time thinking about these types of illnesses, you may think you are at high risk of getting the illness and imagine the worst. You may also worry that your doctor has missed something important.

If you have significant worries about your health, you probably have high levels of anxiety that interfere in your relationships, work and social life. You may also spend a huge amount of time worrying about having an illness and check for changes in symptoms, and read or look for information on the internet or on TV.

How does health anxiety develop?
There are several reasons why you may become very anxious about your health. For example, your family may have been very protective or anxious, or a close friend or family member may have unexpectedly become ill despite doctors’ tests being okay.
What keeps health anxiety going?

Once you’ve begun to worry a lot about your health, you can become anxious about any slight change in your body. Anxiety can produce a big physical response – just think about all the physical sensations we get when we are anxious: there are over 30! People who have worries about their health are more likely to notice changes in ‘symptoms’. The more they fret, the more they notice. Take an everyday example of a headache. The more we think about the headache, the more we pay attention to it, the worse it gets. Often people are reassured for a short while until they notice another change and the cycle starts again.

What can help?
Cognitive Behaviour Therapy is a talking therapy that has been shown to be good at helping the person deal with their health anxiety. It helps a person look at their thoughts and behaviour about illness. The aim is to teach the person to take charge of their own life.

Almost everybody worries about some social situations but for some people these worries can get out of hand and make it very difficult to do things in public. This can interfere with their ability to work, enjoy social activities or even have rewarding relationships. They may be preoccupied with how they are coming across, seeing the normal effects of anxiety – like blushing or sweating – as a disaster and as a result avoid social situations altogether.

In addition, it may be that they become extremely anxious before social events that can’t be avoided and develop ‘tricks’ to help cope. Afterwards they go through everything that happened in detail, feeling ashamed and embarrassed about what did, or did not, happen.

When fear of social situations reaches this level it can be called social phobia or social anxiety. Just as some people have a phobia (extreme fear) of snakes or spiders, here the fear is of being negatively judged or doing something embarrassing or humiliating in public. People who go on to develop social phobia often have experiences of being bullied or criticised in their past, and this has stayed with them, or they may have a naturally shy personality.

Fictional example:
Kevin was a rather shy child but did well in primary school and was very happy. When he transferred to a big secondary school he found it much more intimidating and he did all he could to avoid some lessons. He has a particularly clear and painful memory of an English class where the teacher made him read out his essay and then encouraged the class to laugh at him. Even talking about this today makes Kevin blush and feel the prickle of embarrassment.

At work Kevin does very well and the managers are pleased with him. However before every team meeting Kevin feels sick and shaky and tries to avoid going. He tries to sit in one particular place, near the door and finds it difficult to concentrate as the worries rattle around his head.
He is soon to be promoted but this will mean having to give presentations to the team. Kevin is seriously thinking about leaving as he does not think he could cope with the stress. Socially he is quiet but with one or two friends, he can open up and completely relax. They would be amazed if they knew how difficult he found some situations.

What keeps it going?
Because of how bad anxiety can make them feel, socially anxious people develop lots of ways of reducing or avoiding the fear such as avoiding social situations altogether, or using ‘tricks’ to help them get through. But the very things they do to manage the difficulties can, in the long-term, keep the problem going. Similarly, focusing attention on themselves can increase and magnify the problem. Also, having an excessively negative view of how they are doing, and focusing on any slip ups they think they have made, keeps adding to the anxiety and fear.

What is the treatment?
Cognitive Behavioural Therapy has been scientifically shown to be an effective treatment. In therapy the focus is on actively tackling the fear, by reducing those things that keep the problem going, including some of the ‘tricks’ to reduce the anxiety.

What is bereavement?
Most of us will experience loss of a loved one at some stage in our life and adjusting to this change can be challenging. This common life event can be very distressing. No one can quite prepare us for the roller coaster of emotions that we might go through this journey. Some of these emotions can feel overwhelming and include numbness, denial, anger, sorrow, guilt, hopelessness, loneliness and despair.

Sometimes it is difficult to find the space or the support to process these strong emotions. This can be further complicated by practical demands such as legal, financial and or caring responsibilities. Consequences of this can result in accessing the much needed time to attend to ones’ emotional needs. There is no right or wrong way to grieve and this is an individual journey for those adjusting to the loss process.

Why do these things happen, and what can help?
It is encouraged to seek support from family and friends at this particularly sensitive time. Some people find it more helpful to talk to a professional who is not directly connected to the bereaved. One can expect this space to provide empathy, compassionate understanding and guidance to facilitate the grieving process.

How can the Wellbeing Service help?
For lots of people who have experienced a loss attending our “Overcoming low mood” course can offer a lot of help. We can also help put you in touch with other organisations who will be able to help you.

Everybody worries sometimes, but for some people their worrying feels ‘out of control’ and interferes with their normal lives, and they think that this will make them ill or that they are going mad.

For some people their worrying is always with them. For others it comes and goes, but most would say worrying has been part of who they are for as long as they can remember.

Extreme worrying like this tends to develop slowly and it’s only when they realise that it’s not going to go away by itself that people try to get some help. Generalised Anxiety Disorder or GAD is what people call extreme worrying when you are worrying for at least 50% of the time, so much so that it makes it hard to concentrate on other things.

Extreme worry can make you feel depressed, jumpy and irritable; you may find it hard to get to sleep and more difficult to sort out problems as a result of the worrying. You probably over-estimate the chances that bad things might happen and underestimate the chances that things will turn out well. When things do go wrong you probably cope very well but find it difficult to manage during the period before you know what will happen.

Fictional example:
Rosita is a ‘born worrier’. This worrying has made it difficult for her to enjoy her life. She feels bad about her worrying because ‘there’s no reason for it’.

She was always nervous about going to school and had frequent headaches, so her mum kept her off school. Whenever there was any important event like a family holiday, she would spend days worrying about how it might go wrong, and what she would do if it did. She asked her family for advice but wasn’t reassured because they didn’t seem to worry enough. She would pass up loads of opportunities to get involved in things because she worried, and would say she was needed at home to look after the children.

When her husband died her worrying became worse. She would worry about making mistakes with money, about her or her children and grandchildren’s health, until she couldn’t stop her worrying. She felt very tired and slept poorly because of all the worries running around her head.

What keeps it going?
Like many people with GAD, once a worry took hold, Rosita tried to escape the anxiety by avoiding situations where the frightening event could happen. She avoided not only the thing she feared but also the problems she thought would come from her worrying.

You may think of worrying as a way to anticipate, cope with and help solve problems. But like Rosita found, using worry like this can mean you become even more aware of possible dangers and end up worrying about them as well.

Another way of coping with worrying is to look for reassurance from other people, or from reading or internet websites. Unfortunately, evidence shows that searching for reassurance can make you even more uncertain, for example when the answers you get are not what you expect, or if the information is contradictory.

What is the treatment for extreme worrying?
Cognitive Behavioural Therapy (CBT) is the most widely recommended treatment for worry and helps you look at the costs and benefits of worrying, the difference between helpful and unhelpful worrying, to separate actual facts from anxiety to how to learn how to manage without avoiding things or seeking reassurance. CBT may help to practice letting go of worrying, or limiting worry to certain times of the day. Additionally, CBT can help to look at your ideas about what it means to be a worrier, for example that worrying too much will make you ill, or that you are going mad, or that worrying will in some way protect you from bad events.

This self-referral form should take 10-20 minutes to complete. Please fill in as much information as you can, as this will enable us to process your request quickly. If you have any questions or require any help with completing this form, please call 020 8475 8080. The phone lines are open Monday to Friday from 9.00am to 5.00pm.

You may want to have a look through our FAQs page.

If you have questions or need help with this form, please call 020 8548 5550 (Monday to Thursday from 8:15am to 8:00pm, Friday from 8:15am to 6:00pm).

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If you are currently under the care of a community mental health team (CMHT) you should discuss your needs with them. This is to help with the continuity and consistency of the care you receive. We will not be able to provide treatment to clients currently receiving therapy from a CMHT.

We regret that we are only allowed to accept clients who are registered with a GP who is part of the Richmond CCG. If you are not sure about this, it might be worth contacting your GP practice or giving us a call to confirm your eligibility.

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