COUNSELLING BLOG

Posts tagged psychiatry

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Talking to Someone About their Mental Health Problem

1. Take the lead: If you know someone has been unwell, don’t be afraid to ask how they are. They might want to talk about it, they might not. But just letting them know they don’t have to avoid the issue with you is important.

2. Avoid clichés: Phrases like ‘Cheer up’, ‘I’m sure it’ll pass’ and ‘Pull yourself together’ definitely won’t help the conversation! Being open minded, non-judgemental and listening will.

3. Ask how you can help: People will want support at different times in different ways, so ask how you can help.

4. Don’t just talk about mental health: Keep in mind that having a mental health problem is just one part of the person. People don’t want to be defined by their mental health problem so keep talking about the things you always talked about. Just spending time with the person lets them know you care and can help you understand what they’re going through.

5. Don’t avoid the issue: If someone comes to you to talk, don’t brush it off because this can be a hard step to take. Acknowledge their illness and let them know that you’re there for them.

6. Give them time: Some people might prefer a text or email rather than talking on the phone or face to face. This means they can get back to you when they feel ready. What’s important is that they know you’ll be there when they’re ready to get in touch.

7. Find out more: If you feel awkward or uncomfortable about the conversation, find out more about mental illness.

Source: http://www.time-to-change.org.uk/take-action/talk-about-mental-health/talk-someone-about-their-mental-health-problem

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Attachment Disorder

Attachment disorder is where a child or adult is unable to form normal healthy attachments. This is usually due to detrimental early life experiences - such as neglect, abuse, separation from their parents or primary caregivers (after six months of age and before three years of age), frequent change of caregivers, and lack of responsiveness from their caregivers.

Symptoms vary depending on age. In adults, they fall under one of two categories – either avoidant or anxious/ ambivalent personalities. These are summarized below.

1. Avoidant

· Intense anger and hostility

· Hypercritical of others

· Extremely sensitive to criticism, correction or blame

· Lacks empathy

· Sees others as untrustworthy and unreliable

· Either sees themselves as being unlovable or “too good” for others

· Relationships are experienced as either being too threatening or requiring too much effort

· Fear of closeness and intimacy

· Compulsive self-reliance

· Passive or uninvolved in relationships

· Find it hard to get along with co-workers and authority figures

· Prefers to work alone, or to be self employed

· May use work to avoid investing in relationships

2. Anxious/ Ambivalent

· Demonstrates compulsive caregiving

· Problems with establishing and maintaining appropriate boundaries

· Feels they give they give more than they get back

· Feels their efforts aren’t noticed or appreciated

· Idealizes people

· Expects their partner to repeatedly demonstrate their love, affection and commitment to them, and the relationship

· Emotionally over-invests in friendships and romantic relationships

· Are preoccupied with close relationships

· Overly dependent on their partner

· Believes that others are out to use them or to take advantage of them

· Fears rejection

· Is uncomfortable with anger

· Experiences a roller coaster of emotions – and often these are extremes of emotion

· Tends to be possessive and jealous; finds it hard to trust

· Believes they are essentially flawed, inadequate and unlovable.

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Avoidant Personality Disorder

Avoidant Personality Disorder (AVPD) is a recognised disorder which is characterized by a hypersensitivity to criticism, intense self loathing and a strong desire to isolate themselves. Sufferers believe that they lack social skills, and feel they don’t know or understand “the rules”. Hence, they tend to avoid social situations to avoid the pain of rejection by others.

People in a close relationship with them often feel frustrated by the person’s tendency to pull away from them and avoid other people. They also find it hard to lead an active social life as the sufferer refuses to go to events such as family gathering, work parties and so on. Also, they may feel pressurised to cut themselves off, too, and live in a bubble with the AVPD person. This can be a source of stress for the person and the extended family.

Although people with AVPD will generally display a number of the traits outlined below, each person is unique and different. (Also, most of us display avoidant traits at times but that doesn’t mean we have AVPD).

Symptoms and traits include the following:“always” & “never” statements; blaming; catastrophizing (automatically assuming a “worst case scenario”); circular conversations (endless arguments which repeat the same patterns); “control-me” syndrome (a tendency to form relationships with people who are controlling, narcissistic or antisocial); dependency; depression; emotional blackmail; false accusations; fear of abandonment; hypervigilance; identity disturbance ( a distorted view of oneself); impulsivity; lack of object constancy (the inability to remember that people or objects are consistent and reliable over time – regardless of whether you can see them or not); low self-esteem; mood swings; objectification (treating a person like an object); panic attacks; passive aggressive behaviour; projection (attributing one’s own feelings or traits onto another); self-hatred; “playing the victim” and thought policing (trying to question, control, or unduly influence another person’s thoughts, feelings and behaviours.)

Specifically, the DSM-IV-TR, defines Avoidant Personality Disorder (AvPD) as being:

A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

1. Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection.

2. Is unwilling to get involved with people unless certain of being liked.

3. Shows restraint initiating intimate relationships because of the fear of being ashamed, ridiculed, or rejected due to severe low self-worth.

4. Is preoccupied with being criticized or rejected in social situations.

5. Is inhibited in new interpersonal situations because of feelings of inadequacy.

6. Views self as socially inept, personally unappealing, or inferior to others

7. Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.

A formal diagnosis must be made by a mental health professional.

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Mental Illness: Fact or Fiction?

Those with mental illnesses are often stigmatised as people are confused over what is the truth … and a lot of what we hear is simply misinformation! For example,

1. Fiction: There’s no hope for those diagnosed with mental illness.
Truth: There are numerous treatments and forms of support that make it possible for those with mental illness to hold down jobs and lead a normal life.

2. Fiction: There’s nothing I can do to make a difference in their lives.
Truth: The way you speak and act can make a huge difference. It can promote understanding or it can add to the burden. For example, seek to separate the person from the diagnosis (So instead of calling him or her a schizophrenic, describe them as a person with schizophrenia). Also, don’t label them as crazy or inferior. That is both insulting and inaccurate. Those with mental illness should be treated with respect; they have the same rights as others in society.

3. Fiction: They’re more likely to be violent than the average person.
Truth: There is no evidence that those with mental illness are any more violent than another person (but they ARE more likely to be victims of crime.)

4. Fiction: I’m not at risk of mental illnesses myself.
Truth: Mental illnesses are common - more than half the population will receive a diagnosis at some point in their life. It will likely affect their wider family, too.

5. Fiction: Mental illness is related to mental retardation.
Truth: The two are not related in any way at all. Mental illness affects a person’s mood, thoughts and behaviour; retardation affects their intellectual functioning and creates some challenges for daily functioning.

6. Fiction: Mental illnesses are caused by a weak character.
Truth: Mental illnesses are caused by a number of factors – social, biological, emotional, psychological, environmental, or a mix of these.

7. Fiction: Those with mental illnesses can’t hold down a job (or they’re less effective than most other employees).
Truth: Studies conducted by the National Institute of Mental Health (NIMH) and the National Alliance for the Mentally Ill (NAMI) showed no differences in productivity between those with mental illness and those without mental illness.

8. Fiction: Children don’t suffer from mental illnesses. What we see is bad behaviour due to poor parenting. Many kids just want attention and have been spoiled by their parents.
Truth: 5-9 % of children are diagnosed with a recognised form of mental illness. However, they can still succeed at school and in relationships if they receive the understanding and support they deserve.

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A Look at Borderline Personality Disorder

BPD is listed in the DSM as a newly recognised personality disorder. Having five or more of the following symptoms is a prerequisite for being diagnosed:

· Experiencing a roller coaster of emotions (eg. Feeling happy and confident one day and desperate and despairing another).
Note: Key emotions associated with the disorder are a sense of emptiness and intense anger or rage
· Problems with forming and maintaining relationships
· Having an unstable identity (That is, the way you see and feel about yourself depends on who are with, and their view of you )
· Engaging in impulsive and risky behaviours without considering the consequences (For example, having sexual flings, or changing partners frequently)
· Engaging in self-harm or substance abuse
· Desperately fearing rejection or abandonment
· Occasionally experiencing hallucinations or delusions.
Individuals diagnosed with BPD also tend to have other mental health concerns, like anxiety, depression, fears and phobias, eating disorders and substance abuse. They also go from one unstable and intense relationship to an equally unhealthy relationship.

In romantic relationships and close friendships, they are clingy, insecure and have low self-worth (which often leads to feelings of jealousy). Thus although they seek for closeness and intimacy their sense of neediness can make this hard to sustain.

In other social relationships, they continually battle with low self-esteem, expect to be judged, and don’t feel like they belong. Thus, they expect these relationships to disappoint and fail.

It is unclear what causes borderline personality disorder. It is believed to be due to a combination of factors, including: innate temperament, difficult early life experiences (such as a major house move, the loss of a parent through death or divorce, childhood neglect, or some kind of abuse), and experiencing ongoing or significant stress. However, this is not the case with all sufferers.

In terms of treatment and support, the main thing to target is the person’s need for love, unconditional acceptance and a chance to be heard. Often, talking therapy is very useful here – as well access to a person when they’re feeling overwhelmed. (That is, having access to some kind of crisis counselling). Usually, medication is only prescribed to treat related symptoms like anxiety.

Filed under counselling psychology therapy self improvment personality disorder mental health mental illness borderline personality disorder psychiatry online counselling college

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Dependent Personality Disorder

Dependent personality disorder (DPD) is one of a cluster of disorders defined by symptoms of anxiety and fear. The specific, identifying symptoms include:

  • Being emotionally dependent on others; feeling they can’t take care of themselves
  • · Investing a lot of time and effort in trying to please significant people
  • · Displaying clingy, passive and needy behavior
  • · Avoiding disagreements for fear of losing approval and support
  • · Experiencing separation anxiety and intense fear of abandonment
  • · Finding it hard to be alone
  • · Putting the needs of others before their own
  • · Tolerating mistreatment and abuse for fear of disapproval and abandonment
  • · Being crushed, and feeling helpless, when relationships end – and forming new relationships as soon as possible
  • · Being unable to make even the simplest decision without the input and reassurance of others
  • · Rarely taking the initiative
  • · Avoiding personal responsibility
  • · Avoiding responsible jobs and careers that require independent, autonomous functioning
  • · Being over-sensitivity to criticism
  • · Feeling negative and pessimistic; expecting to disappoint and fail
  • · Having low self esteem and lacking confidence, including a belief that they are unable to care for themselves.

The cause of disorder is still unclear, and probably includes both a genetic and environmental component. Some researchers have speculated that it could be linked to an authoritarian or overprotective parenting style – which acts as a trigger for a genetic predisposition.

Treatment is usually initially sought for some other problem or concern – such as feeling overwhelmed – so that they can’t cope with life. Also, sufferers will often have a mood disorder so they seek help for depression or anxiety at first.

The normal treatment for this particular disorder is counselling or psychotherapy. However, the emphasis is short term therapy so the person doesn’t form a dependency – and then look to the counsellor to take care of them. Prognosis with support is generally good.

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Avoidant (or Anxious) Personality Disorder

This is very similar to generalized social phobia. Those with the disorder think of themselves as being inadequate, unlikeable and socially inept. They fear being rejected, criticised or ridiculed and would rather avoid most social situations. The reasons can differ may be related to emotional neglect and peer group rejection in childhood and/ or adolescence. Symptoms may include the following:

- Hypersensitivity to rejection/criticism

- Self-imposed social isolation

- Extreme shyness or anxiety in social situations. (However, the person still has a strong desire for close and meaningful relationships)

-  May avoid physical contact with others (because it is associated with emotional or physical pain)

- Painful feelings of inadequacy

- Poor self-esteem

- Intense feelings of self consciousness

- Self hatred or self-loathing

- Mistrust of others

- Emotional distancing/ fear of intimacy

- Highly critical of their ability to relate naturally and appropriately to others

- Do not feel they can connect with others (although others may view them as easy to relate to)

- Intense feelings of inferiority.

- In more extreme cases, may suffer from agoraphobia.

Treatment approaches include social skills training, cognitive therapy, gradually increasing exposure to social situations, group therapy and, occasionally, drug therapy. Gaining and keeping the client’s trust is essential for progress to be made.

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The 7 Emotional Needs of Children

All children are born with emotional needs. These needs must be met by the adults in their life if they’re to grow into confident and independent adults.  The acronym PARENTS summarises children’s needs (Protection, Acceptance, Recognition, Enforced limits, Nearness, Time and Support).

Protection: It’s crucial that all children feel safe and secure. This is essential for their very survival – and all children fear rejection and abandonment.  They need a sense of order and predictability, routine, peace and stability – so they can learn to trust others, and build relationships. However, if trust is absent, and they feel insecure, they’ll start to put up walls to keep other people out, and they’ll find it hard to trust and get close to anyone.

Acceptance: All children need to feel that they are loved and accepted - for who and what they are – without any strings attached. They so desperately want to be worthy of acceptance, and cherished and loved despite their limits and their failings. This is crucial information - for their parent is a mirror who reflects back to them the world’s perception of the child. It should tell them they are valuable and worthy of love – so the child learns to value and believe in themselves. However, if a parent is demanding, harsh or critical then the child will develop chronic low self-esteem.

Recognition: Children have an innate need to make their parents happy, and are desperate for praise, and to hear their parents say: “I’m so proud of you. You did a fabulous job.” But if approval is withheld, so the child feels they are worthless, they’ll likely give up hope, and they will lose the will to try. This may show itself in angry, acting out behaviour … or the child may withdraw, and expect little in life.

Enforced Limits: Children need a sense of predictability. They need to see that rules are followed, so life is NOT chaotic. For the world feels scary and doesn’t make much sense if boundaries are fluid and “just anything goes”.

Nearness: Expressing love is crucial for communicating love - so children need to be held and be hugged by their parents. In a very concrete way, this sends the powerful message that the child’s needs matter, and their parents care for them.  

Time: Children don’t distinguish between quality time and just hanging out, and spending lots of time with parents. They need to be in their presence, and to have their full attention, as that sends the message “I like being with you.” They then believe that others will like and want them, too.

Support:  The outside world is a scary place for children. It’s full of unknown dangers and unmet challenges. Thus, to launch out and discover they can cope and survive, children need to be certain that their parents’ will be there. That is, they need their encouragement, their affirmation, their constant support and their belief in the child. That helps the child to venture into and explore the outside world, so they develop independence and increased autonomy.

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Some Symptoms of Depression

- An inability to function normally in everyday life

- Lethargy, fatigue, and the feeling that doing things takes too much energy

- Persistent sadness, including fits of crying (either uncontrollably or being set off easily)

- Feelings of anxiety or emptiness

- Feelings of worthlessness, self-blame and low self esteem

- Sleeping a lot more or less than usual, or experiencing insomnia

- Compulsive overeating, or a loss of appetite

- Finding thinking or concentrating difficult, “foggy” thinking; inability to make clear decisions; forgetfulness

- Pessimism; feeling that life is hopeless, pointless and futile

- Numbness/ an inability to feel anything at all

- Aches and pains, digestive problems, headaches

- Generally feeling irritable and restless

- Being troubled by suicidal thoughts/ thoughts of dying.

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How to Cope with Depression

Depression can often be difficult to fight as it usually drains you of your energy. And though you can’t overcome it by willpower alone, you still have some control, no matter how you feel. The suggestions below can help you with this.

1. Keep doing the activities you previously enjoyed (even if you don’t enjoy them as much when you’re depressed).

2. Try and build some exercise into your day as it releases endorphins – the body’s “feel good” hormones.

3. Know what your triggers and your risk factors are. For example, loneliness, stress, disappointment and pain are common triggers and risk factors for depression.

4. Stay in touch with your friends. Often those who are depressed start to isolate themselves – but that leads to loneliness - which makes depression worse.

5. Try and maintain some kind of routine, especially when it comes to getting up and going to bed. Taking naps in the daytime can cause insomnia and leave you feeling drained, so you have no energy.

6. Try to get a handle on how much you tend to worry. Take note of your thought patterns; don’t dwell on negatives. Instead, challenge faulty thinking so it’s much less pessimistic … and try to be thankful … and look for positives.

7. Make sure you do things that make you feel more relaxed. Often people who’re depressed feel uptight and agitated. So it’s important that you find things that help you to relax.  

8. Resist the temptation to self-medicate (especially through alcohol or substance abuse.) That will lead to greater problems - and make you feel much worse.

9. Seek out support. Talk to a good friend, or someone that you trust. You’ll usually find there’s someone who genuinely cares.

10. Talk to your doctor. It may be medication is the answer for you so don’t be afraid to try and get professional help.

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How to Overcome Emotional Numbness

Emotional numbness is where we experience mild to severe feelings of detachment – so it’s hard for us to access normal feelings any more. This includes both negative and positive emotions as you can’t decide to shut just one feeling off. Common causes of emotional numbness include different stresses or traumas … from receiving bad news … to being in an accident … to recovering from the death of someone close … to a relationship breakup … to feeling deeply humiliated or ashamed. So how do you overcome emotional numbness and live with emotional integrity again?

1. The first thing to do is to choose to respect and allow all emotions – no matter what they are. Also, try and grasp the fact that suppressing your emotions will likely lead to heartache and problems later on (as they’ll possibly resurface at inappropriate times.)

2. Try and understand that feelings and actions are two very different, and unrelated, things.  That is, you can still feel angry without becoming violent – so don’t assume your feelings will affect your actions, too.

3. Try to figure out the message behind intense emotions. Are you angry because you’ve been hurt, used or abused? Are you sad because deep down you feel that you’ll never find true love - as you can’t believe that anyone will love you for yourself?

4. Take that risk – and find the courage to ask someone for help. If you’re honest with yourself, you’ll know that there are those who genuinely love you like – like a true and caring friend. The important thing is not to try and isolate yourself, and to make the extra effort to prioritise self-care. You need other people to help you work through this.

5. Seek professional help if the symptoms persist. There are excellent counsellors and therapists out there who have the training and skills to help you to get free – so you can live a more fulfilling and normal, healthy life.

6. Be patient within yourself. It’s likely to take time – as you will need to learn to trust, and take some barriers down, so you can be yourself again (and that is often hard to do when you’ve experience hurt and pain).  

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If you know someone who’s depressed, please resolve never to ask them why. Depression isn’t a straightforward response to a bad situation; depression just is, like the weather.

Try to understand the blackness, lethargy, hopelessness, and loneliness they’re going through. Be there for them when they come through the other side. It’s hard to be a friend to someone who’s depressed, but it is one of the kindest, noblest, and best things you will ever do.

Stephen Fry

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What are the Different Types of Abuse

Abuse can take many forms. It can include:

1. Physical abuse such as hitting, pushing, pinching, shaking, misusing medication, ; withholding food or drink; force-feeding ,scalding, restraint and hair pulling, ; failing to provide physical care and aids to living.

2. Sexual abuse such as rape, sexual assault, or sexual acts to which the person has not or could not have consented, or pressurising someone into sexual acts they don’t understand or feel powerless to refuse.

3. Psychological or emotional abuse such as threats of harm or abandonment, being deprived of social or any other form of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse and being prevented from receiving services or support.

4. Financial or material abuse such as theft, fraud or exploitation, pressure in connection with wills, property, or inheritance, misuse of property, possessions or benefits.

5. Neglect such as ignoring medical or physical care needs and preventing access to health, social care or educational services or withholding the necessities of life such as food, drink and heating, or failing to ensure adequate supervision or exposing a person to unacceptable risk.

6. Discriminatory abuse such as that based on race or sexuality or, harassment, /slurs / maltreatment because of someone’s race, gender, disability, age, faith, culture, or sexual orientation

7. Institutional abuse can sometimes happen in residential homes, nursing homes or hospitals when people are mistreated because of poor or inadequate care, neglect and poor practice that affects the whole of that service.

Source: http://www.lancashire.gov.uk/acs/sites/safeguarding/identifying/index.asp?pageid=12140

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Talking to Someone about their Mental Health Problem

1. Take the lead: If you know someone has been unwell, don’t be afraid to ask how they are. They might want to talk about it, they might not. But just letting them know they don’t have to avoid the issue with you is important.

2. Avoid clichés: Phrases like ‘Cheer up’, ‘I’m sure it’ll pass’ and ‘Pull yourself together’ definitely won’t help the conversation! Being open minded, non-judgemental and listening will.

3. Ask how you can help: People will want support at different times in different ways, so ask how you can help.

4. Don’t just talk about mental health: Keep in mind that having a mental health problem is just one part of the person. People don’t want to be defined by their mental health problem so keep talking about the things you always talked about. Just spending time with the person lets them know you care and can help you understand what they’re going through.

5. Don’t avoid the issue: If someone comes to you to talk, don’t brush it off because this can be a hard step to take. Acknowledge their illness and let them know that you’re there for them.

6. Give them time: Some people might prefer a text or email rather than talking on the phone or face to face. This means they can get back to you when they feel ready. What’s important is that they know you’ll be there when they’re ready to get in touch.

7. Find out more: If you feel awkward or uncomfortable about the conversation, find out more about mental illness.

Source: http://www.time-to-change.org.uk/take-action/talk-about-mental-health/talk-someone-about-their-mental-health-problem

Filed under counselling psychology therapy mental health mental illness self help self improvement psychiatry relationships online counselling college

640 notes

Mental Illness: Truth or Fiction

Those with mental illnesses are often stigmatised as people are confused over what is the truth … and a lot of what we hear is simply misinformation! For example,

1. Fiction: There’s no hope for those diagnosed with mental illness.
Truth: There are numerous treatments and forms of support that make it possible for those with mental illness to hold down jobs and lead a normal life.

2. Fiction: There’s nothing I can do to make a difference in their lives.
Truth: The way you speak and act can make a huge difference. It can promote understanding or it can add to the burden. For example, seek to separate the person from the diagnosis (So instead of calling him or her a schizophrenic, describe them as a person with schizophrenia). Also, don’t label them as crazy or inferior. That is both insulting and inaccurate. Those with mental illness should be treated with respect; they have the same rights as others in society.

3. Fiction: They’re more likely to be violent than the average person.
Truth: There is no evidence that those with mental illness are any more violent than another person (but they ARE more likely to be victims of crime.)

4. Fiction: I’m not at risk of mental illnesses myself.
Truth: Mental illnesses are common - more than half the population will receive a diagnosis at some point in their life. It will likely affect their wider family, too.

5. Fiction: Mental illness is related to mental retardation.
Truth: The two are not related in any way at all. Mental illness affects a person’s mood, thoughts and behaviour; retardation affects their intellectual functioning and creates some challenges for daily functioning.

6. Fiction: Mental illnesses are caused by a weak character.
Truth: Mental illnesses are caused by a number of factors – social, biological, emotional, psychological, environmental, or a mix of these.

7. Fiction: Those with mental illnesses can’t hold down a job (or they’re less effective than most other employees).
Truth: Studies conducted by the National Institute of Mental Health (NIMH) and the National Alliance for the Mentally Ill (NAMI) showed no differences in productivity between those with mental illness and those without mental illness.

8.  Fiction: Children don’t suffer from mental illnesses. What we see is bad behaviour due to poor parenting. Many kids just want attention and have been spoiled by their parents.
Truth: 5-9 % of children are diagnosed with a recognised form of mental illness. However, they can still succeed at school and in relationships if they receive the understanding and support they deserve.  

Filed under counselling psychology therapy mental health mental illness self help self improvement psychiatry online counselling college