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Discovering your purpose

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Article by Dr Tom Cotton, Existential-Analytic Psychotherapist, Executive Coach & Founder, Mind Environment

In recent years I’ve become preoccupied with purpose, both professionally and personally. As a psychotherapist and executive coach, while my clients are from a broad range of backgrounds, they seem increasingly to share a need to be clear about their purpose in the world. For my own part, making sense of my own purpose has been a long struggle with notable peaks and troughs. Lost in adolescence, breakdown and failed relationships in my twenties, the death of my father and leaving a career in film in my thirties, all led to periods of intense questioning about who, and what, I was supposed to be in the world. Re-training as a psychotherapist and coach, marrying and becoming a parent, meanwhile, while not always plain sailing, helped me to discover that, in part, my purpose was to support others in their attempt to navigate their own path through life. 

Having reached fifty recently, the question of purpose has once again become a pressing question. Passing this midlife milestone has coincided with a growing global awareness of the challenges facing the world, and, like many other people, I have been wondering how my purpose can contribute to the solutions to these challenges.

Last year I set up an organisation with colleagues, called Mind Environment, which offers programmes to help people work intensively on their purpose. One of my core aims was to take personal development work out of the clinic and conference centre and into an inspiring natural location where participants have the space to fully step back and consider the complexity of their relationships and life roles. The remote French mountain village of Bardou, which is surrounded by the wilderness Southern Languedoc National Park, was home to our first programme in October 2019, and not withstanding Covid-19 disruption, will be our base for our autumn programmes this year.

If you have also found yourself wondering about purpose, you might be interested in some of the key learning points that have emerged from the first year of developing Mind Environment.

One view of purpose

There are of course a myriad of ways of defining purpose, but the following points outline how purpose now appears to me:

  • As people, our purpose is a deep, often unspoken, or indeed unconscious personal statement about who we are and what’s important to us. It is our design for life.
  • Purpose is the thread that connects some of the core human concerns: meaning, identity, values and legacy.
  • Purpose drives and guides what we want to do in the world and the way that we want to be in it. That has a profound impact on the quality of not only our lives, but also the lives of the people around us – family, partners, colleagues, community. It has the potential, therefore, to further the common good, or undermine it.

Becoming aware of one’s own purpose

Often, purpose might be thrust upon us, rather than being self-engineered. For example existential transition points, such as becoming a parent, a significant relationship starting – or breaking down, losing a loved one – or a job, entering adulthood, mid-life or old age, may all demand a re-orientation of purpose. Equally, the need to pivot one’s purpose might not just come from within. For example, on a macro level, in the wake of Covid-19, issues such as climate change and social inequality have come into sharper focus. As a result, it is becoming more difficult to avoid the reality that we are all connected, and that our individual actions have an impact that reaches further than our immediate spheres of influence.

How do you examine your purpose?

Achieving clarity of purpose can be difficult. You know when you have purpose, but when you want to reconfigure it, or even radically revise it, it can be difficult to see what’s lacking, and why. In part, this might be because we lead busy lives that don’t stop, and so there is little space to step back and reflect on where we are, take soundings from others, and to be curious about what emerges. However, it is also important to look at the deeper, more complex reasons why this examination might be difficult.

  • To see your own purpose more clearly, you need to look in detail what is obstructing it, so that you can make space in your mind for a fresh perspective.
  • From a psychoanalytic view, obstructions do not occur in the intellectual realm – they manifest below the surface in the areas that are difficult to verbalise: the emotional, unconscious and seemingly irrational undercurrents of individual and group experience. This is the same, opaque place where obstructions tend to occur in relationships and organisations, for example, and are difficult to address because they are often unseen and unspoken.
  • To see your purpose more clearly, therefore, it might help to engage with these below-the-surface forces and bring them into consciousness, where they can be worked with more productively.

Working with purpose

Human beings tend to focus on the known aspects of the world that they can see and control, and so tend to avoid direct contact with below-the-surface. With this challenge in mind, we designed the Mind Environment Individual Programme to blend outdoor activity, discussion and creative representation techniques, such as drawing (skill plays no part here!), and contain these elements within a confidential group process framework in order to help participants to quickly reach beneath the surface and explore where potential obstacles to purpose might lie. This framework is guided by two main principles:

  • The philosopher, Martin Heidegger’s contention that Being is encountered environmentally[1]. In other words, to see your being more completely, you need the perspective of others that you relate to environmentally, or put another way, in the world around you.
  • To paraphrase the Depth Psychologist, Carl Jung, ‘You find what you need most in the place where you least want to look’[2]. While individually, the part of us that wants to remain in control might prevent us looking in this beneath-the-surface place, the group reminds us of what we would rather not see, but what we often desperately need to hear. As Jung might say, you need to get close to the heat of the furnace to benefit from the deep level learning, but it is essential that when speaking one’s mind, one does so with both kindness and respect.

Working immersively in this way over four days, we found that participants on our October 2019 programme were able to bring together below-the-surface experience where blockages occur, with above-the-surface thinking, in order to work productively on their purpose.  We found that participants developed a greater awareness of the choices that they make as individuals, a better understanding of the complex relationships that they are part of, a capacity to think more critically and creatively about both the challenges and the opportunities that they see ahead of them, and to take their revitalised purpose back into their lives, into their families, relationships, workplaces and communities.

It is with immense pride that I report that this first group have chosen to continue supporting each other with the purpose plans that they developed during the programme, and remain active members in our Mind Environment community. You can read about their experiences of the programme in the short video clip on the Individual Programme page.

While Covid-19 has been a major disruption to our programmes this year, it has also provided an opportunity to think deeply about how we offer what we do. If the Mind Environment Individual Programme might be of interest to your clients, or to you as a practitioner looking for a CPD opportunity, please visit our website for more details. Alternatively, please do feel free to contact me directly at tom@mindenvironment.co.uk if you have any thoughts or questions.


[1] Heidegger, M (2008 [1926]) Being and Time (Trans. Macquarrie, J. & Robinson, E.) Harper. London: Perennial Modern Classics. p155.

[2] Jung, C (1983) The Collected Works, Vol 13, New Jersey: Bollingen. P35.

Psychotherapy for Complex Trauma

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What is Complex Trauma and who experiences it? 

Many people have heard of the term PTSD – Post Traumatic Stress Disorder – a condition that sometimes follows overwhelming and life threatening events such as a road traffic accident, assault, torture or combat experience. PTSD is diagnosed when someone has been suffering symptoms (severe anxiety, flashbacks to the traumatic event and avoidance of reminders) for longer than four months after the event. 

What is not widely known is that there are many people who are suffering from the symptoms of severe PTSD without it ever being diagnosed. These are people who have experienced long periods of neglect and/or abuse in their childhood and formative years, or perhaps people who have experienced long periods of domestic violence or bullying as adults. These people are living with the effects of complex trauma…terrifying events repeated over a long period of time. 

How does complex trauma affect us? 

Children have evolved to attach to their parents and carers and form strong bonds with them. If their carers are abusive, then children have to learn to adapt to this and form bonds with carers who are hurting and neglecting them. This affects the child’s sense of self, attitudes towards the world and other people. The traumatised child will develop an attachment style that instead of being secure is insecure and chaotic. They will expect mistreatment from others based on their repeated experiences and may even believe they deserve to be abused. 

Many children cope with their suffering by dissociating before, during and after the terrifying events. This may take the form of physical numbing off or blocking one’s experience so that it does not stay in awareness. Highly traumatised children develop intricate and sophisticated dissociative states. 

Sometimes traumatised people use alcohol, food, drugs, self harming, and even sex to cope – these attempts to cope distract them from their traumatic memories. Unfortunately this can lead to even more difficulties as life becomes more complicated as a result. 

What kind of psychotherapy heals complex trauma? 

Children who are repeatedly traumatised within family relationships grow up to develop insecure and disorganised attachments to other people. They benefit from a psychotherapeutic approach that takes their style of relating to others into account, gives them an opportunity to explore different aspects of their identity and helps them to test their models of reality inorder to create more adaptive and helpful models of the world. 

The therapist helps the traumatised person to update their internal model of the world. Learning how to trust again, spotting cues that mean a situation is dangerous, understanding that just because they were hit as children they were not necessarily deserving of that. 

Unfortunately traumatised people experience their own models of the world as protective even though they actually keep them trapped in patterns of relating that are retraumatising. For example, people may find themselves repeatedly having affairs that are inappropriate; they may find themselves attracted to people who hurt them; they may keep experiencing bullying in all their relationships and they may be struggling to cope with these painful situations in ways that add to their problems. 

What does the trauma therapist do? 

Therapists working with complex trauma develop a therapeutic relationship that offers respect, information, a real connection and hope that these difficulties can be overcome. The therapist encourages the traumatised person to overcome destructive relationships, keep behaviour within safe boundaries, become aware of when unhelpful patterns are being repeated and manage their levels of anxiety so they do not feel so much the need to dissociate by for example drinking or self harming. 

Certain trauma therapies like EMDR help the traumatic information move from an unprocessed and chaotic memory stored in the body to a memory that is stored in the brain which can be understood and talked about. EMDR is a recommended treatment for simple PTSD (following one off events) and some EMDR therapists have adapted their approach to work with complex trauma . 

Trauma therapists’ work is usually conducted in phases. 

Phase one – establishes safety, manages anxiety and other symptoms
Phase two – reprocesses traumatic memories so they stop being traumatic
Phase three – strengthens new ways of living through repeated practise in the therapy relationship and elsewhere. 

Why are short term approaches inappropriate for treating complex trauma? 

Because complex trauma changes one’s attachment style, identity and models of the world, short term treatments do not provide the consistently safe therapeutic environment that is needed for such patients to risk change. 

In fact short term therapy can have the effect of confirming people in a belief that they are ‘untreatable’, ‘difficult’ or ‘too dependent’ and that there is no person with whom they can form a safe enough relationship. When someone has coped for years with trauma, they need to take time to trust the therapist before they can feel safe enough to talk candidly about their experience. 

There is a large and consistent body of evidence to support this view within the trauma field. To find out more see the resources listed below: 

Treatment of Complex Trauma: A Sequenced, Relationship-Based Approach By Christine A. Courtois, Julian D. Ford (2016) 

Complex PTSD: From Surviving to Thriving By Pete Walker (2013) 

Getting past your past by Francine Shapiro (2012) 

Jessica Woolliscroft, Director 

Brightstone Clinic, Sandbach, Cheshire, CW11 1BA 

www.brightstoneclinic.co.uk

Why it’s time to invest in video for your practice

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A picture says a thousand words and a video says even more. Video can be an incredible form of communication- particularly for personality driven businesses such as therapy. Ensuring strong therapeutic alliance from the start enables a client to get the most out of therapy. Video can be a great medium for clients to get to know you better, ensuring fewer drop-outs, and ultimately better outcomes for the client- and you. Clients often struggle to find the right type of therapist for them- by increasing the probability of getting it “right the first time”, they’re far more likely to be advocates of not only therapy, but also your practice. 


Videos are a great way to market yourself and your practice. If you’re looking to make your first video why don’t you sign up to Noah– the app that does all the thinking behind your videos so that you don’t have to.

Sources:

  • Wordstream
  • Insivia
  • HubSpot
  • H2 Crowd

Ask The Expert

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You can access all of our sister site, Private Practice Hub’s, past and upcoming webinars by becoming an Exclusive member for just £10 per year. 

Early 2020 gave rise to the relaunch of Private Practice Hub’s, ‘Ask the Expert’ webinar series! The 20-minute episodes have been completely refreshed and reformatted and are led by expert host, Jayney Goddard.

The next Ask the Expert will be taking place on Thursday 25th June at 3.30pm and our guest this month is Dr Colin Clerkin from Your Practice Coach, part of Clerkin Psychology Services Ltd. Colin will be sharing advice on getting started in private practice, more information to follow. Please do share and sign up here.  

More and more, helping professionals are open to the prospect of working for themselves, rather than seeking employment within the NHS or other agencies. Everyone considering this path faces the challenge of how to make it happen, asking: is this possible? Is it something I can do? Despite often spending many years acquiring the skills of their profession, training rarely addresses the “business” of therapy or how to create a practice and thrive. So therapists, of all levels of experience, find themselves stumbling around in the dark, making it up as they go along, making mistakes, suffering setbacks and frustrations from having to learn and adjust as they go, without support, feeling anxious and lost. This can lead to people giving up or missing out on opportunities that ultimately cost them money, when they could be earning a decent income. 

Colin, a Clinical Psychologist and Coach, successfully runs a thriving psychology practice parallel to his coaching practice. He helps therapists, counsellors, coaches and helping professionals of all disciplines move from having an initial idea of wanting to work for themselves to making it a reality. He takes the uncertainty away by setting out a structure for people to follow to ensure solid foundations are laid for their new business. 

Join the live webinar to gain:
– An understanding of the importance of treating your plans for your business as a business if you want to succeed
– Clarity about your “why” for your business
– Reassurance that you can make your dream of working for yourselves a reality
– Confidence that you can take your plans forward, safe in the knowledge that you are not overlooking something crucial for your business development
– Realise the importance of valuing your “offer” so that you price services in a way that will ensure you can make a living from your business dream

Tax Debt and Mental Health

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Rift Refund have produced a useful guide concerning debt and mental health.

It contains helpful information including:

  • Understanding the impact of debt to mental health – the different kinds of debt (e.g. tax debt) and how they can be a key source of stress, depression, and anxiety if not planned and managed properly.
  • Advice for dealing with debt such as setting up a Debt Management Plan or an Individual Voluntary Arrangement (IVA), qualifying for a Debt Relief Order (DRO), or even filing bankruptcy to get some protection and keep life essentials like pension savings safe from creditors.
  • What to do if debt problems begin affecting your mental health. This includes recognising the symptoms and early warning signs of mental health problems associated with debt as well as advice on where to turn to for help and support.
  • Other useful information and resources, including debt charities and organisations that are dedicated to helping people conquer their debt problems.

To read the whole guide written by Tyra Sullivan click here.

Preparing to cope with loss and grief

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Coronavirus is affecting everyone, right across the globe. Nobody is being spared of its tightening grip. As difficult as this is, everyone suffers loss and grief at some point in their lives. There is no right or wrong way to deal with it. It often comes along when you least expect it, so how can you prepare to turn up and give the best version of yourself at this kind of event?

Churchill share an in-depth guide about the bereavement process and how to cope with death and grief. The guide is called “ A Guide To Coping With Death & Grief” by Ellen Wise.

The Therapeutic Power of Writing

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This article is written by Linda Grandes, a cognitive behavioural therapist (CBT) who strives for finding unorthodox forms of therapies for her clients. The Therapeutic Power of Writing. Writing is a form of art and a powerful tool for expressing our deepest thoughts and emotions. Just like any other form of art, writing can help us deal with emotional struggles, negative experiences, worries, and burdens. In other words, writing can be used as a successful form of self-therapy and can have beneficial effects on our mental health. Therapists all over the world prescribe writing as a part of a client’s therapy. If you’re curious to find out what therapeutic powers writing has for our mental health, and why you should try and recommend it to your clients, just keep reading.

Self-Knowledge:

Emotional crises are often caused by our deepest inner struggles, and can’t be solved until we’re able to learn about ourselves. Talking to a friend, a family member, or our therapist is often not as honest as it should be, and people still omit those facts which make them vulnerable and fragile. However, writing can be used as a form of gaining self-knowledge.

To put it simply, therapeutic writing is about:

  • being brutally honest on paper
  • writing freely, openly and without reservations
  • admitting the deepest, most painful detail about your fears, emotions, and thoughts

This way, a person will be able to learn a lot about themselves, which will help them overcome emotional obstacles easier.

Emotional Healing & Growth

There are those situations in which a person needs therapeutic help not to solve a problem, but rather to overcome the emotional barriers they’ve come across. Writing can help a person find emotional balance and stability, and prevent the emotions from taking over their lives. Here’s what they need to do:

  • write about their emotions
  • transfer the negative emotions from their body to the paper
  • take control of them
  • process their emotions through writing
  • get it all out of their system

By dealing with their emotions and writing down anything that has been bothering them, your clients are actually processing the emotions and finding a way to heal. In addition, this will promote emotional growth and allow them to power through a future emotional crisis.

Empowerment

When we’re sad, suffering, emotionally broken, or confused, sometimes all we need is a push in the right direction to get through it. However, not everyone has the emotional support from friends or family, and they need to have their own back. Writing can help your clients find the strength they need within themselves and become aware of their own energy and courage. You can recommend your client to start practising affirmations writing. Affirmations are based on the belief that “a positive mental attitude supported by affirmations will achieve success in anything” (Wikipedia). Here’s how it works:

  • a person writes their own affirmations nurturing a positive attitude towards the world around them
  • affirmations need to be positive and empowering:
  • I am a strong, stable person.
  • Today, I will do great things.
  • I will conquer my fears.
  • the person says the affirmations out loud, for several times in a row
  • it’s best to do them in the morning, right after getting out of bed

Affirmations writing will have strong therapeutic power and help your clients recover their self-esteem and emotional stability.

Confronting Problems

One of the most commonly seen issues when it comes to emotional problems is suppressing them. “Many people state that the biggest issue with solving a problem is admitting that it exists. Most people try suppressing their problems, but it’s impossible to do it long-term,” says Leona Pearson, a therapist, and writer at Studicus.com. Therefore, writing in the form of a journal can help a person:

  • admit there’s a problem
  • define their problem
  • confront it
  • find a way of dealing with it

Solving a problem is impossible until we’ve admitted it’s there and it’s scary. With the power of writing and the possibilities it gives us, it’s easier to come clean with yourself and be open about your issues.

Reducing Stress

Stress is a dangerous feeling of emotional tension and physical unease. It’s known to be the cause of other major health conditions such as increased heart rate, high blood pressure, heart attack, and many other issues. Therefore, it’s important for each person to find a way of dealing with stress, reducing it, and overcoming it. Writing can work wonders for many people struggling with stress and help them lower it or eliminate it completely. This goes especially for creative writing, but stands for any other form of writing, as well. All that the person needs to do is:

  • whenever you feel stressed out, write
  • write about anything that comes to your mind
  • it can be poetry writing, fiction writing, or just a dear-diary type of writing

Try using writing as a form of eliminating anxiety, relaxing, and overcoming stressful episodes of your day.

Final Thoughts 

Writing definitely has therapeutic powers and can be extremely helpful for people struggling with all kinds of emotional problems. It’s a great form of therapy to recommend to your clients and help them improve their mental health. Make sure to read all about the therapeutic powers of writing we’ve provided above and give your clients a relaxing, creative way out of their problems.
BIO: Linda Grandes aim is to explore the efficiency of unconventional treatment methods and guide her clients on the road towards regaining mental health. She is also an enthusiast blogger at Studyton.com and one of the writers at coursework writing service.

Fear behind the symptoms

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For 30 years I struggled with Bulimia/Anorexia. Nothing much changed during that time, the symptoms simply became more pronounced and my fear grew daily.

Then 20 years ago I got a horse, not my idea…my son’s, he was 10. First we were given a pony and then to keep Gus company we got Bronwen. Gus thought I was a piece of his own faeces and treated me as such. I was bitten and kicked regularly, I became good at dodging both but not much else. Bronwen was more respectful, but that didn’t help I was scared stiff of both of them. Bronwen was huge and strong, Gus was small and unnerving.

This was the most amazing start. My fear was well and truly out in the open, it was quickly very clear there was no hiding it from these two…they’d entered my world and I was exposed.

Our mental health becomes disordered the minute we first experience fear, probably before birth but certainly from the moment we’re born. If our experience of fear is not allowed to run its natural course and disperse, then it builds and attracts more fear-filled events which confirm our view that the world is a threatening scary place. Fear lies behind the symptoms of all mental health disorder; if the fear can be located, acknowledged, identified and released, the symptoms can naturally disappear. It is exactly the same for horses, they’re prey animals attuned to fear as a survival strategy; they prevent it wreaking havoc on their nervous systems and general health by releasing it before it reaches the point of overwhelm.

Horses living naturally, with space, company and good grazing know that fear is an essential survival mechanism. They are alerted to danger, they respond and let go when the danger is over. The whole process completes from alarm bells to grounded calm in as long as it takes to be certain that both the environment and other herd members are safe.

Horses in a less natural environment sometimes struggle with overwhelm as their capacity to release fear becomes limited. Without space in which to run free and without close relationships in the community of the herd, they can feel vulnerable and unsafe. The life affirming support and protection of other herd members allows them to completely let go, relax and feel safe.

When we, as humans, enter the natural herd, the horses scan us and skillfully read the energy created by our fear; and yes they do feel and see our fear but interestingly they don’t always respond to it in the way we would expect. Armed with a clear energetic template of our fear, the herd members check in with each other and then the environment to see if they too have cause to be fearful, if no threat is seen or felt in either their environment or the herd’s response they return to grounded calm … why would they do otherwise? They’re safe, the fear is ours, not theirs.

Their innate ability to read our fear is at the heart of the horses’ capacity to heal. The Natural Herd is exactly that, natural, it is working with the rhythm of nature at its very purest. In doing so it heals, rebalances, cultivates, nurtures and nourishes life itself; when we enter the herd we become part of this wonderful healing, rebalancing cycle. How amazing is that!

However, what remains is for us to learn to do this for ourselves and this is where the The Natural Herd Model came into being. We can re-learn; we have always known what the horses know, but forgotten, how to scan for our own fear levels and energetically release fear as we acknowledge, identify and let it go.

At Hopethruhorses we help a wide range of people of all ages and from all walks of life. Each dealing with their own personal set of symptoms. Many come hoping to recover from the devastation and fearfulness of trauma and anxiety or the hopelessness of depression. While others battle with self-hatred and non-existent self-esteem that results in an eating disorder.

​We also do all we can to help improve the lives of vulnerable and disadvantaged children and young people, many of whom have complex emotional, behavioural and social difficulties.

The horses are no exception. Previously unwanted horses and ponies find a home and a purpose in the herd. In return for peace, love and the freedom to become horses again, these magical creatures give themselves to people, and are instrumental to their healing. Clients come to Hopethruhorses to aid their own recovery and in doing so, also to give purpose to rescue-horses.

Written by Joanna Corfield at Hopethruhorses

The Power of Three And Online Therapy

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isoshealth

Life is hectic, so finding therapists who deliver online therapy, who suit you and can fit in with your schedule can be a challenge.

Our friends at isoshealth have come up with a solution to change all that.

Their online healthcare platform allows you to handpick the team of experts you’d like to work with and using digital video technology, brings the sessions into your home at a time that suits you.

You can hand pick your team, comprising of a Dietitian, a Physiotherapist and a Psychologist and can select times for your personalised sessions that fit in around your lifestyle.

You’ll have six 30-minute sessions, two with each expert. Your Power of 3 team works together to deliver a holistic diet, exercise and motivation package which will give you longer lasting results.

Registration is open now or you can visit the website for more information.

The registration process is best suited for your desktop, since this is the best place for you to have great sessions with Health Practitioners.  Grab a cuppa, and get started. The isoshealth team look forward to welcoming you.

Please feel free to connect with the isoshealth team via social media on Twitter or Facebook or for any questions, please #AskAimee.

Are you ok? Don’t miss signs of depression

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By Denise Winn: Denise is a journalist, editor and author specialising in psychology – who has also practised as a human givens therapist since 2000. She tutors a 1-day training course ‘How to lift depression’ for Human Givens College. You may also be interested in the Human Givens online course: ‘How To Break The Cycle of Depression’.

Would you know if someone you care about has depression? Most people probably think that they would, but it isn’t necessarily as obvious as you might expect. Indeed, until some simple screening questionnaires were introduced for GPs to use, half of them were missing the diagnosis in patients that came to consult them.

Suppose, for instance, you have a friend who used to come to a class with you, perhaps sport or dancing or a fine art class. Then one week they don’t want to go. Perhaps they say they have strained a muscle or that they are working late more often. You believe them – why not? Time passes and maybe you call or you run into them in the street and ask if they are going to come back to class. No, they say, they have kind of lost interest, or the injury is still a problem, or they don’t seem to have time. You suggest a meal out one evening. Money is tight right now, they say, but they promise to keep in touch. And more time passes and you suddenly realise that you haven’t spoken for quite a while. Perhaps you feel hurt and think it must be something you said. Or perhaps they have depression.

Very many people will not say that they are depressed or may even deny it. They may manage a smile even though they are feeling deadened inside. But one important tell-tale sign is loss of interest in activities that someone used to enjoy. When people start to experience low mood (perhaps they have had a disappointment or a bereavement or have been made redundant or, for some other reason, start not to feel good about themselves or their lives), they gradually tend to withdraw from social activities. The more time they spend alone, however, the more time they have to dwell on whatever is worrying or upsetting them. The more they dwell, the more hopeless they may feel. They are very often filled with feelings or worthlessness and guilt (because depression gets everything out of proportion) and, unbeknownst to you, may have fleeting or not so fleeting thoughts of killing themselves. They find it hard to get to sleep or to stay asleep, feel exhausted in the mornings and lack motivation to get going with their day. They may comfort eat or avoid eating – both are common symptoms of depression particularly in women, whereas males are more likely to cut off their feelings through drinking or other substance abuse.

And they find it hard to think straight, so that even making unimportant decisions feels overwhelming. Perhaps you notice that they seem less sharp or more tearful. Or maybe you don’t get the chance to notice much at all. So the first alarm bells that should ring are when the person you care about stops engaging in and enjoying whatever used to give them pleasure. This is especially often the giveaway for adolescents in whom symptoms of depression can manifest as negativity, irritability, not feeling understood, behaving antisocially, etc, which may easily be mistaken for ‘normal’ adolescent behaviour.

Depression is a horrible, too often hidden, condition. But the good news is that, once recognised, there are simple, speedy straightforward ways to treat it that don’t require medication.