kry.co.uk > Your health

Health information, articles, news and advice for NHS patients.

kry.co.uk > Your health > Metainfo

Your health | KRY

Stress and [anxiety](/medical-advice/mental-health/anxiety/) can seem like adult problems, but children are vulnerable too. Up to 20% of children and adolescents experience mental health problems,  and half of all mental disorders start before age 14.  The most common disorders in children are generalised anxiety disorder and depression. They’ve been on the rise for decades, and the pandemic has only added to the rise.

‘There are a lot of reasons why children might be stressed, but generally speaking, we live in a society that doesn’t provide a lot of space for children to be encouraged and validated,’ says Madeleine Gauffin, Licensed Psychologist and Psychotherapist at Kry.

By creating safe, restful spaces and routines, you can give your child the best chance of growing into a resilient adult. 

## What causes anxiety in children?

High levels of stress, whether at home, school or elsewhere, can affect children and their nervous systems.

The home environment is especially significant for a child’s wellbeing. ‘The more conscious we can be of children’s need for calm and peace, the better,’ says Gauffin. In particular, the way parents talk to their children can have a big impact. Research shows that using controlling, fear-inducing language, like ‘don’t climb too high’ or ‘do it this way’ can contribute to anxiety in children.  

Screens can also be stressful for children. While social media can have its positives, spending too much time on social media channels is linked to mental health problems, particularly in combination with poor sleep. 

Other risk factors for generalised anxiety disorder are a family history of the condition, physical or emotional stress, a history of trauma, and experiencing another anxiety disorder or chronic health condition. 

## Signs and symptoms of anxiety in children

The symptoms of stress and anxiety in children and young people are the same as in adults. Here are some of the symptoms to look out for in your child:

### Physical symptoms: 
- Nausea
- Pain in different parts of the body, particularly headaches and tummy aches
- Dizziness
- Recurring infections

### Psychological symptoms: 
- Difficulty falling asleep or getting back to sleep after waking at night
- Nightmares
- Appearing lethargic or apathetic (sluggish)
- Restlessness or hyperactivity

## 7 tips for supporting anxious children and minimising stress in their lives

### 1.	Make time to talk things through
If you’re worried about your child’s anxiety levels, start a conversation. ‘Ask what’s going on and how they’re feeling,’ says Gauffin. ‘A small child won’t be able to tell you why they feel the way they do, but you can help them figure it out.’ 

Making time for these chats is crucial. ‘You might need to cancel activities and take some time to really show you are there for your child,’ adds Gauffin. 

You can also help your child identify their triggers. ‘Ask how they feel in certain situations and around certain people to pinpoint the situations triggering their anxiety,’ Gauffin advises. ‘It could be a specific subject in school that makes them feel insecure or perhaps a specific person or group – maybe bullying is a culprit. The key thing is making time for a proper chat, not just 5 minutes before bedtime.’

### 2.	Validate your child’s feelings
‘Show your child that you take their experiences seriously. Validate their feelings – try not to minimise the situation, or they’ll be less likely to confide in you again,’ says Gauffin. 

### 3.	Be there in the moment
In situations where your child is overwhelmed or panicking, try to stay calm. ‘Hold them, breathe calmly, and see if you can help them to breathe more calmly too,’ advises Gauffin. ‘Reassure your child that you’re there for them and not going anywhere.’

### 4.	Plan ahead
Gauffin recommends planning ahead to help streamline your morning routine. ‘Get everything ready the evening before,’ she says. ‘Put out their clothes, and serve whatever breakfast you know they will eat.’

A smooth bedtime routine can also help the parasympathetic nervous system kick in and promote calmness. ‘Listening to relaxation tracks and sleep music is a great way to help your child unwind,’ says Gauffin. 

Avoiding screens, if possible, is also key. ‘Depending on the age of your child, you might choose to stay with them until they fall asleep,’ adds Gauffin. ‘Many children need that – they can’t let go on their own. It might take an extra half an hour, but that’s half an hour well spent.’

If your child is having trouble sleeping, read our guides to [helping your child get to sleep](/your-health/tips-to-help-children-get-to-sleep/) and [what to do if they have nightmares](/your-health/children-and-nightmares-advice-from-a-child-psychologist/).

### 5.	Prioritise downtime
Do what you can to create a calm home environment. Consider the number of extra-curricular activities your children are doing – although it’s well-intended, young children don’t necessarily need a packed schedule to thrive. 

Try making time to do things like going for a walk after school. ‘Too much activity in the evenings can contribute to high stress levels in children,’ says Gauffin. ‘Stress hormone levels should go back down after a spike, but we know that continuously high levels tend to stay high – that’s what makes us burn out.’

### 6.	Keep an eye on your own stress levels
‘The more aware you can be of your own ways of dealing with everyday challenges and fears, and how you express stress, the better,’ says Gauffin. ‘If you’re frequently grumpy and snap at your children, ask yourself what you can do about the stress levels in the family.’

### 7.	Lead by example
‘We need to show children that resting is allowed and that there’s time and space for it,’ says Gauffin, explaining that time to unwind together each day is important – and ideally not just in front of a screen. ‘It can be good to model this by saying, “I’m feeling stressed, so I’m going to have a rest.”’

## When should you seek professional help?

If the problem persists for more than a few weeks, and you’re having trouble helping your child, seeking help is an option. A professional can help your child learn coping mechanisms like acceptance, problem-solving and CBT strategies to change negative thought patterns.  

‘Don’t put it off,’ says Gauffin. ‘If you’re stressed yourself and can’t get through to your child, ask for help so that someone else can help them.’ Mental health issues that are not addressed in childhood are more likely to continue into adulthood, so helping your child get timely help can be an important, positive turning point.  

__This article has been medically approved by Madeleine Gauffin, Licensed Psychologist and Psychotherapist at Kry.__


kry.co.uk > Speak to a GP about anxiety in children> CTA

Speak to a GP about anxiety in children

kry.co.uk > Your health > How to help a child with anxiety – a therapist’s tips

How to help a child with anxiety – a therapist’s tips

What are the signs of stress and anxiety in children, and what can you as a parent do to help? Get expert advice here from our Licensed Psychologist and Psychotherapist

How to help a child with anxiety – a therapist’s tips | Kry UK

Supporting others

Opening up about mental health isn’t always easy, but looking for help is the first step towards getting and staying well. As many as 1 in 5 adults have experienced depressive symptoms so far in 2021 – more than double the proportion before the Covid-19 pandemic – but many of us aren’t accessing the support and treatment we need.

If you’re struggling to talk about your mental health – whether it’s anxiety, depression or another condition – you’re not alone,’ says Dr Rhianna McClymont, Lead GP at Kry. ‘There’s lots of help and support available. You just have to reach out to get it. It doesn’t really matter how you tell someone, as long as you do.’ 

## How to talk about your mental health with family and friends

Whether you’re concerned about burdening your loved ones or other people’s judgement, it can be difficult to talk about your feelings. ‘It’s important to remember that the people closest to you are often the most valuable source of support,’ says Dr Cecilia Radecka, a Kry psychologist. ‘We often underestimate how much our loved ones can help.’

### Be as honest and open as you can
Explaining how you’re feeling can allow others to understand what you’re experiencing. If you think describing your condition or how you’re feeling might be overwhelming, show them an article from a book or website. 

### Think about what you want from the conversation
Explaining to your family or friends what you want from the discussion can help them understand the best way to help you – this may be simply listening, offering emotional support or helping you access practical help. 

### Don’t expect too much from the initial conversation
Although mental health problems are very common, sometimes they can be difficult to understand. You may discover that the person you’re speaking to has had similar experiences or knows someone who has, which can help you feel less alone. Give them time to process what you’ve said, and plan to come back to the conversation at some point. 

### Conversation starters
Some useful ways to start a conversation with friends or family could include:
- ‘I’ve been struggling with my feelings lately.’
- ‘I’m not feeling like myself. Do you mind listening to what I’m going through?’
- ‘I know we don’t talk much, but I’m having a tough time. Can I give you a call?’

## How to talk about your mental health with a doctor

Doctors are there to help and can advise you on treatments and support available. They’re also familiar with mental health conditions, so there’s no need to feel embarrassed or ashamed. In the UK, for example, 40% of doctor appointments are now mental health-related. 

‘In some cases, it might be necessary to consult a doctor if you notice physical symptoms or need advice about medication,’ says Dr Radecka. ‘Speaking to a psychologist or therapist can also help if you’re struggling with depression or anxiety.’

### 1. Write down what you want to say
Make a list of the things you want to talk about before the appointment. This might include questions to ask or words or phrases that represent how you feel. That way, if your mind goes blank during your appointment, you’ll have notes to refer to. 

### 2. Don’t be afraid to ask for more information
A doctor should discuss different treatment options with you, whether it’s talking therapies or medication. Always ask for more information if you need it. 

### 3. Be transparent about how you’re feeling
This is your opportunity to give the doctor as much information as you’re comfortable with. If the doctor feels that your job is affecting your mental health or you’d benefit from some time off, they may sign you off work. A doctor can make an assessment based on your symptoms and provide you with a note advising you of the length of time to take off. 

### 4. Conversation starters 
At your doctor’s appointment, it’s a good idea to be prepared to get the most out of it. Here are some useful ways to start your conservation:
- ‘I’ve been feeling this way for [X amount of time].’
- ‘I’d like to see what support is available for how I’ve been feeling.’

## How to talk about your mental health with your employer

Your mental health can affect all areas of your life, including your work. Many of us will hesitate to bring a mental health problem up at work, for fear of being judged or not being taken seriously. A US report found that nearly 60% of employees have never spoken about their mental health to anyone at work.

However, good employers are there to support you to do the best job possible, so it’s worth speaking to them about the issues you’re facing. 

‘Showing that you need help from your employer is one of the bravest things you can do,’ says Dr Radecka. ‘It’s maybe not the easiest, but when we avoid the things we fear, we tend to increase negative thinking surrounding it. 

‘More often than not, employers will appreciate you coming forward with your feelings and will understand.’

### 1. Choose whether you want to talk to your doctor or boss first
‘If you’re suffering from work-related stress, it’s justifiable to speak to your employer first,’ says Dr McClymont. ‘Often, if an employer can improve the work situation, you won’t need anything else. 

‘But if your problems are separate from work, I’d say get the right help from your doctor first. A doctor’s note may be helpful to explain your situation, particularly if you might need some time off.’

### 2. Think about what you want to get from the conservation
If you or your workplace can make adjustments to help you do your job and protect your mental health, it’s worth writing these down to discuss. These might include being allowed time off for treatment or changes to your working hours or working area. 

### 3. Speak to HR if you’re not comfortable talking to your boss
It’s your choice who to speak to, whether it’s human resources or your supervisor or manager. Book a time to chat in a private room or somewhere you feel comfortable. 

### 4. Conversation starters 
Starting a conversation with your boss might seem intimidating, but it doesn’t have to be. Try these conversation starters:
- ‘I need to talk to you – do you have time to listen?’ 
- ‘I’ve been struggling with a lot of stress and would like to talk about making some changes to my workload.’
- ‘I need to make my mental health more of a priority. Can we talk about adjusting my hours?’

## How to get help during a mental health crisis

It’s important to have a conversation with a doctor if you can’t manage your mental health on your own any more. Local urgent mental health crisis teams are available 24 hours a day for advice and support. 

If you reach the stage where you’re at serious risk of harming yourself or having suicidal thoughts, call 111 or 999 for emergency help. Or go straight to A&E – the doctors there are experienced in providing mental health help in a crisis. Alternatively, the Samaritans are available at any time by calling 116 123.


Section > Call out > GP CTA for content

Speak to a GP

kry.co.uk > Your health > How to talk about your mental health if you’re struggling

How to talk to ppl about your mental health

Opening up about mental health isn’t always easy, but looking for help is the first step towards staying well. A Kry GP shares advice on how to talk about mental health.

kry.co.uk > Your heath > How to talk about your mental health if you’re struggling  

How to talk about your mental health if you’re struggling | Kry UK

kry.co.uk > medical reviewer

IMG 20200730 224911 865-33- 1 .jpg

Dr Rhianna McClymont

Lead GP at Kry

Mental health

How to talk about your mental health if you’re struggling

Loneliness can affect all of us from time to time. More than 1 in 5 people say they often or always feel lonely. While social isolation and loneliness existed well before the Covid-19 pandemic, social distancing and other measures have intensified an already serious problem. 

Being socially isolated isn’t just a lonely experience – it can have a detrimental impact on your mental health. In fact, social isolation can be both a cause and a symptom of mental health issues.

‘If you’re feeling socially isolated or lonely, there are a variety of ways you can get help,’ says Dr Cecilia Radecka, a Kry psychologist.

## The difference between social isolation and loneliness 

‘The main difference between social isolation and loneliness is in how people experience them,’ says Dr Radecka. ‘Social isolation is a state where you have few people to interact with regularly. Loneliness is a feeling, where you can be surrounded by people yet still feel lonely.’ 

Social isolation happens when you have little or no contact with people. Being socially isolated can lead to loneliness in some people, although it’s important to note that people can also feel lonely without being socially isolated. 

‘Studies show that it isn’t the quantity but the quality of social interactions that matters,’ says Dr Radecka. For example, while social media can help us stay connected, it can lead to lower quality interactions. One study found that spending too much time on social media can increase feelings of loneliness. 

## It’s not just the elderly who feel lonely 

Social isolation disproportionally affects older people, and in some countries, up to 1 in 3 older people are lonely. ‘Older adults are at increased risk of loneliness and social isolation due to living alone, the loss of friends or family and poor health,’ says Dr Radecka. 

But social isolation can affect us all at some point. For some, being socially isolated comes and goes – perhaps as a consequence of life events, like a death of a loved one, a relationship break-up or moving somewhere new. For others, it’s more long term. 

## Our brains and social isolation

‘Research suggests that the loneliness of social isolation can impair brain function and cognition,’ says Dr Radecka. Existing studies have found the following areas of the brain are particularly affected:

### Hippocampus
This area of the brain has a major role in regulating how we respond to stress. A review found that people with smaller social circles have higher levels of the stress hormone cortisol. 

### Amygdala
This region of the brain is important for forming memories – research suggests that people with a busy social life appear to have more volume in this area. 

### Prefrontal cortex
This part of the brain plays an important role in social behaviour, decision making and memory function. Studies suggest the function and volume of this area is reduced without regular social interaction. 

‘Social isolation can also have an impact on our memory and how we process information,’ explains Dr Radecka. ‘There’s even evidence that social isolation accelerates cognitive decline, and loneliness has been found to increase the risk of developing dementia, especially Alzheimer’s,’ she says. 

## How social isolation affects our mental health

Humans are social beings, and regular social connection, through community, friendship and support networks, is vital for our mental wellbeing. 

Social isolation is associated with an increased risk of mental health problems like anxiety and depression – and mental health issues can also increase your chances of feeling lonely. There’s even evidence that social isolation can shorten life span. A study found that people who are socially isolated are more likely to die prematurely, regardless of underlying health issues. 

However, while social isolation and loneliness can impair our cognitive function, there’s also evidence that re-socialising and making new connections can reverse the negative effects of isolation. In a recent study conducted during the pandemic, residents who suffered cognitive decline during lockdown quickly recovered when restrictions eased.

## How to overcome the effects of social isolation 

If you’re feeling disconnected from life and experiencing loneliness, asking for help can be difficult and you might not know where to turn. ‘Often, we don’t want to admit to being lonely, as it carries a strong stigma. But it’s always a good idea to do so,’ says Dr Radecka. ‘It’s important to remember that there’s nothing shameful in feeling lonely – it’s a normal human experience.’

Here are some steps you can take to overcome the effects of social isolation:

### 1. Make social connections a priority

‘Although it may seem impossible, making small steps to connect with others is important. There are many forms of friendships – but the key here is quality, not quantity,’ explains Dr Radecka. ‘Arrange to chat to someone you haven’t spoken to in a while or set up a weekly phone call.’

### 2. Engage in the community 

Being part of a community gives us a strong sense of belonging. Join a class based on your interests. ‘Doing activities that we enjoy is good for our mental wellbeing and a way to meet new people,’ says Dr Radecka. Try taking part in a book club, dog-walking group or choir or volunteering at a community garden. One study found that group singing significantly boosts psychological wellbeing. 

### 3. Get moving

‘If you’re struggling with social anxiety, keeping physically active can improve your mood and decrease symptoms of depression and anxiety,’ says Dr Radecka. ‘It boosts the feel-good chemicals in the brain and decreases stress hormones, including adrenaline and cortisol.’

### 4. Ask for help

‘If you feel that social isolation and loneliness are affecting your health, don’t be afraid to reach out to family, friends or a health professional,’ says Dr Radecka.

‘A Kry doctor or therapist can evaluate your symptoms and talk you through treatment options available.’

__This article has been medically approved by Dr Cecilia Radecka, a Kry psychologist.__


kry.co.uk > Your health > How does social isolation impact your mental health?

Social isolation

What does it mean to be isolated? How does it affect us? Kry psychologist Dr Cecilia Radecka shares advice on overcoming social isolation.

kry.co.uk > How does social isolation impact your mental health? > Meta

Social isolation and your mental health | Kry UK

How does social isolation impact your mental health?

Heart attacks, alongside other cardiovascular diseases, are sadly one of the leading causes of death globally. But by addressing the risk factors and learning to recognise the early and immediate signs of a heart attack, you can improve the chances for early detection and treatment.  

## What is a heart attack?

‘A heart attack (or myocardial infarction) occurs when the flow of blood to the heart muscle is interrupted, usually by a blood clot,’ says Dr Rhianna McClymont, Lead GP at Kry. ‘This means the heart muscle isn’t supplied with enough oxygen, which causes damage and stops it functioning.’

## Who is more likely to have a heart attack?

There are several factors that put you at greater risk: 

- Smoking
- Being overweight
- Having high blood pressure or high cholesterol

There are also some uncontrollable risk factors, like family history of early heart disease. The risk of a heart attack also increases for men after age 45 and for women after menopause. 

## What does a heart attack feel like?

‘A heart attack is described as a feeling of tightness, squeezing or pressure across the centre or left side of the chest,’ says Dr McClymont. This pain or tightness may radiate into the left arm, neck or back and is often accompanied by other symptoms such as:

- Shortness of breath
- Nausea
- Dizziness
- Sweating
- A feeling of intense anxiety

There are other symptoms of a heart attack as well – some that are less common and many that are less obvious. Some people experience unexplained fatigue or feel faint.  People with diabetes may have few or very mild symptoms. On rare occasions, people experience no symptoms at all and are surprised when they find out they’ve had a heart attack. 

## What is a ‘silent’ heart attack?

‘A silent heart attack is one that happens without the characteristic tight chest pain, or with other more unusual symptoms such as indigestion. This is more common in women, older adults and those with diabetes, and it makes it more difficult to recognise a heart attack when it’s occurring,’ says Dr McClymont.

## Are the symptoms and outcomes of a heart attack different for men and women?

‘Both men and women experience the typical symptoms of a heart attack like a tightness of the chest, but the signs of a heart attack in women may be slightly less recognisable – like dizziness, nausea or indigestion,’ Dr McClymont explains. ‘A heart attack presenting in an atypical way can be more difficult to diagnose.’

More research is needed to map out just how big the differences are between the symptoms women and men experience while having a heart attack.  But it’s clear that women with chronic heart disease have worse outcomes than men, likely as a result of presenting without chest pain and instead experiencing symptoms like stomach pain, breathlessness, nausea and fatigue.  

While around one-third of both male and female patients are initially misdiagnosed when presenting with a heart attack, women are twice as likely to be misdiagnosed.  

This might, in part, be a result of women sometimes having lower levels of troponin. This is a protein released into the bloodstream during a heart attack, which helps to establish a diagnosis. 

## Is there anything I can do to prevent a heart attack?

While you can’t do anything about ageing or your family history, there’s a lot you can do to lower your risk of having a heart attack. Lifestyle factors that can help to significantly reduce your risk of cardiovascular disease include:

- Stopping smoking
- Cutting down on alcohol consumption
- Exercising regularly
- Maintaining a healthy weight
- Eating a healthy diet rich in fruit, vegetables and fibre and low in saturated fat, trans fat, salt and sugar 

[‘Monitoring your blood pressure](/your-health/are-my-blood-pressure-levels-healthy-a-doctors-guide/) every now and then is also a good idea, as many people have high blood pressure without realising it,’ adds Dr McClymont.

## What’s the difference between the symptoms of a heart attack and angina?

Angina is chest pain that can feel tight, dull or heavy. ‘Angina symptoms happen when blood flow to the heart is reduced – typically at times when the heart muscle requires more oxygen than normal, such as while exercising – while a heart attack occurs when blood flow to the heart is blocked,’ says Dr McClymont. 

‘Angina symptoms tend to be temporary and occur mainly when the heart is experiencing increased demand or activity, and symptoms tend to be relieved when resting.’

## What is sudden cardiac arrest?

‘A cardiac arrest is when the heart suddenly stops beating,’ says Dr McClymont. ‘Among other causes, this could be because of a large blood clot or an interruption to the electric impulses causing the heart to beat.’

## Why is it important to know the signs of a heart attack?

‘The earlier a heart attack is diagnosed and treated, the less damage is done to the heart muscle and so the better the prognosis for the future,’ says Dr McClymont. ‘It’s very important to get symptoms assessed as quickly as possible.’

## What should I do if I think someone’s having a heart attack or sudden cardiac arrest?

If you think someone is having a heart attack, you should:

- Call 999 for immediate medical help
- Perform CPR, if you know how to do it ([read our guide on how to do CPR here](/your-health/learn-how-to-do-cpr-a-step-by-step-guide/))
- 999 operators will guide you and help you with CPR until emergency help arrives

__This article has been medically approved by Dr Rhianna McClymont, Lead GP at Kry__


See a GP about risk of heart attack

kry.co.uk > Your health > How to spot the signs of a heart attack

How to spot the signs of a heart attack

Dr Rhianna McClymont explains the risk factors and how to spot the immediate signs of a heart attack.

How to spot the signs of a heart attack | Kry UK

General health

General health and seasonal

It’s difficult to watch someone you care about struggling with an eating problem, and it can be hard to know how to help. Recent global estimates suggest up to 8% of people have an eating disorder at any point in time.  Sadly, the numbers have also risen during the Covid-19 pandemic.  

Right now, being a source of support is more important than ever. Taking steps to better understand eating disorders is a useful strategy to support someone living with one. 

## What is an eating disorder? 

An eating disorder is a mental illness that can affect people of any gender, age, race, religion, body shape or weight. While they are more prevalent among women, men can have eating disorders too.

‘Eating disorders are a symptom of an underlying pain or inner conflict,’ says Madeleine Gauffin, Licensed Psychologist and Psychotherapist at Kry. ‘Patients try to control things within themselves by controlling external factors, like food.’ 

‘One of the main qualities with eating disorders is being very disciplined, which might manifest as exercising excessively, restrictive eating or having a lot of anxiety about specific foods or food in general.’

## What are the common types of eating disorder?

### Anorexia nervosa (AN) 
Where someone tries to control their weight by not eating enough, exercising too much, or both.

### Bulimia nervosa (BN) 
Where someone loses control over how much they eat, then takes extreme action to avoid gaining weight.

### Binge eating disorder (BED) 
Where someone eats big portions of food until they’re uncomfortably full.

## What are the warning signs of an eating disorder?

While each case is different, many people have similar patterns of behaviour. ‘It very often starts with cutting out certain foods, such as sugar, fat or meat,’ explains Gauffin. 

‘You may have noticed that your friend or relative is significantly lowering the number of calories they eat or eating extremely small portions, which may be signs of anorexia. On the outside this might seem “healthy”, but it can be covering something deeper, like an eating disorder.

'When someone is living with anorexia, there’s no realistic understanding of what nutrition the body really needs to be able to function. The focus is on getting as few calories as possible.

‘Bulimia and binge eating present differently, but the catalyst for the behaviour is often the same. These illnesses are still governed by control.’ 

Eating a lot of food very quickly and eating alone might be warning signs of binge eating disorder.  Following careful eating schedules, making frequent trips to the bathroom and excessive exercising can be signs of bulimia. 

People may withdraw and completely isolate themselves. ‘This is often a consequence of food being such a universal part of our lives,’ says Gauffin. ‘Many environments are triggering.’ 

## How can I help support someone with an eating disorder?

While we may have good intentions, offering unsolicited advice to your loved one may cause more harm than good. The most important thing is to listen and be there for them.

### 1. Try not to be confrontational
Accusing someone of not eating enough or demanding they seek help isn’t helpful at all,’ says Gauffin. ‘Try to find another way to connect with the person. Say, “I’ve noticed that you seem to be cutting out certain foods and I’m worried about you,” or simply, “How do you feel today?”’ 

### 2. Consider your own language around food
Living with an eating disorder can be exhausting. Many people might experience an inner monologue of dos and don’ts around food, so be mindful of the way you talk about eating. 

‘Avoid talking about diets, exercising or food because these are things that people with eating disorders think about for a lot of their day,’ says Gauffin. 

### 3. Continue to include them – in a helpful way
When it comes to socialising, make plans that don’t centre around eating. ‘Try to find other activities that aren’t food-related, so that they can just be themselves, without having to withdraw,’ says Gauffin. ‘It’s very painful and challenging for someone with an eating disorder to be sat in a café, for instance, while their friends are all eating pastries. These social situations also open them up for questioning, which can be extremely difficult.’ 

### 4. Be there for them
‘People with eating disorders tend to want to protect themselves from anyone who might try to change their eating habits,’ says Gauffin. ‘They might be afraid of being convinced to eat more or having to exercise less. Instead, just showing that we want to be around them and that we want to try to understand how they’re feeling is a positive step.’ 

### 5. Finally, ask this one simple question…
We often struggle or simply forget to see things from the perspective of others and go on autopilot advice, which may not be helpful. ‘Try not to take the role of the psychologist or those providing treatment,’ says Gauffin. ‘Instead, ask, “How can I support you in this?” It’s something we don’t ask enough.’ 

__This article has been medically approved by Madeleine Gauffin, Licensed Psychologist and Psychotherapist at Kry.__


Speak to a GP about eating disorders

kry.co.uk > Your health > How to help someone with an eating disorder – a therapist’s guide 

Eatingdisorder

kry.co.uk > Your health > How to help someone with an eating disorder – a therapist’s guide  > meta info

Therapist Guide: Help Someone With an Eating Disorder | Kry

How to help someone with an eating disorder – a therapist’s guide 

Depression is one of the most common mental health problems around the world. Globally, there are around 280 million people who suffer from the condition, and at its worst, depression in men or women can lead to suicide.

According to the [Office for National Statistics](https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/suicidesintheunitedkingdom/2019registrations), around three quarters of registered suicide deaths in England and Wales (in 2019) were among men. The male suicide rate is also at the highest its been since 2000. This is particularly alarming, as men are less likely than women to get help for depression.

The disorder can manifest in men in a multitude of ways, and sometimes without the traditional signs of depression most of us are aware of. 

## What is depression?

Depression is a serious mood disorder that affects both men and women across all age groups. It leads to a persistent feeling of sadness, hopelessness and loss of interest in activities you’d normally enjoy.

There are many symptoms – both emotional and physical. To get a diagnosis of clinical depression, these symptoms of depression need to be present for at least two weeks.

## Depression in men

While the common perception is that women suffer more from depression, and statistics reflect that, men are less likely to speak out and seek help. This means that lots of cases of male depression are going undiagnosed.

‘Sometimes, men would rather not talk about their feelings and instead may turn to other, potentially destructive ways of coping,’ says Lina Anderhell, registered Livi psychologist. ‘Their reluctance can be down to not wanting to show themselves as vulnerable.’

## Male depression may appear differently

Another reason that men don’t often ask for help, says Anderhell, is that they ‘might not recognise themselves in the symptoms that are described.’ For example, the traditional signs of depression like a low or depressed mood, change in sleep patterns and losing pleasure in things they enjoy, may not be the first thing depressed men notice about their experience.

Men may still feel sad and lose interest in activities they used to enjoy but they may also show other signs not necessarily associated with depression.

Here are some of the signs of depression in men to look for.

### Emotional signs
- Anger
- Irritability
- Frustration
- Loss of interest in work, social life or hobbies
- Indecisiveness or inability to concentrate

### Behavioural signs
- Aggressive behaviour
- Withdrawing and isolation
- Drink and drugs
- Overworking
- Suicidal thoughts

### Physical signs
- Sleep problems
- Changes in appetite and eating
- Weight changes
- Unexplained aches and pains
- Loss of libido
- Loss of energy
- Digestive problems

## What causes mood swings in men?

There are several common causes of depression and mood swings in men, and these can lead to depression in women too.

Age, financial circumstances, lifestyle, illness, family history and even genetics have been shown to affect the likelihood of depression in men. There may be a trigger or series of stressful events which can lead to someone becoming depressed.

In men, dealing with any kind of loss is a possible cause to trigger depression. This could include a relationship breakdown, the death of a loved one or the loss of a job.

## How to help a partner with depression

It can be difficult to know how to broach the subject of depression in relationships with sensitivity. This is particularly hard if the man you’re worried about has withdrawn and is not open about his feelings.

‘What’s important as a partner or friend, is to bring up the subject even if it feels scary,’ says Anderhell. ‘Dare to ask the question, “how are you feeling?’’

She suggests expressing what you’ve noticed about their behaviour and what’s worrying you. ‘The key thing is not to blame but to show support and ask the person if there’s anything you can do to help them,’ she says.

Be aware that the form of support they want will be very individual. ‘They might just want somebody to listen, or maybe they’d like you to go with them to see a professional,’ Anderhell says.

## Self-help for depression in men

Talking about your problems to friends, family or professionals, avoiding too much alcohol and maintaining a healthy lifestyle are all beneficial for preventing male depression.

Practicing mindfulness and using [mindful techniques](https://www.livi.co.uk/your-health/why-mindfulness-matters/) can also regulate your mood as they allow you to step back from a problem. Similarly, exercise has been shown to help prevent depression in men, as it releases feel-good chemicals called endorphins into our body.

Low-intensity exercise can improve nerve cell connection too, and so helps reduce recurring or long-term symptoms of depression in men.

## Getting depression treatment

Knowing when to see a doctor is hard, especially as men have a tendency to avoid seeking help. When dealing with depression, it’s important to seek help as quickly as possible. This can make treatment a slightly easier and shorter process. 

A Livi GP can help you to better understand your problems as well as give you advice and support on how to deal with things that feel difficult. 

Depression treatment can vary a lot depending on the individual. Some men benefit more from psychological support like Cognitive Behavioural Therapy (CBT) and talking therapies, whereas others see more improvement from antidepressants, or a combination of both.

__This article has been reviewed by Livi psychologist Lina Anderhell__


Speak to a GP about depression

livi.co.uk > Your health > Signs of depression in men

signs of depression in men

Expert medical guidance on managing and treating the symptoms of male depression

kry.co.uk > Your health > Signs of depression in men

Depression in men

How to spot and treat the signs of depression in men | Kry UK

Signs of depression in men

## Quick facts

- Over half of men between 40 and 70 will experience erectile dysfunction (ED)
- 90% of men have at least 1 underlying physical cause 
- Underlying causes can include cardiovascular disease, diabetes and hormone problems, which is why it's important to speak up

Most men experience trouble getting or maintaining an erection at some point in their lives. This is often referred to as erectile dysfunction or ED. According to the British Association of Urological Surgeons, ED affects more than half of men between the ages of 40 and 70.  

But awareness of ED is low in men and women aged 20 to 70, a recent survey commissioned by the European Association of Urology (EAU) has found. The majority of the respondents did not know what ED was, and 1 in 4 had never heard of any of the most common treatments for ED. 

## Why you should talk to a doctor about erection problems

It’s not helpful that our culture often refers to men as having to ‘perform’ in bed. This can lead to undue pressure and anxiety, which can compound the problem.

But while many will keep quiet, feeling ashamed or too awkward to broach the subject witha doctor, it’s essential they do. 

That’s because ED isn’t just a problem that affects your sex life. It can also be one of the first signs of underlying health problems that may have no other symptoms, including [heart disease](/medical-advice/cardiovascular-diseases/congenital-heart-disease/) or type 2 diabetes. 

What’s more, ED can affect self-esteem and lead to frustration, anger and mental health issues.

The good news is, simple lifestyle changes can sometimes reverse ED. Where they don’t, a variety of medical and psychological help is available, starting with a doctor's appointment.

We’ve called on the expertise of Dr Rhianna McClymont, Lead GP at Kry, to help raise awareness of ED and answer some commonly asked questions. 

## What’s the best way to talk about erectile dysfunction (ED) with a partner?

Whether you’re the person affected, or you have a partner who is experiencing ED, it can be a tricky thing to talk about. Of course, it’s worrying when ED happens but don’t panic and assume your sex life is over.

‘Any man can struggle to get or maintain an erection at times, and there can be a number of reasons — in particular, psychological factors — why this might occur,’ says Dr McClymont.

‘So, give your partner time, gently encourage him to get help but don’t pressure him, listen in a non-judgemental way if he’s experiencing stress or struggling with mental health, and try not to take your partner’s erection difficulties personally.’

And remember, penetration doesn’t have to be the endgame of sex. ‘You can adjust your sexual activity as a couple to find other ways to please each other and remain intimate.’ 

## What causes erection problems?

There are many factors that can contribute to erectile dysfunction and 90% of men have at least 1 underlying physical cause for their problem. 

These can commonly include underlying or undiagnosed [cardiovascular disease](/medical-advice/cardiovascular-disease/) or diabetes — which is why it’s so important to talk to a doctor about it. 

ED can also be caused by hormone problems, neurological disorders, pelvic surgery or physical trauma.

Around 10% of men’s erection problems are caused by psychological factors like stress, [anxiety](/medical-advice/mental-health/anxiety/), depression or ‘performance anxiety’.  

Although it’s rare, around 1-3% of men may have an anatomical abnormality like a tight foreskin or penile inflammation or curvature. 

## What is ED and who commonly get it?

Getting and maintaining an erection requires a healthy supply of blood flow to the penis. But common circulatory problems that restrict blood flow such as atherosclerosis (a narrowing of the arteries due to fatty deposits of substances like cholesterol) can impede this process, resulting in erection problems. 

‘Occasional episodes of erectile dysfunction can happen to a man at any age,’ says Dr McClymont.

‘Persistent difficulties in erections, however, are more common in men over the age of 40, when conditions that may contribute to it, such as diabetes, high blood pressure, heart disease or neurological conditions, more frequently occur,’ Dr McClymont points out.

‘Various medications can also cause ED as a side effect,’ Dr McClymont adds. These include widely prescribed medicines for conditions such as [depression](/medical-advice/mental-health/depression/), high blood pressure and prostate enlargement.

## What lifestyle changes can help erection problems?

Simply becoming more active may reduce your risk of erectile dysfunction by up to 70%.  

In fact, a review of studies  found that doing 40 minutes of moderate to intense cardiovascular activity (the type that gets you sweaty), 4 times a week could decrease ED within 6 months.

Stopping smoking, losing weight, reducing alcohol intake, lowering stress levels and avoiding illicit drugs can also play a big part in alleviating erectile problems.

‘Things like stress and excess alcohol are common triggers for ED,’ says Dr McClymont. ‘So, if occasionally a man struggles to get or maintain an erection when perhaps he’s had a bit too much to drink or is under exceptional pressure at work, then he should not worry,’ says Dr McClymont. 

If you ride a bike for more than 3 hours a week, your doctor might recommend you try a period without cycling to see whether that helps improve things. If you do cycle, it’s vital you have a properly fitted, comfortable seat — some saddles are specifically designed to relieve pressure on the blood vessels and nerves supplying the penis. 

## When should you see a GP?

Many men find this issue embarrassing so they wait for more than 2 years before seeing a medical professional, research has found — but doctors are trained to deal with ED. 

If you’ve been having erection problems for a few weeks, book an appointment with a Kry doctor. 

‘If it’s your partner that’s affected, and he is reluctant, encourage him to seek further help as his doctor may need to run further tests to exclude a physical cause,’ says Dr McClymont.

## How can a GP treat erectile dysfunction?

Thankfully, the majority of cases of ED can be treated. A doctor will first ask you for your full medical history and may also perform blood and urine tests to help detect any underlying medical conditions. 

Your doctor may then recommend lifestyle changes. If these don’t help, other treatments are available for ED:

#### Medication 
There are currently four tablets available: sildenafil (brand name Viagra), tadalafil (Cialis), vardenafil (Levitra) and avanafil (Spedra). These belong to a group of medicines called phosphodiesterase inhibitors (PDE5i).

Viagra is now available in the UK to buy without a prescription and at least two-thirds of men have improved erections after taking it. 

But you should always talk to a doctor or pharmacist before taking such drugs — and never buy them online as they may be fake. 

Drugs used to treat ED can produce side effects which commonly include headache, stuffy nose, flushing or upset stomach. If that happens to you — or they don’t work for you — a GP may prescribe other treatments to support erectile function. These may include penile injections or, if physical trauma is the cause, surgery.

Occasionally, Viagra-type drugs can produce serious side effects such as chest pains, seizures, painful erections and a sudden loss of vision. Always call a doctor straight away if you suffer from any of these.  

If atherosclerosis is the cause of your ED, a doctor may also prescribe statins to control your cholesterol levels and drugs to lower your blood pressure.

#### Vacuum pumps 
You’ve probably read reports online about treatment options like vacuum pumps. These cause an erection by encouraging blood to flow to the penis. They can be used if drugs are not suitable and work for most men. Speak to your doctor about the best way to get a pump.  

#### Testosterone treatment 
Your doctor may find your hormone levels are contributing to your ED . They may be able to prescribe Testosterone Replacement Therapy (TRT) or refer you to an appropriate specialist to consider this.  TFT comes in the form of a gel rubbed into the skin every day or as a long-acting injection given every 6-12 weeks.  

## Does depression cause erectile dysfunction?

This can work in two ways. ‘[Depression](/medical-advice/mental-health/depression/) can cause erectile dysfunction,’ says Dr McClymont, ‘and some of the medications that are used to treat depression can also contribute to erection issues.

‘Conversely, many men who suffer with persistent erectile dysfunction from another cause such as heart disease or diabetes find that having ED adversely affects their mental health — with men suffering feelings of anger, sadness and frustration.’

In both instances, counselling or Cognitive Behavioural Therapy (CBT) may help. A Kry doctor can help refer you for a course of psychological therapies to help with dealing with ED.


Kry.co.uk > Your health > Erection problems — a doctor’s guide to getting help 

Erection problems — a doctor’s guide to getting help 

Erectile dysfunction is common and it can be embarrassing at times, but there are plenty of solutions available. Dr Rhianna McClymont, Kry Lead GP, has advice

Kry.co.uk > Your health > Erection problems — a doctor’s guide to getting help Erection problems 

Reviewer > Dr Rhianna

IMG 20200730 224911 865[33] (1)

Men Health

Men's Health

Kry.co.uk > Womens health hub > Banner

How often do you check your breasts? If it’s rarely or never, then you might be inadvertently putting your health at risk. Breast cancer is the most common cancer in women worldwide, representing 25.4% of all cancers in women. It’s also one of the most treatable and the earlier it's picked up, the better the outcome.

‘The earlier breast cancer is detected and treated, the better the prognosis,’ says Dr Elisabeth Rosen, medical doctor and women's health specialist at Kry. ‘That’s why it’s important to get into the habit of checking your breasts for lumps regularly.’

## When is the best time to check your breasts?

‘Knowing how your breasts should look and feel normally can help to alert you to any unusual changes that may be a symptom of breast cancer,’ says Dr Rosen. ‘Ideally, you should check your breasts once a month on the same day, a few days after your period.’ 

Like the rest of your body, your breasts react to hormonal changes during your menstrual cycle. Many women, for example, find their breasts naturally become swollen, tender and even lumpy in the week or so leading up to their period, so that’s not an optimal time to check them. 

If you’re postmenopausal, you should be checking your breasts for lumps on the same day every month.

## Am I eligible for breast screening?

The risk of breast cancer increases with age and most breast cancers are diagnosed after age 50. It’s important to have regular breast screening, called a mammogram, when you’re invited. The aim of mammograms is to detect breast cancers early, when they’re too small to see or feel. 

In the UK, women aged from 50 to 71 are invited for breast screening every 3 years. Anyone who has symptoms or a family history of breast cancer is also eligible to have a mammogram.

## How can I know what’s normal for me?

‘Look out for anything that’s different in how your breasts, armpits and nipples look and feel,’ says Dr Rosen. By checking regularly, you’ll become familiar with what’s normal for you regarding: 
- skin colour
- skin texture
- feel and shape of your breasts
- look, feel or shape of the nipples

## Most breast lumps aren’t cancer, right?

‘If you find a lump in your breast, you should always have it checked by a GP,’ says Dr Rosen. But a new symptom doesn’t automatically mean you have breast cancer. Around 9 in 10 breast lumps are benign. 

‘It could be that you’ve simply got a cyst, or a fibroadenoma, which is a non-cancerous, solid growth of fibrous or glandular tissue,’ says Dr Rosen.

Most cysts go away by themselves and are nothing to worry about. But if a cyst is large or causing discomfort, the fluid can be drawn off. Fibroadenomas may also disappear over time. In some cases, surgery (an excision biopsy) might be needed to remove it.

## What changes am I looking for?

Always consult a doctor if you notice any of the following changes:
- A new lump, bumpy area, swelling or thickening in one breast or armpit that’s different to the same area on the other side
- A change in the size, outline or shape of your breast
- A change in the look or feel of your skin, such as puckering or dimpling
- Nipple discharge (not milky, for example, if you’re breast-feeding)
- Bleeding from your nipple
- A rash or redness on or around the nipple area or a sore that doesn’t heal
- Any change in the position of the nipple – eg: becomes inverted, or is pointing differently
- Any new discomfort or pain in the breast (although pain is a rare symptom of breast cancer)

‘Checking your breasts for lumps monthly will help you to become aware of how they look and feel,’ says Dr Rosen. ‘It’s perfectly normal, for example, to have one breast that’s slightly bigger than the other. Most women have slightly asymmetrical breasts. What you’re looking for is anything that’s not normal for you. This means any changes and symptoms that weren’t there before.’  

## How to do a breast self-examination – a checklist

When you check your breasts, stand in front of the mirror with your shoulders straight and your arms on your hips. Observe the following:
- Are your breasts the same size and shape as usual?  
- Are there any visible distortions or swellings?
- Are there any changes in colour or texture to your breasts, armpits or nipples? For example, are there any areas that look red, inflamed, crusty, puckered or dimpled? Is there any soreness, rash or swelling? 
- Do you notice any indentations? This may be caused by a lump or tumour that’s pulling the skin inwards
- Has your nipple changed position; drawn inwards instead of protruding outwards?
- Check whether there’s any fluid or discharge coming out of your nipples eg: watery, yellow or bloody

Now raise your arms above your head. Notice how your breasts move while you do so. Are they moving in the same way as always? Breast cancer can make breasts less mobile. Keeping your hands above your head, look for any of the changes above.

Now check your breasts for how they feel. Standing or sitting, use your right hand to feel your left breast, and your left hand to feel your right breast. If you're less mobile, you can also lie down. Now:

- Keeping your index and middle fingers flat and together, using circular motions, feel your breast – from side to side, from the collarbone to the top of your abdomen and from your armpit to your cleavage. Begin at the nipple, moving towards the outer edge of the breast. Make sure you cover the whole breast. Next do the same of your armpit area.
- Do you feel any lumps, bumps or swellings? 
- Does skin feel different than usual?

## When to get help for a breast lump

‘If you find a breast lump or notice any other signs, always see your doctor as soon as possible,’ says Dr Rosen. ‘Try not to panic, as the vast majority of lumps are benign and there may be other reasons for them. Also, lumps that hurt are usually not cancerous but hormonal. Your GP will examine you and refer you to a breast cancer unit or clinic for further tests.’

## How will I be tested for breast cancer?

If you have symptoms, you may be referred for a mammogram. You may also need an ultrasound scan, which uses high frequency waves to create an image of part of the body.

If breast cancer is suspected, you will have a biopsy, which examines cells taken from your breast to see whether they are cancerous. A needle biopsy (where a sample of tissue is taken from a lump) is the most common type of biopsy. A biopsy can also be done by needle aspiration, where a sample of breast cells is removed using a small needle. 

If a diagnosis of breast cancer is confirmed, tests will be needed to confirm the stage and grade of the cancer, and the best method of treatment.

## What about gene testing for breast cancer?

Certain types of breast cancer may be genetic. For example, if you have BRCA1 or BRCA1 genes, this may raise your risk of developing breast cancer, and ovarian cancer.

If you’re concerned, for example, if breast cancer runs in your family, and you’re worried you may also develop it, talk to your GP about genetic testing. 

Not everyone is eligible and you would usually have to have good reasons to have this done. For example, if a relative has already been tested and shown to carry the BRCA1 or BRCA2. Testing is often inconclusive. You may also need to consider whether you really want to know, as a positive result may cause ongoing anxiety. 

Start with a discussion with your GP about your family history and they will help you decide on next steps.

__This article has been approved by women’s health specialist Dr Elisabeth Rosen.__


kry.co.uk >     article page >   CTA

See a GP about a breast lump

Kry.co.uk > Your health > Are you checking your breasts correctly? A doctor’s guide

Are you checking your breasts correctly? A doctor’s guide

Most breast lumps are harmless. But if they’re cancerous, then the earlier they are treated the better — so, make sure you’re checking your breasts regularly

How to Check your Breasts for Lumps - A Doctor's Guide

Women Health

Women's Health

kry.co.uk > Your health > Articles

All articles

See a KRY GP download app

Your health 

Kry UK

Kry is Europe’s leading digital healthcare provider. We combine digital technology with clinical expertise to help NHS services and health insurers solve the biggest challenges in healthcare.

Kry.co.uk > Meta information

Global > og Image > KRY

Kry | Building better healthcare for everyone