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Section > Stats

Stats > Stat > Insight 1

Brits report feeling stressed every day

Insight no 2

of Brits feel more stressed than pre-pandemic

Stats > Stat > Insight 3

Brits have an anxiety disorder

For many of us, the Covid-19 pandemic has caused a dramatic shift in the way we work. Unpredictable workloads, less social interaction and, for some of us, the demands of running a home alongside our jobs has caused our [stress levels](/your-health/physical-signs-of-stress-on-the-body/) to rise. 

In 2019, [the World Health Organization](https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases)  highlighted [burnout](/your-health/7-early-signs-of-burnout/) caused by chronic workplace stress as an occupational phenomenon. A recent report by [YouGov and Microsoft](https://query.prod.cms.rt.microsoft.com/cms/api/am/binary/RWxzz5)  found that 30% of UK employees are working longer hours and 53% feel they must be available all the time. 

## Why are we so stressed at work?

‘One of the most common triggers for stress is an unhealthy psychosocial work environment,’ says Kry Psychologist Dag Härdfeldt. That’s the interpersonal and social interactions that influence our behaviour and development at work. 

‘In many work situations, we encounter unclear expectations, shifting requirements, a blurred work-life balance and a lack of respect for free time,’ adds Härdfeldt. Concern about redundancy and the unpredictability of the future can also fuel our feelings of stress and overwhelm. 

## How can I better manage my workplace stress?

To help you cope better and manage feelings of work-related stress, Härdfeldt has these 5 tips for coping with the biggest stress triggers.

### 1. Stress trigger: Blurred work/life balance

__Suggestion__: Establish clear boundaries

Besides the more obvious advice like limiting your access to emails or work calls, Härdfeldt recommends making changes at home to help you establish clearer boundaries between work and time off.

‘Everyone’s situation and living space will be different, but try to isolate your work zone when you’re not on the clock,’ says Härdfeldt. That means steering clear of using your laptop in bed or taking work calls from the sofa when you can.

‘Our brains are conditioned to respond to our physical environment and the activity that takes place within them,’ says Härdfeldt. ‘It’s because of this that we often recommend to people with sleep disorders that the bedroom should only be used for resting or sex.’ 

### 2. Stress trigger: Unrealistic time management

__Suggestion__: Break down your work into main and sub-goals

One of the key triggers of stress is poor time management. Härdfeldt explains that this is often due to the uncertainty of deadlines, how long different aspects of your job might take and how far you think you should have progressed. 

‘Try breaking down your tasks into main goals and sub-goals,’ Härdfeldt suggests. The main goal is the end result – for example, a presentation. The sub-goals are the small goals you need to achieve to get there. 

‘The key difference between a main goal and a sub-goal is that it’s harder to determine when you’ve reached your main goal, or it can feel like you’re never properly finished. You can always keep improving or practising a presentation, for instance,’ explains Härdfeldt. ‘With sub-goals, you can create them in such a way that they can be divided into complete and not complete.’ 

The idea behind this is to help reduce the amount of decisions your brain needs to process. By dividing the whole task into manageable chunks, it’s much easier for your body’s stress system to cope. 

### 3. Stress trigger: Changing or overwhelming workloads

__Suggestion__: Learn to say no (even if it’s uncomfortable)

Sometimes saying no to things is necessary. But evidence has shown that saying no is more difficult for people who skew towards the ‘agreeableness’ end of the personality scale.

‘Agreeableness is related to an increased sense of empathy, kindness and compassion,’ Härdfeldt explains. ‘More agreeable people tend to say yes to reduce the chance of conflict.’ 

The first step to learning how to say no is to sit with the emotions that come up when you do it. Then, it’s about learning how to accept these emotions in order to build up your tolerance.

‘If you want to become better at it, practise just saying no. You don’t owe every person an explanation,’ says Härdfeldt. Of course, when talking to someone like your manager you may want to explain further, but keep it direct and clear: ‘At the moment I’m working on X, so no, I can’t do Y right now. I can get to it on Thursday.’ 

### 4. Stress trigger: Fewer social interactions

__Suggestion__: Don’t forget to check in with your colleagues 

Working remotely has affected how we socialise with our colleagues. Instead of impromptu coffees and quick catch-ups in the kitchen, we’re operating in a more functional way – working autonomously or scheduling focused video meetings. It means we have less time for those ‘water-cooler moments’. 

‘One of the most impactful things peers can do is attempt to understand their colleagues’ work situations,’ says Härdfeldt. ‘It needn’t be a grand gesture, but something as small as asking someone from a different department what their workload is like will show your support.’ 

Instead of getting straight into emails when you switch on your laptop, take a minute to check in with a colleague. You might find it’s a simple destresser for both of you.

### 5. Stress trigger: Unpredictability of your work environment

__Suggestion__: Ask your manager for support

Remember that your boss is there to support you, so schedule a regular one-to-one with them and use that time to raise any concerns you’re having.

‘It’s part of your manager’s responsibility to ensure that your psychosocial work environment isn’t having a detrimental effect on your mental health,’ advises Härdfeldt. ‘If you’re a manager yourself, show an interest in your employee’s specific work situation and ask if they have everything they need to perform their job properly.’  

## When to get professional help with work-related stress 

If you’re constantly feeling stressed or overwhelmed at work, it might be time to seek professional help. 

‘My advice is to talk to a doctor about your stress levels before you experience burnout. The sooner you put preventive measures in place, the better the prognosis is,’ explains Härdfeldt. 

‘If you feel your stress is getting worse, don’t try to push through it. Sometimes a period of sick leave is the best option, even if that might be difficult to accept. Severe burnout could alter your working capability in the long run.’ 

If you’re concerned about feelings of stress or overwhelm, book a meeting with a doctor to help identify the causes and the best support you can access.

__This article has been medically approved by Dag Härdfeldt, Kry psychologist.__


Section > Call out > GP CTA for content

Speak to a GP

kry.co.uk > Your health > A therapist’s guide to coping better with work-related stress 

A therapist’s guide to coping better with work-related stress 

Why are we so stressed at work? Kry psychologist Dag Härdfeldt explains and shares useful tips for managing workplace stress

kry.co.uk > Your health >A therapist’s guide to coping better with work-related stress 

How to cope better with work-related stress | Kry

Everyday mental wellbeing

How to cope better with work-related stress – a therapist's advice

Staring at the ceiling, tossing and turning in bed or randomly wide awake at 3am? Having trouble sleeping is common. A global sleep review found that [up to one-third](https://www.nature.com/articles/s41562-020-00965-x.epdf) of us struggle to get the recommended 7 hours of sleep each night. 

The pandemic has also impacted our sleep, with [recent research](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7744844/) showing that the majority of us are getting poorer quality sleep than before Covid-19.

So, what can we do to sleep better? 

## Why is sleep so important?

‘Good sleep is essential for your body and mind to function properly,’ says Dr Saloojee. ‘It’s as important as regular exercise and a healthy diet. Sleep helps us to feel alert and refreshed and can help us[ maintain a healthy weight](/your-health/5-things-you-need-to-know-about-sustainable-and-healthy-weight-loss-according-to-a-doctor/) and stave off diseases. 

‘In contrast, poor sleep has negative effects on the body and can lead to reduced concentration, weight gain and an increased risk of problems such as heart disease, obesity and diabetes. Chronic sleep problems can also negatively impact our mood and mental health.’ 

[Trouble sleeping](/your-health/5-sleep-problems-to-discuss-with-a-doctor/) is linked to a wide range of factors, from mental health problems like depression to shift work and [stress](/your-health/3-ways-stress-can-disturb-your-sleep/). 

This is why it’s important to explore the particular reasons for your own sleep problems – especially if it lasts more than a couple of months.

## How much sleep do I need?

‘Most adults need between 7-9 hours of sleep at night to function optimally,’ says Dr Saloojee. ‘Children need even more.’

Getting a good night’s sleep is vital, so it’s worth taking seriously and prioritising your sleep as much as you can.

## What are some common sleep problems?

- Difficulty falling asleep
- Waking up at night and having trouble falling back asleep
- Waking up early in the morning

[Sleep problems](/your-health/5-sleep-problems-to-discuss-with-a-doctor/) can also include night terrors, nightmares and walking or talking in your sleep. All these things can also disrupt the quality of your sleep.

Sleeping poorly and[ being tired](/your-health/why-am-i-always-tired/) during the day can sometimes make us feel anxious around bedtime, which, in turn, can make it even harder to fall asleep. This can create a negative spiral where you associate sleep with stress rather than rest.

If this is the case for you, it’s important to work on reducing your stress levels – either with self-care or by speaking to a doctor or therapist.

## What is deep sleep and how do I get more of it?

‘When we fall asleep, our bodies follow a sleep cycle that is divided into 4 stages,’ says Dr Saloojee. ‘Deep sleep is known as the most physically restorative stage of sleep.’ 

‘The first 3 stages are all called non-rapid eye movement (NREM) sleep and the fourth stage is called rapid eye movement (REM) sleep.’

![Sleeopcycle table](//images.ctfassets.net/h8qzhh7m9m8u/jMrYx0959I0CCMJdg0PeM/a8787c14f4130cb44c8b9144144a86bc/Sleeopcycle_table.png)

### Stage 1 NREM – lightest sleep
This is when your body is beginning to relax and you’re falling asleep. You might experience slow, rolling eye movements, sudden jerks or muscle spasms. At this stage, you can wake up easily

### Stage 2 NREM – light sleep
This stage is a period of light sleep before you enter deeper sleep. Your heartbeat slows and your body temperature begins to drop. Stage 2 usually lasts the longest of the 4 stages.

### Stage 3 NREM – deep sleep
Stage 3 is the period of deep, restorative sleep that helps you feel more refreshed the next day. Your heartbeat and breathing are at their lowest rate. It’s much harder for you to be woken up at this time.

### Stage 4 REM – deepest sleep
The last stage is REM sleep, the deepest stage of sleep. It first happens about 90 minutes after you’ve fallen asleep. Your eyes move rapidly from side to side behind your eyelids, your heart rate increases and your brain becomes more active. This is when most of your dreaming occurs.

Each sleep cycle lasts 90-120 minutes and will repeat several times during the night until you wake up. NREM usually makes up 80% of each cycle. 

‘Having good sleep hygiene – or a regular sleep routine – can help improve the quality of your sleep and increase the deeper NREM sleep that helps you feel refreshed the next day,’ says Dr Saloojee.

## How can I sleep better?

Dr Saloojee recommends these tips for a good bedtime routine and getting better, deeper sleep:

### During the day 

- __Keep your sleep routine as consistent as possible__
Our internal body clock regulates our sleep cycle, controlling when we feel tired or alert. The clock operates on a 24-hour cycle, known as the circadian rhythm. 

Keeping a consistent sleep and wake time, even on weekends, will help keep your circadian rhythm on track. 

- __Spend time outdoors__
Getting some sun (or artificial bright light) during the day helps keep our circadian rhythm healthy. Research has shown that daily light exposure increases sleep quality and duration at night, too.

### During the evening

- __Be mindful of caffeine__
Try to avoid caffeine in the late afternoon and evening. Caffeine stimulates your nervous system and keeps you alert, which you don’t want at night. Caffeine levels in your body can remain elevated for 6-8 hours and can significantly impact your sleep quality.

- __Watch your [alcohol intake](/your-health/what-does-alcohol-do-to-your-body/)__
Drinking can also negatively affect your sleep. [Research](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6751071/) has shown that while alcohol can make you sleepy at first, it may interrupt your sleep later at night and in the early morning. Drinking has also been linked to [snoring](/your-health/how-to-stop-snoring/).

- __Turn down the lights__
Avoid too much light – including blue light from your TV, phone and laptop – in the evening as this can trick your circadian rhythm into thinking it’s still daytime. This in turn reduces hormones like melatonin, which helps you relax and sleep well. 

- __Wind down before bedtime__
Relaxing in the evening will help to lower your stress levels and potentially prevent a racing mind before bed. Take a bath or shower, read a book, listen to music, try meditation or do some [breathing relaxation](/your-health/3-breathing-exercises-a-psychologist-recommends/) techniques.

### Just before bed
- __Increase your chance of uninterrupted sleep__
If you live with a snorer or know the daylight wakes you early, small changes can make a big difference. Make sure your bedroom is dark and quiet – use thick curtains, blinds or an eye mask and earplugs. 

### When you wake up
- __Keep a sleep diary__
Make a note of when you sleep badly and when you sleep well. This will help you identify potential triggers or factors and will be useful if you talk to a doctor.

## What if my sleeplessness is becoming a long-term problem?

If you’re regularly having problems sleeping, you may have insomnia. 

Speak to a doctor if:

- You’ve already tried some simple lifestyle solutions 
- Your insomnia has lasted a few months or more
- Your sleeping problems are making it hard to cope with your daily life

A doctor will be able to help identify and advise on the possible causes of your insomnia and give guidance on good sleep hygiene. They may refer you for talking therapy like cognitive behavioural therapy (CBT), which may help uncover the underlying reasons you’re having trouble sleeping.  

In rare situations, a doctor may prescribe medication. In the case of chronic sleep disorders, you may be referred for an investigation in a sleep laboratory. This might include an in-depth analysis and monitoring of your sleep.

__This article has been medically reviewed by Dr Roshaan Saloojee, a Kry GP.__


kry.co.uk   >       article page >          CTA

See a doctor about sleep

Kry.co.uk > Your health >  How to sleep better 

 How to sleep better 

How much sleep do you need and what helps you get a better night’s sleep? Read our guide with a doctor’s tips on how to sleep better

How to sleep better | Kry

Depression affects around 264 million people worldwide.  Recent UK figures  show that almost 1 in 5 adults (19.2%) experienced depression during the coronavirus crisis in 2020 — a figure that almost doubled from around 1 in 10 (9.7%) before the pandemic. People most affected included younger adults aged 16-39 years, women, those with financial worries and people with disabilities.  

‘There are many factors  that may contribute to depression,’ says Madeleine Gauffin, Licensed Psychologist and Psychotherapist at Kry. ‘But social isolation, lockdowns, money and health worries during the pandemic are further factors, causing more people to feel depressed.’

There are some simple, daily practices that science has shown may positively affect your mood, if you practice them regularly. Here’s a toolkit to get you started.

## 1. Find time to head outside every day

‘Lack of sunlight can cause seasonal affective disorder (SAD) in some people,’ says Gauffin. ‘This is a type of recurring depression with a seasonal pattern.’ It’s not certain what causes SAD, but some theories suggest a lack of light in winter may affect mood-regulating chemicals in the brain. Typical symptoms include persistent low mood, irritability, feelings of despair, lack of energy, sleeping for longer than normal, craving carbohydrates and weight loss or gain.   

__Tools to use daily__ 

- Get as much daylight as possible.  Even a short daily walk can be beneficial. Natural light is the most important cue for maintaining circadian rhythms (the body’s natural sleep/wake cycle).  A lack of sunlight can throw this internal body clock out of sync and by affecting sleep and appetite, make symptoms worse
- Spend time in nature. One study showed that just 10 minutes spent sitting or walking in a natural environment can have a positive impact on mental wellbeing  

## 2. Get moving (and your heart pumping)

Exercise can support your mood if you have depression and is especially useful for people with mild to moderate depression. 

This doesn’t have to mean sweating for hours. It could be as little as a daily 20-minute walk. According to a recent meta-analysis, exercising for a total of 150 minutes each week can reduce the risk of depression by a third.

‘Exercise is important if you’re feeling depressed,’ says Gauffin. ‘Moving physically has an energising effect,’ she explains. ‘The less you move, the more lethargic you feel. Try and do some exercise that gets you out of breath every day such as dancing, stretching, walking or running. If you find it hard to motivate yourself, arrange to meet a friend for a socially distanced walk.’  

__NHS recommends...__
- Each week, aim to do 150 minutes of moderate activity (like brisk walking, gardening, rollerblading) or 
- 75 minutes of intense activity (including jogging, aerobics, walking up the stairs) weekly or
- A combination each week — to maintain your health

## 3. Connect with friends and family as often as you can

‘One of the reasons people are finding it hard to cope during the coronavirus crisis is because they can’t spend time with friends and family in the same way as they did before,’ says Gauffin.  

A US study found that confiding in friends and social connection generally has a protective effect against depression (it also found that reducing time watching TV and napping in the day also help to lower depressive symptoms).

__Tools to use daily__

- Talk to friends regularly on the phone or Zoom
- If you don’t feel like talking, check in with friends over text
- Join an online art, book or music club. Or, find a local mental health support group
- See friends in person where possible, depending on the restrictions in your area

## 4. Avoid processed foods and sugar

‘If you’re feeling low or depressed, you’re less likely to cook healthy meals,’ says Gauffin. ‘And, if you eat a lot of processed foods, sugar and carbohydrates, you may feel worse.’ One of the reasons for this is that processed and sugary foods can lead to blood sugar highs and lows, which many people find affects their mood. 

A recent review of the scientific literature on food and depression  reported that the most beneficial diet to reduce depression contained plenty of vegetables, fruit, fibre, fish, wholegrains and legumes and was low in processed foods and sugar. 

__Tools to use daily__

- Make sure you eat a wide variety of whole foods
- Aim to get enough of the micronutrients magnesium (like green leafy vegetables, low-fat dairy, nuts and seeds), folate (including legumes, asparagus and beetroot) and B vitamins (such as eggs, seafood, dairy products and leafy greens) as these were found to be associated with lower rates of depression 
- Try to avoid cutting out entire food groups, unless advised to do so by a doctor or dietitian. This was associated with higher rates of depression. It’s not possible to prove causality but cutting out food groups can affect your health in other ways too, so it isn’t a good idea to do so before discussing it with a medical professional 

## 5. Consider Cognitive Behavioural Therapy (CBT)

CBT is a talking therapy that can help you to change the habitual thought patterns that might be playing a part in your depression.  

‘CBT can be very helpful in treating depression,’ says Gauffin. In fact, a large body of scientific evidence has shown that CBT is effective in treating low mood.  In one recent meta-analysis  of 91 studies, it was shown that CBT interventions showed a larger short-term decrease in depression compared with other treatments. 

‘When you start CBT, you write down your thoughts, feelings and behaviours and then look for connections between these and your depression,’ says Gauffin. ‘This helps you to become more aware of your thoughts and actions.’

__Tools to use daily__

- A GP can refer you for CBT on the NHS. This can teach you the behaviours and practices you can use every day to help stop the thought patterns that may be affecting your mood. These include challenging thinking patterns, breathing techniques and journaling

## 6. Explore the art of mindfulness  

Mindfulness is about paying attention to the present moment. It involves observing your breath, thoughts and emotions, without any judgement. 

By focusing on your breath and bodily sensations, even if a negative thought creeps in, you can let it go. ‘You can apply mindfulness to any situation, including making a cup of tea and washing the dishes, right through to meditation,’ says Gauffin.

‘Mindfulness can help with depression,’ says Gauffin. ‘But it requires consistency, consciousness and commitment. To be effective you need to commit to practicing it daily. Even 10 minutes every day will make a difference but it may take a couple of weeks to notice improvements.’

__Tools to use daily__

- Practice daily mindfulness of breathing meditation — even if it’s only for 10 minutes a day. This will help you observe your thoughts and emotions and, in time, see that they will pass and cannot hurt you 
- A mindful pause and deep, belly breath is available to you at any time of the day. This can help you stop and observe your emotions when you’re feeling overwhelmed by them
- Try to be more mindful in everyday life by focusing on one task at a time, be that washing the dishes or finishing a report for work. This helps you become more grounded in the present moment. That in turn may help reduce the catastrophising and ‘what ifs?’ that can lead to depressive thoughts

Read more about how to [deal with a panic attack](/your-health/6-causes-of-panic-attacks-and-expert-tools-for-how-to-cope/)

## 7. Practice yoga 

Yoga’s psychological benefits have been proven to help increase mental energy and improve mood.  In one study, it was shown that doing yoga for 60 minutes three times a week increased  levels of gamma-aminobutyric acid or GABA, a chemical in the brain that helps regulate nerve activity and mood.

__Tools to use daily__

- Start with a little and often approach if you’re just beginning yoga, such as a few sun salutations each day. A recent study showed that when participants practised the Sun Salutations (12 physical postures done as a flowing sequence) every day for just 20 minutes, they felt mentally calmer, more relaxed, well rested, refreshed and joyful after 14 days 

## Should you see a doctor about your mood?

Sometimes, all the lifestyle changes in the world won’t impact the way you’re feeling — and that’s okay. Don’t beat yourself up, there is help available so seek it sooner, rather than later.

See a doctor if you experience symptoms of depression for most of the day, every day, for more than 2 weeks.  

Symptoms of depression  include:
- Continuous low mood or sadness
- Feeling hopeless and helpless
- Feeling tearful
- Feeling irritable, guilty and intolerant of others
- Having no motivation or interest in things
- Difficulty making decisions
- Moving and speaking more slowly
- Changes in appetite and weight
- Sleep disturbances
- Lack of energy 
- Low sex drive
- Unexplained aches and pains
- Feeling suicidal – if you feel like this, you must always seek help

If you think you have depression, a Kry doctor can assess your symptoms and suggest a plan of action to help you feel better.

__This article has been approved by Dr Rhianna McClymont, Lead GP at Kry and Madeleine Gauffin, Licensed Psychologist and Licensed Psychotherapist at Kry.__


Kry.co.uk > Your health > Help for depression — 7 daily tools to improve your mood

original (17)

If the pandemic or winter’s dark days have affected your mood, these simple tools have been shown to help day-to-day mental health

Help for depression — 7 daily tools to improve your mood

General health

General health and seasonal

Most of us cry from time to time. It’s a healthy way to express how you’re feeling and release built-up stress or sadness. Some people cry more than others, but sometimes, it can become excessive. If you’re crying for no reason or more than you’d like, it’s important to know that help is available if you need it.

## Why do we cry?

There are [3 types of tears](https://www.psychiatrist.com/pcc/psychiatry/diagnosis-and-management-of-crying/): basal, reflex and emotional. 

__1. Basal tears__ are important for eye health. They stop the eyes drying out and protect eyesight.

__2. Reflex tears__ happen in response to irritation. When we get something in our eyes, our eyes will water with reflex tears to wash away the dirt.

__3. Emotional tears__ happen when we feel strong feelings, like sadness caused by grief or pain, happiness or joy. Lots of animals, like us, make tears to keep their eyes healthy, but emotional crying is [uniquely human](https://pubmed.ncbi.nlm.nih.gov/29687400).

‘Scientists think that crying helped us develop social bonds by letting others know we needed help,’ says Dr Oyefeso. ‘If someone’s crying, people are likely to be kinder and more understanding towards them.’

## Can crying make me feel better?

Shedding tears is a natural reaction to negative or positive feelings. ‘Crying is a sign that you’re processing emotions,’ says Dr Oyefeso. 

‘It increases endorphins, the feel-good hormones that improve your mood. It can also help you relax by decreasing stress hormones like cortisol. This is why you might feel much better after a good cry.’

Other benefits of crying include:
- Helping us feel more connected to our emotions
- Boosting the immune system by [producing antibodies that help fight infections](https://www.mdpi.com/1660-4601/17/13/4911/htm)
- Reducing pain by releasing neurochemicals
- Helping process grief

## Why do I cry so easily? 

Everyone is different when it comes to how easily, how often or why we cry.

‘Babies and young children cry when tired, hungry or frustrated, as they can’t communicate any other way. Teens may cry more due to hormonal changes, and adults might cry more during times of intense stress or sadness,’ explains Dr Oyefeso.

Although crying is usually a natural response to emotional triggers, feeling like you’re crying for no reason can be worrying. There are several key reasons why this can happen:

### 1. Mental health problems
Crying more often, or without knowing why, may be a sign of a mental health condition like [depression](/depression/), [postnatal depression](/medical-advice/mental-health/postnatal-depression/) or [bipolar disorder](/medical-advice/mental-health/bipolar-disorder/). 

‘If you’re worried your crying is due to a mental health condition, speak to a doctor or therapist,’ says Dr Oyefeso. ‘They can help you understand what’s going on and identify the best way to address it.’

### 2. Hormones
Hormonal imbalances can cause changes in mood that might cause you to cry more easily. Changes in hormone levels caused by pregnancy, [menopause](/your-health/lets-talk-about-menopause-and-mental-health/) or premenstrual syndrome (PMS) can all impact your mood.

### 3. Medication
Sometimes medications can cause changes in mood as a side effect. If your medication causes mood swings, speak to a doctor. They may be able to alter your dosage or switch you to a different medication.

### 4. Exhaustion
Physical and emotional exhaustion can lower your threshold for crying, so getting plenty of rest can help. 

### 5. Pseudobulbar affect (PBA)
PBA is a condition that causes uncontrollable crying or laughing. It can affect people with Parkinson’s disease, [Alzheimer’s disease](/medical-advice/neurological-disorders/alzheimers-disease/), traumatic brain injury or [stroke](/medical-advice/cardiovascular-diseases/stroke/).

‘Medication can help regulate outbursts if you have PBA, so if you’re struggling, talk to a doctor or mental health professional,’ Dr Oyefeso advises.

## How do I stop crying?

Crying is an important self-soothing mechanism, but sometimes it’s not always convenient to let the tears flow. Dr Oyefeso shares some tips on how to temporarily stop crying:
- Take deep breaths or try some [breathing exercises](/your-health/3-breathing-exercises-a-psychologist-recommends/)
- Pinch your nose or hold your breath for a few seconds
- Distract yourself by thinking about happy memories or something funny

Remember, while these are temporary techniques to stop crying in the moment, it’s not a good idea to stifle your tears all the time. Crying can be a beneficial way to cope with stress.

## When should I seek help?

There are some more serious symptoms to look out for:
- Crying more than usual
- Crying and feeling hopeless or exhausted
- Feeling like you can’t stop crying
- Crying and feeling like you’re going to throw up or have a panic attack
- Crying and blurred vision or chest pain – this could be a sign of a heart attack

‘There are many possible causes of excessive crying, so always see a doctor to determine any underlying medical conditions. Once a medical condition has been ruled out, there are a few different treatment options,’ says Dr Oyefeso.

‘One option is [talking therapy](/your-health/is-talking-therapy-for-me/), which can help you understand and process your emotions healthily. You may also be prescribed medication to help regulate your mood.

‘Whatever treatment option you choose, it’s important to remember that help is available if you find yourself struggling to control your tears,’ reassures Dr Oyefeso.

__This article was medically reviewed by Dr Adenekan Oyefeso, a psychologist at Kry.__


kry.co.uk > Why am I crying for no reason? A therapist’s guide

Why am I crying for no reason?

Have you ever found yourself crying for no particular reason? Or are you wondering why you can’t stop? Learn why it might be happening and what help is available.

kry.co.uk > Meta information > Why am I crying for no reason? A therapist’s guide

Why am I crying for no reason? A therapist’s guide | Kry

Medical review

Dr Adenekan Oyefeso

Psychologist and Clinical Lead for Mental Health at Kry

Why am I crying for no reason? A therapist’s guide

We know that exercise can boost your mood, increase self-confidence and help you relax. But did you know that it can also act as a stress reliever?

There’s evidence to suggest that exercise can improve how you deal with stress. When you exercise, your brain releases endorphins, which are feel-good chemicals that help you to feel less stressed and anxious. Physical activity also reduces levels of the stress hormones in your body, like adrenaline. 

Interestingly, moderate to intense exercise actually spikes your cortisol levels, which play a role in managing your body's “flight-or-fight” response. But in this case, the cortisol can be beneficial, helping you regulate your blood pressure during vigorous exercise. 

## 7 stress-relieving workouts  
The next time you’re feeling overwhelmed and stressed, step away from your phone, laptop or TV and try these exercises. 

### 1. Yoga
It may come as no surprise that yoga is one of the best exercises to relieve stress. One study found that yoga has an effective role in reducing stress, anxiety and depression. 

Yoga involves postures with controlled breathing, which can help you relax and manage stress and anxiety. It can also help activate your parasympathetic nervous system, which is responsible for rest, relaxation and recovery. 

So, for the days when you don’t feel like going for a run in the cold or dark, find a comfortable spot where you can be alone and uninterrupted. Or join a regular class to commit yourself to a routine. 

### 2. Strength training 
You may have considered taking up strength training – also known as resistance training – for its physical benefits. But have you ever considered how these activities can be a great stress reducer? 

Strength training boosts the production of feel-good endorphins as well as giving you the feeling of accomplishment for lifting a heavier weight than you did last time. One study found that strength training twice a week for 8 weeks reduced worry and anxiety symptoms among young adults.  

And you don’t even need equipment to reap the benefits of strength training. Try common bodyweight exercises, like squats, sit-ups or push-ups.

### 3. Swimming
As well as being a great full-body workout, swimming is a fun and effective way to relieve stress. Swimming also releases neurochemicals in the brain that make the body feel good. One study found that, compared to running, swimming was more effective in reducing cortisol. 

Submerging your whole body in water can also be therapeutic – the repetition of a swimming stroke gives you something to focus your mind on. 

### 4. A brisk walk in nature
We know that the great outdoors can do wonders for your mental health, but research suggests that taking a walk-in nature can reduce your stress levels too. A new study discovered that a 60-minute walk in nature reduced activity in the stress-processing area of the brain. 

As well as giving you the opportunity to take a break, taking a walk in nature allows you to breathe in the fresh air, loosen up and move your body and give you time to think. 

### 5. Dancing 
If you love dancing, the good news is that this type of physical activity reduces stress. A new study found that dancing for at least 150 minutes per week reduced stress, depressive symptoms and anxiety. 

As well as being a great cardiovascular activity, many types of dance require you to get physically close with a partner, which can help release a chemical called oxytocin. One study found that tango dancing may be as effective as mindfulness meditation in reducing stress, anxiety and depression. 

### 6. Something you just love doing
The best exercise you can do for stress relief is a favourite sport or any activity you enjoy doing. Whether it’s playing a game of football or tennis, doing a physical activity can distract the mind and activate neurotransmitters, like dopamine and serotonin, which enhance your mood and ease stress and anxiety. 

The same goes for any kind of activity you like, such as gardening. There’s evidence to suggest that gardening 2 to 3 times a week can lower stress levels and promote better wellbeing.  

### 7. Stretching
There are times when you just need to take things slow and stretch and breathe. What’s more, it’s always a good idea to warm up before starting each activity and stretch out your muscles to avoid injury. 

And if you were thinking of rushing off somewhere after a workout, think again. Stretching your muscles afterwards can reduce tension and relieve stress, as well as help lower your stress levels and bring your cortisol levels down.  

## When to speak to a doctor 
Always speak to a therapist or doctor if you’re struggling to cope with your feelings or symptoms of stress. It’s always a good idea to seek help if stress is negatively impacting your daily life.


Kry.co.uk > Your health > 7 of the best stress-relieving workouts

Stress relief workouts

There’s growing evidence that exercise can relieve stress. Read on to discover what exercises can help you relax and let off steam 

Kry.co.uk > Stress relief workouts > Meta information

7 of the best stress-relieving workouts | Kry UK

kry.co.uk > medical reviewer

Dr Bryony Henderson

Lead GP at Kry

7 of the best stress-relieving workouts – according to the research

Whether you’ve just started talking therapy or are only considering it, taking action to look after [your mental health](/your-health/talking-about-mental-health-with-a-gp/ "Talking about your mental health") can feel like a big step. It’s a good idea to start thinking about what you’d like to get out of therapy and how to get the most value out of the experience. 

## What is therapy?
Therapy is a form of psychological treatment that involves talking about your thoughts, behaviour and emotions with a trained therapist. It can be a really useful way to help you deal with or overcome mental health problems such as [depression](/medical-advice/mental-health/depression/), [anxiety](/medical-advice/mental-health/anxiety/) or [stress](/medical-advice/mental-health/stress/). 

There are a number of different types of therapies, but some are more suitable for certain types of problems. People will also be more suited to certain types of therapy, so there’s no one-size-fits-all approach. 

The person delivering the therapy will depend on the type and intensity, but they can be counsellors, therapists, psychologists or psychiatrists.

To help make your experience of therapy as useful as possible, here are 7 things to consider before, during and after therapy. 

## What to consider before you start therapy

### 1. Make sure talking therapy is the right thing for you now 

[Talking therapy](/your-health/is-talking-therapy-for-me/ "Is talking therapy for me?") may be a good idea if you need help coping with a challenging life situation or a mental health problem. But you don’t have to be going through a crisis to try it – it can also help support your personal development. Sometimes, just talking to someone who isn’t a friend or family member can be a helpful healing process.

It’s worth noting that having therapy is a commitment, and it requires work from your side. Consider whether you feel ready to talk and open up about your feelings. Therapy often requires you to talk about the most personal of things and this can be hard to do if your emotions are still very raw. 

It’s important to remember that therapists are trained to help you navigate your experiences, thoughts and feelings at a pace that suits you. They’re there to help in a way that makes you feel psychologically safe and comfortable. 

### 2. Understand the type of therapy you’re getting 

There are several different types of therapy – from CBT therapy to group therapy – and it can be hard to know which is best suited for you. Doctors recommend certain types of therapies for specific issues, so it can be helpful to speak to a GP or a specialist about your options. It can also be useful to read about each type so you can make a judgement on which is most suited to your personality and preferences. 

### 3. Think about what you might want to achieve 

Ultimately, you’re doing this to help yourself, so think about what you want to get out of therapy. You may want help coping with a traumatic experience, [processing grief](/your-health/a-therapists-advice-for-coping-with-grief-in-your-own-way/) or developing techniques to [lower your anxiety](/your-health/need-help-for-anxiety-here-are-your-questions-answered/) levels. It can even be helpful to write your thoughts down so both you and your therapist are clear about what your goals are.

## How to maximise your time during therapy

### 4. Make sure you have a comfortable and private set-up 

Therapy involves talking about personal thoughts and issues. So, if you’re trying digital therapy and having your sessions from home, make sure you have a comfortable, private setting. If you don’t feel comfortable or think people are able to listen in, it can be very hard to properly open up and get the most out of a session. 

Equally, if your session takes place outside the home, make sure that you’re comfortable in that environment.

### 5. Try to be open and honest with your therapist 

This can be one of the hardest parts of therapy, but discussing your thoughts and feelings openly is key. Therapy should be a safe space where no judgement is passed and your therapist will work to help create this atmosphere. 

Don’t worry if you don’t feel like this immediately, as it can sometimes take a while for this trust to develop. It’s also important that you aren’t afraid to tell your therapist if you feel some things aren’t working. This can really help them personalise your therapy. 

### 6. Set realistic expectations 

Try to remember that therapy isn’t a magic bullet that will solve your problems immediately. It can be a long process – usually between 6-8 sessions, while some people may need therapy for a longer period. 

However, if you don’t find it helpful, or after this time you don’t feel that you’re getting out of it what you’d like, you can talk to your therapist about making a change in the type of therapy you receive. You can also speak to a doctor who may be able to help with changing your therapist or exploring other options.

## What to think about after therapy 

### 7. Try to take your learnings with you

Therapy can be a great way for you to see things more clearly, but your session will only take up a small proportion of your week. To really benefit, try to take your learnings from each session with you and implement some of the techniques you learn into your everyday life. It can help to write these down so that you can reflect on them at a later stage. Speak to your therapist about some practical ways to help you do this. 

## When should I speak to a doctor or therapist?

If you’re interested in therapy, it’s a good idea to speak to a doctor. They can help you find the best option for you. 

It might be a good idea to speak to a doctor or therapist if:

- You’re feeling low on a regular basis
- You’re struggling with anxiety or stress
- You’re experiencing [depression](/medical-advice/mental-health/depression/) or another mental health issue
- You need support with [grief](/medical-advice/mental-health/grief/), a difficult life change or a traumatic experience

__This article has been medically reviewed by Dr Bryony Henderson.__


kry.co.uk > Your health > 7 ways to get the most out of therapy

How to get the most out of therapy

Talking therapy can feel daunting, particularly when you don’t know what to expect. Read our guide on the steps you can take to get the most out of it

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7 ways to get the most out of talking therapy | Kry UK

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Dr Alessio Platania

7 ways to get the most out of therapy 

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‘Menopause has always been a disruptive time for women, but as is the case with so many other women’s health issues, it’s been disregarded and under-researched. Now it’s a recognised phenomenon,’ says Dr Elisabeth Rosén, a Kry doctor and gynaecology specialist.

Mental health difficulties during perimenopause and menopause are so widespread that some researchers have proposed a new term to describe them: ‘menopause distress’. The symptoms are described as significant and persistent, yet different enough to other depressive diagnoses to warrant their own label.

‘Around 70% of women experience some sort of mental health impact during menopause,’ says Dr Rosén. ‘But the good news is that these symptoms tend to go away when the body gets used to the new hormone levels.’ There’s also plenty you can do to look after yourself and get professional help.

## What are perimenopause and menopause, and how do I know they’re happening?

Entering menopause happens once you haven’t had a menstrual bleed in 12 months. The average age of menopause is 51. ‘Perimenopause is the time before and around menopause. It starts on average 4 years before menopause, but it can last longer than that,’ Dr Rosén explains.

Menopause happens as a result of a decline in ovarian function, which leads to a change in the production of the female sex hormones oestrogen and progesterone. 

‘The most obvious sign of perimenopause is changing periods – initially shorter and shorter cycles, followed by irregular and heavy bleeds,’ says Dr Rosén. Look out for these symptoms, which are often linked to reduced oestrogen levels:

- Sweating and hot flushes
- Tiredness and insomnia
- Vaginal dryness
- A [decreased libido](/your-health/8-causes-of-low-libido-a-doctors-guide/)
- Psychological symptoms like irritability, low moods, a lack of motivation, aggression, difficulty concentrating and stress
- A relapse of previous psychological illness

## How do perimenopause and menopause impact our mental health?

The exact link between perimenopause and mental stress is yet to be established. ‘We do know that hormonal fluctuations and changing oestrogen levels can affect and interact with the neurotransmitters of the brain, which in turn impacts our mood,’ says Dr Rosén. 

There are two main ways that hormonal changes are thought to have a psychological effect:

### Reduced oestrogen 

Oestrogen affects your mood because of its impact on the levels of serotonin in your brain. ‘Serotonin is a hormone that stabilises your mood and promotes happiness and wellbeing,’ Dr Rosén explains. ‘When the levels of oestrogen go down, so do the levels of serotonin, which explains why you might feel closer to tears, a bit low or even depressed.

‘The oestrogen drop comes in phases, which can make the psychological problems more pronounced. When the body has acclimated to the new hormone levels, your mood tends to stabilise, only to suddenly worsen again the next time the oestrogen drops.’

### Reduced progesterone

The other female sex hormone, progesterone, has a calming effect. ‘Decreasing progesterone levels can lead to sleep issues, low moods, irritability and anxiety,’ says Dr Rosén.

On top of the impact of hormonal changes, many women find that the physical symptoms of menopause have a negative impact on their mood, too. ‘It’s tough to walk around worrying about sudden hot flushes, to not get the sleep you need, to be unable to enjoy sex to the same extent and to get used to a new weight, for instance,’ acknowledges Dr Rosén.

A growing body of research is now pointing to a potential link between vasomotor symptoms in particular – that’s night sweats and hot flushes – and changes in cognition and brain function in menopause. It’s possible that treatment of these physical symptoms could also relieve some of the cognitive difficulties.

## What mental health problems are most common in perimenopause and menopause?

Anxiety, mood swings and depressive symptoms are common problems during this time. ‘The difficulties can be quite pronounced and often seem to appear out of the blue, which can make them more difficult to deal with,’ says Dr Rosén.

Oestrogen doesn’t only impact serotonin levels, it can also affect our cognition. As a result, during perimenopause, it’s common for people to experience:

- Forgetfulness 
- Brain fog
- Brain fatigue
- Difficulty concentrating
- Frustration as a result of the above, which can then negatively impact our mood

You are 2-5 times more likely to experience depressive disorders during perimenopause than during the late premenopausal years. For some, emotional exhaustion can make everyday tasks difficult. 

‘Around 25% of people experience psychological problems they need professional help with, and many find the psychological changes during perimenopause more difficult to manage than the physical symptoms.’

## How might perimenopause and menopause impact our sleep?

‘Many perimenopausal women experience sleep problems, including those who have never had issues with sleep before,’ says Dr Rosén. ‘Changes to oestrogen and progesterone levels impact other hormones that are responsible for regulating your body temperature, which can cause intense night sweats. The hormone changes themselves, as well as anxiety, can also make it difficult to sleep, and it’s not unusual to wake up suddenly in a panic.’

However, these symptoms can often be treated and alleviated, which can not only improve sleep but also prevent mental illnesses that long-term insomnia can contribute to. 

## Are there any other risk factors for mental health issues during menopause?

Midlife is a time when many of us go through life-changing experiences and events. Life stressors and adversity can contribute to mental health difficulties, which is why psychotherapy or cognitive behavioural therapy (CBT) can help. In addition, people who have experienced depression previously are at higher risk during perimenopause.

## What should you do if you’re struggling with your mental health during menopause?

There are many things you can do to improve your chances of a positive menopause transition. Dr Rosén advises the following:

1. [Read up about perimenopause](/your-health/7-signs-of-perimenopause-a-doctors-guide/) so that you’re able to identify symptoms and know what to expect.
2. Try to accept and manage the psychological difficulties – let yourself feel your emotions while also trying to find peace.
3. Identify situations that trigger negative emotions and try to avoid them.
4. Allow yourself to take things more slowly throughout this period of your life, as perimenopausal problems tend to be more difficult to manage if you’re stressed.
5. Exercise regularly. Research shows that physical activity has a positive effect on both physical and mental health during perimenopause. It also releases endorphins and other feel-good hormones.
6. Eat a well-balanced diet. 
7. Use techniques like meditation or yoga to help lower stress levels. 
8. Maintain a good sleep routine, keep the bedroom cool and keep extra bed sheets close by to improve your chances of a good night’s sleep.
9. Tell family and friends how you’re feeling – they can be a huge support during tough times.

## What if I feel like I need professional help?

If these habits don’t relieve your symptoms, reach out for professional help. Depressive symptoms are very common during perimenopause, and a doctor will be able to guide you through your options, including talk therapy, antidepressants, HRT or a combination. 

For many people, a mixed approach is best. While in many countries, HRT is currently only prescribed for night sweats and hot flushes, some recent studies suggest it might also help prevent depression in perimenopause. Options like family therapy can also be helpful. 

‘The physical consequences of reduced hormone levels can’t be reversed, even if HRT may postpone the reduction by a few years, while local oestrogen tends to help with vaginal dryness,’ says Dr Rosén. 

‘But psychological problems tend to ease off and eventually go away when the body has adapted to the new levels of oestrogen.’ 

__This article has been medically reviewed by Dr Elisabeth Rosén, a Kry doctor who specialises in gynaecology and obstetrics.__

kry.co. > Call out

See a GP about menopause and mental health

kry.co.uk > Your health > Let’s talk about: menopause and mental health

Menopause

Why do so many people feel low during perimenopause and menopause? What can you do if you’re struggling? Get expert advice from a Kry gynaecology specialist

kry.co.uk > Meta information > Let’s talk about: menopause and mental health

Let’s talk about: menopause, anxiety and mental health | Kry UK

Life events

Let’s talk about: menopause and mental health

The weeks and months after giving birth can be a vulnerable time for new parents. If you think you may be suffering from postnatal depression, here’s how you can find help.

### Quick facts
- Depression among new mothers has almost tripled since the start of
the pandemic
- Up to a third of new fathers can experience depression, yet only 1 in 5
seeks help
- Support and therapy are available through your doctor

Having a baby can be one of the happiest times. But it can also be stressful — one that can bring feelings of confusion, loneliness and for many, depression.

‘Adjusting to motherhood can be a challenge under normal circumstances,’ says Dr Elisabeth Rosen, medical doctor at Kry.

‘But giving birth during a pandemic presents extra concerns — social distancing, changes in hospital procedures and worries about exposure to Covid-19, can make women feel even more susceptible to anxiety and depression.’

### You’re not alone

Postnatal depression is a common problem that affects 1 in 10 women in the UK, within a year of giving birth.

A new study shows that depression among expectant and new mothers has almost tripled since the start of the coronavirus pandemic – going from 15% to 41% of new mothers. It also showed moderate to high anxiety rose from 29% to 72% in pregnant women and new mothers.

### Postnatal depression or ‘baby blues’?

‘It‘s perfectly normal for many women to experience what‘s commonly known as the ‘baby blues‘ in the first week or so after giving birth,‘ says Linda Karlsson, Licensed Psychologist at Kry.

‘This can last anything from a few days to a week or so.‘ Typical symptoms include feeling emotional and bursting into tears for no apparent reason, feeling irritable or touchy, low mood, anxiety and restlessness.

‘If you’re still feeling low after 2 weeks, this may be a sign of postnatal depression. This can also affect fathers and partners.’

### Symptoms of postnatal depression

Postnatal depression can occur at any time in the first year after giving birth. ‘All women are different and not all women with postnatal depression get all the symptoms,’ says Karlsson. If you get any of the symptoms below, talk to a doctor or psychologist.

__Main symptoms include:__
- Persistent depression, sadness and low mood
- Lack of energy and feeling tired all the time
- Lack of enjoyment and interest in the wider world

__Other symptoms may also include:__
- Problems sleeping at night and feeling sleepy during the day
- Difficulty bonding with your baby
- Withdrawing from other people
- Lack of concentration and finding it hard to make decisions
- Disturbing thoughts, for example, about hurting your baby or suicide

### How your hormones can affect your mood after childbirth

‘We don’t know exactly why postnatal depression occurs,’ says Dr Rosen.
‘But one of the reasons (although there’s no conclusive evidence for this) may be the rapid drop in the hormones oestrogen and progesterone straight after you give birth.’

‘Low progesterone can cause anxiety, mood swings, irritability and depression,’ says Dr Rosen.

‘The drop in oestrogen can also trigger depression and anxiety. While the
increase in the calming, bonding hormone oxytocin (that [occurs during breastfeeding](/your-health/breastfeeding-whats-happening-in-your-body/)) should help to compensate for this, it seems that in some women this doesn’t happen. Once you stop breastfeeding, hormones should gradually go back to normal.’

Be aware, though, that postnatal depression can be triggered by many other factors, and it differs from person to person.

### Breastfeeding and emotions

Some women who are breastfeeding experience abrupt dysphoria, or negative emotions like sadness, depression, anxiety and irritability just prior to the moment milk is released. This is a condition called Dysphoric Milk Ejection Reflex (D-MER).

These feelings are usually brief and pass in 30-90 seconds. While they can be distressing, it can be reassuring to know that these are not a sign of postnatal depression.

But if you‘re experiencing postnatal depression, D-MER will be harder to handle.

So it’s important to get help from a doctor or a psychologist.

### Who’s at risk of postnatal depression?

Some people will be more at risk of developing postnatal depression — these include:
- Women (and men) with a history of mental health issues, particularly
depression
- A history of mental health problems during pregnancy
- Having no close family or friends to support you
- A poor, troubled or abusive relationship with your partner
- A history of substance abuse
- Lack of sleep after the baby is born
- A stressful or traumatic labour
- Feeling overwhelmed and worried about being a parent
- Having experienced recent stressful events like a bereavement or
separation from your partner
- Experiencing the baby blues
- Financial worries

### Postnatal depression in men

It’s not just women who are at risk of developing postnatal depression – men can get it too.

Until recently, it was believed approximately 10% of new fathers experience postnatal depression. But a recent study suggests this figure might be as high as 27%. Yet fewer than 1 in 5 fathers who were depressed sought help, and a third had considered self-harm.

The study showed that while many women are screened for postnatal depression, the mental health of fathers is rarely assessed. What’s more, postnatal depression in men may show itself in different ways, like anger, irritability, working longer hours and drinking too much.

Read more about the signs of [depression in men](/your-health/signs-of-depression-in-men/).

### Help for postnatal depression

‘To meet the criteria for postnatal depression, symptoms need to last for at least 2 weeks,’ says Dr Rosen. ‘It usually happens between 4 and 6 weeks after giving birth, but may be any time after pregnancy. ‘There is an expectation of women that they should feel super-happy after having a baby, but many women are hesitant to admit they don’t feel this way.

‘In fact, it’s common for new parents to feel depressed, confused, frustrated, tired and disillusioned — that’s nothing to feel ashamed of.‘Support and treatments are available, so speak to a doctor, who can help you to work out what are the best options for you.’

In the UK, many healthcare visitors have been trained to recognise postnatal depression and can help advise you on strategies that can help.
‘Whatever you do, don’t suffer in silence,’ says Dr Rosen. ‘If you think your partner is having problems, encourage them to get help too.’

### Postnatal depression self-help

__Talk to family and friends__. Tell them how you’re feeling and don’t be afraid to ask for help with things like looking after the baby, so you can catch up on sleep or have a night in with friends.

__Find local support__. If you don’t have anyone to turn to, for example, you’re a single mother with no friends or family close by, look for local support groups. A doctor should be able to help you find one in your area.

__Rest__. Try not to be a perfectionist. It doesn’t matter if your house doesn’t look immaculate, or if not all the chores are done. It’s more important that you catch up on sleep and rest when you can.

__Eat healthily__. Having a baby makes demands on the body. So eating a healthy diet and exercising regularly (or when you can) is crucial. If you haven’t the energy to go shopping or cook properly, ask friends and family to help out until you get back on your feet again.

### Expert help available

__Psychological therapies__. Your doctor can refer you for a course of therapy with a psychologist. Cognitive behavioural therapy (CBT) is shown to be effective in treating postnatal depression.

__Medication__. Antidepressants may be recommended in certain cases where
depression is severe and other treatments haven’t helped. Your doctor will
advise you on the safest options to take if you’re still breastfeeding.

If you have a history of mental health issues or depression, or a family history, talk to a doctor or mental health team if you’re thinking about having a baby.

Your doctor should arrange for you to be seen regularly in the first few weeks after giving birth.

__This article has been approved by Dr Elisabeth Rosen, medical doctor, Kry__


Kry.co.uk > Your health > Help for postnatal depression

Help for postnatal depression

If you think you may be suffering from postnatal depression, here’s how you can find help

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Feeling the need to self-harm can affect anyone at any point in their lives – and sadly it may be more common than we think. Research shows that self-harming cases have [tripled in the last 10 years.](https://www.bmj.com/content/365/bmj.l4058) 

Self-harm can be upsetting for the people around you because they might not understand it, and they may find it very painful to see physical evidence of your distress.

‘If you’re considering harming yourself, it’s important to remember it’s only a temporary way to cope,’ says Dr Oyefeso. ‘It can also bring up painful feelings and make things even worse.’

## What is self-harm?
Self-harm is when you hurt yourself on purpose as a way to cope with difficult feelings or experiences. 

There are lots of different ways people might hurt themselves including cutting, scratching, banging your head or burning your skin.

‘While self-harm can be noticeable on the skin, some people hurt themselves in less obvious ways, like through not eating, heavy drinking, getting into fights or drug use,’ Dr Oyefeso explains.

## Why do people self-harm?
Everyone finds their own way to try and cope with life’s challenges. People have described self-harm as a way to:
- Have a sense of being in control
- Turn invisible emotions into something visible
- Have a short-term release from overwhelming thoughts or feelings
- Punish themselves for things they feel or have done
- Escape traumatic memories
- Make themselves ‘feel something’ rather than numbness
- Express [suicidal thoughts](/your-health/what-to-do-if-youre-having-suicidal-thoughts-a-psychologiss-advice/) without taking their own life
- Let other people know they need help

‘When someone harms themselves they may be feeling sad, guilty, hopeless or ashamed,’ says Dr Oyefeso. ‘Although there can be a link between suicidal thoughts and self-harm, most people who self-harm don’t want to die, but instead manage severe distress while living their life.’

## Who is more likely to self-harm?
Self-harm can affect anyone, but certain people can be more vulnerable. Self-harm is more common in:
- Young people
- Girls and women
- People with a a mental health problem like [depression](/medical-advice/mental-health/depression/), [anxiety](/medical-advice/mental-health/anxiety/), [borderline personality disorder](/medical-advice/mental-health/borderline-personality-disorder/) or an [eating disorder](/your-health/how-to-help-someone-with-an-eating-disorder-a-therapists-guide/)
- [LGBTQIA+](/your-health/lgbtqia-healthcare-glossary/) people due to discrimination
- People who were abused as a child
- People who have lost someone through suicide
- People who are in prison
- Asylum seekers
- Veterans of the armed forces

## How to stop self-harm when the urge arises
It may seem hard to see a way past urges to harm yourself, but there are ways you can help yourself and find professional support.

### 1. Understand why you self-harm
When you become familiar with your patterns of self-harm, you’ll know when the urge is coming on and ultimately be in a better position to stop it. 

__Learn to recognise your triggers__ – Note what you were thinking or feeling just before you hurt yourself. Did a certain situation, person or memory cause you to self-harm?

__Take note of what the urge feels like__ – This might be a physical feeling like a racing heart or numbness, or an intense emotion like anger, sadness or despair.

__Keep a diary__ – Write down what it feels like before, during and after you self-harm, how regularly you do it and when. You’ll see patterns if you keep this up for at least a month. It can be difficult to see your emotions and behaviour patterns on paper, so make time to take your mind off it after. 

### 2. Try to distract yourself
‘Different distractions work for different people, so it’s good to try a few strategies,’ Dr Oyefeso says. ‘Especially if the thing that triggers you to self-harm tends to change.’

__If you feel sad or fearful__ – Listen to soothing music, get cosy at home or try to sleep, go for a walk in nature, let a friend or relative know how you feel, or just let yourself cry.

__If you feel angry__ – Try to channel your anger through hitting cushions, tearing up a piece of paper, or through exercise like running. Only continue with these distraction methods if you feel a positive effect, not if it makes the anger worse.

__If you feel like you need to punish yourself__ – Do some exercise or find a creative way to express your self-hatred, like writing a poem or drawing. You can also try writing a letter to yourself from the part of you that feels you deserve to be punished, then write back as though you were a friend with compassion.

__If you feel you need to be in control__ – Tidy your home, do some gardening, write lists or practice clenching your muscles and then releasing.

__If you’re feeling disconnected__ – Try holding ice cubes, smelling something strong like garlic or onion or having a cold shower. 

### 3. Delay self-harming
‘It isn’t always easy to fight the immediate urge to self-harm, but by waiting just 5 minutes, you may find the intense feelings have passed. You could even try sitting on your hands during this time,’ Dr Oyefeso recommends.

If delaying works well for you, try waiting a little longer each time and it may become easier to avoid hurting yourself altogether.

## How to stop self-harm in the long-term
Overcoming self-harm completely can take a bit more work than helping yourself in the moment each time. It involves a deeper exploration of why you self-harm so you can find alternative ways to manage your thoughts and feelings. There are a number of ways you can help yourself in the long term.

### 1. Learn to accept your feelings
‘It can be scary to let yourself experience difficult feelings again, but it's a very brave thing to do,’ says Dr Oyefeso. You can try to:
- Keep a journal to prevent you being overwhelmed by your feelings
- Name feelings as you become aware of them
- Use online tools and worksheets to help you deal with feelings – [Self-injury Support](https://www.selfinjurysupport.org.uk/) has some useful resources
- [Work with a therapist](/your-health/is-talking-therapy-for-me/) who can help you validate and accept your feelings

### 2. Improve your self-esteem
Finding ways to look at yourself in a positive light is important to helping you overcome self-harm. 
- Write down things you appreciate about yourself on a regular basis
- Try to think about yourself in the same way as you’d think of someone you love or admire
- Learn to be assertive by setting boundaries and expressing what does and doesn’t work for you in life
- Think in a more empowered way, for example, ‘Even though I’m hurting myself, I’m determined to make progress.’ 

### 3. Delve deeper into why you self-harm
‘The more you understand your relationship with self-harm and the role it plays in your life, the better equipped you’ll be to move on and find new ways to cope,’ Dr Oyefeso reassures. Ask yourself:
- What was the reason you first started to self-harm?
- What is self-harm to you? What role does it play?
- What situations make you likely to hurt yourself?
- What worries you about living without self-harm?
- What would you miss about it?
- What are the benefits of not harming yourself?

### 4. Focus on healthy living
Looking after your overall wellbeing can make you feel stronger and better about yourself. So try and make time to:
- See friends and family, even if it feels easier to stay by yourself
- Do regular exercise – even going for walks can reduce stress
- Eat healthy meals with fruit and vegetables
- Get enough sleep

### 5. Seek professional help
It can be hard to reach out, especially if you’re worried people will judge you or won’t understand why you self-harm. But it’s okay, and very important, to ask for help. [Mind](https://www.mind.org.uk/information-support/types-of-mental-health-problems/self-harm/useful-contacts/) has a list of useful contacts to help with self-harm – alternatively a doctor or therapist can help.

## How can I help a friend who self-harms?
‘If you find out that someone you care about is self-harming, it can be hard to know how to approach the situation. It’s normal to feel shocked, confused, angry or hopeless, but it’s important not to panic. 
‘If you respond well, they’ll feel more comfortable opening up to you about self-harm,’ says Dr Oyefeso.
- Try not to judge them
- Try to have empathy – remember it’s their way of managing very difficult feelings
- Let them know you’re there for them
- Remind them of their positive qualities
- Offer to help them find professional support

### What isn’t helpful?
- Calling self-harm 'attention-seeking'
- Trying to force them to change
- Acting in a way that might take control away from them
- Either ignoring their injuries, or focusing too hard on them instead of the reason they exist

## When to seek emergency help
If you’ve caused an injury through self-harm, or you think your self-harm could be a risk to your life, call 999 or go to A&E. You can also call a 24-hour helpline like Samaritans at 116 123.

Alternatively, mental health crisis teams are available locally round the clock, or you can request an emergency GP appointment.

## When to speak to a therapist
‘A therapist can provide you with practical techniques that can help you overcome self-harm. Talking therapies like cognitive behavioural therapy (CBT), dialectical behaviour therapy (DBT) and psychodynamic therapy have been proven to help people who self-harm,’ Dr Oyefeso explains.

If you find yourself self-harming, here are some signs that it might be time to seek professional help:
- You’ve been self-harming for a long time and find it difficult to stop
- You can’t control your self-harming behaviour
- You feel like self-harming is the only way to cope with your emotions
- You feel ashamed or embarrassed about your self-harming behaviour
- You’re harming yourself in ways that could cause serious injury
- You’re using self-harm as a way to cope with trauma
- You’re using self-harm as a way to cope with an eating disorder
- You feel like you’re in danger of harming someone else

‘If you’re experiencing any of these signs, seek help from a mental health professional immediately,’ says Dr Oyefeso. ‘You deserve the support you need to heal.’

__This article has been medically approved by Dr Adenekan Oyefeso, Psychologist and Clinical Lead for Mental Health at Kry.__


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What is self harm?

It’s not easy to know someone you care about isn’t feeling like their usual self. Being close to someone who’s depressed can have an impact on your relationship, especially if you’re living with someone who has depression. It’s normal to feel confused, overwhelmed or unsure about what you can do to help. 

‘Although it can be difficult to know what to say to someone who is depressed, supporting them can play a really important role in helping them feel better and keeping your relationship strong,’ says Dr Oyefeso.

## What can cause someone to feel depressed?
[Depression](/medical-advice/mental-health/depression/) can affect anyone and the causes vary between different people. Some people become depressed without any clear reason, and for some it might be down to certain factors or life events. 

- A person might experience depression because:
- They had a difficult childhood, for example neglect or an unstable family situation
- They’ve [lost someone close to them](/your-health/a-therapists-advice-for-coping-with-grief-in-your-own-way/)
- Their relationship has ended
- They’ve lost a job or are going through a period of unemployment
- They experience bullying or abuse including racism and homophobia
- They use recreational drugs, alcohol or medication that affects their mood
- They have other mental health struggles like [anxiety](/medical-advice/mental-health/anxiety/) or [low self-esteem](/your-health/how-can-i-build-my-self-esteem/)
- They have a physical health problem like chronic pain, a disability or hormonal issues

Understanding what could have caused someone’s depression can be key to giving them the support they need. 

## What are the signs a friend or loved one is depressed?
‘Until your friend opens up, you may not know exactly how they feel. But there are certain behaviours you can look out for to help know if they have depression,’ says Dr Oyefeso. 

Signs to look out for include:
- Avoiding activities and social events
- Getting less pleasure out of things they’d usually enjoy
- A [reduced sex drive](/your-health/8-causes-of-low-libido-a-doctors-guide/)
- A lack of confidence
- Constant tiredness
- Difficulty concentrating or keeping up with conversation
- [Difficulty sleeping](/your-health/how-to-sleep-better/) or sleeping too much
- Sudden weight gain or weight loss from a [reduced appetite](/your-health/8-causes-that-could-explain-your-loss-of-appetite/)
- Smoking and drinking more, or taking recreational drugs
- Displaying signs of self-harm, like marks on their arms

## 9 tips to help someone with depression
### 1. Show and remind them you care
‘The first important step you can take is to let your friend or loved one know you’re there, and want to help as much as you can,’ says Dr Oyesefo. ‘Just being present and available to talk can make a big difference. Some people want face-to-face interaction, while others prefer a phone conversation.’

### 2. Meet for regular walks
‘Getting enough exercise and fresh air is an integral part of managing depression and can help improve mood, increase energy levels, and promote better sleep,’ Dr Oyefoso explains.

If someone you know is dealing with depression, encourage them to get regular exercise by joining them – this could be an opportunity for them to talk about how they’re feeling too.

### 3. Take it in turns to cook meals
What we eat can have a significant impact on our mood. While we know eating healthily is vital for our physical health, [research proves](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6769512/) that it can also help manage depression. You could try cooking healthy meals together or take it in turns to cook for each other to help them maintain a balanced diet.

### 4. Try something new together
‘Something that can really help people recover from depression is finding meaning and purpose in life,’ says Dr Oyesefo. ‘You can start them on this journey by helping them find a hobby or activity that brings them joy, or helping them volunteer for a cause they feel passionate about.’

### 5. Help keep them stress-free
When someone is feeling depressed and lacking energy, it can be hard for them to keep on top of their everyday tasks. Help them stay in control by picking up some shopping for them, offering to do one of their household chores or asking them what they’d appreciate from you to take some weight off their shoulders.

### 6. Talk about getting professional help
‘Depression is a real condition that often needs treatment from a qualified mental health professional. This can involve [talking therapy](/your-health/is-talking-therapy-for-me/), medication or a combination of both,’ says Dr Oyefeso.

If a person with depression doesn’t want to get in touch with a professional, reassure them that it’s okay to ask for help when they feel ready.

### 7. Help them build a network
‘One of the best things you can do for someone with depression is to help them develop a support system,’ advises Dr Oyesefo. ‘This might involve connecting them with friends or family members who can offer emotional support, or helping them find a support group of other people with depression.’

### 8. Find specific support groups
‘There are also support groups available for substance abuse, which is a common problem among people with depression. [Alcohol and drugs](/medical-advice/mental-health/support-for-addiction) can make depression worse and can also lead to other issues. If this is the case for someone you know, find a local support group they can join.’

### 9. Look after yourself too
Taking care of someone close to you might put a strain on your own wellbeing, but remember that your mental health is important too. Make time for your own enjoyment and relaxation, and don’t be afraid to ask your own friends or relatives for help. Take a look at our [mental health hub](/medical-advice/mental-health/) if you need more support.

## What to say to someone with depression

Positive reinforcement is often key to helping someone manage their depression. Here are some examples of ways you can offer reassurance.

1. __“Everything is going to be okay”__
This helps them take small steps to improve their situation.

2. __“Your feelings are valid”__
You can acknowledge that depression is a real but treatable illness.

3. __“It’s not your fault”__
Depression is not self-inflicted or something that can be quickly fixed.

4. __“You’re a good person”__
Minimise their guilt about being too unwell to work or socialise.

5. __“You’re not a burden”__
It’s important they feel comfortable about opening up or asking for help.

## What further help is available for someone with depression?
‘[Talking therapy](/your-health/is-talking-therapy-for-me/) has been proven to help with mild to moderate feelings of depression – a therapist can help someone understand their emotions and navigate through difficult life events,’ explains Dr Oyefeso.

Antidepressant medication is sometimes recommended. A GP can prescribe medication if it’s necessary, and introduce your friend or relative to the right mental health service for them. 

If you think someone is in danger or they're [expressing suicidal thoughts](/your-health/what-to-do-if-youre-having-suicidal-thoughts-a-psychologiss-advice/), call 999 or go to A&E straight away.

Call 111 if it’s not an emergency but someone might need urgent medical help for their mental health.

__This article has been medically approved by Dr Adenekan Oyefeso, Psychologist at Kry.__

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How to help someone with depression

Supporting a friend or loved one with depression can play an important role in helping them feel better. A Kry psychologist shares their advice. 

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