A mental health journey: Anonymous

Mental health is such a raw subject. I am 22 years old and have struggled through mental health problems since the age of 11. It’s so hard, people underestimate the pain people go through. Having your own thoughts turn against you, you get so impulsive that it makes the world spin. You don’t know what your next move is going to be, will it be a dangerous act against my life or will be an act of self care and self worth? Now that is a question I was never able to answer. I never knew what my day had in stall for me. I never knew if that day I was going to wake up and try to kill myself or I’d go for a nice walk in the park with friends.

I had this devil inside me called borderline personality disorder. This meant that I couldn’t hold friendships, I would make everyone turn against me on purpose. I would purposely start arguments so I didn’t have to communicate properly with people. Now I hate arguments and I can’t stand being around arguments. They scare me and that was caused by my own insecurities. I was so impulsive that one minute I’d be laughing and joking then the next I’d be self harming alone on my bathroom floor. I was so unpredictable to myself but most people would say I was ‘predictable’ even though I never knew what was around the corner for me. I’d go through phases of not eating and starving myself to eating normal amounts and purging all of that up. At one point I was so delicate, I was very poorly and had to force myself to drink endures in order to keep my rights from being on a section and being tubed. Although I was sectioned I still had a choice – eat or be force fed through a tube – now that was when I hit rock bottom.

Why should I be forced to make choices I don’t want to make? Why should I better myself when I’m so worthless and such a horrible person? I didn’t want to get better because I felt like I didn’t deserve a single ounce of it. I was scared of being happy, I thought if I was happy something would soon pop up to bring me down further and further.

Flashbacks that would take me back to horrible events in life that should never have to be remembered. Flashbacks that mentally and physically took over my body, hearing a voice, feeling a sensory feeling. Going paralysed. Banging my head against a brick wall just to numb my thoughts. It was a never ending battle between my body, my abuser and my mind.

But now…

I have an amazing boyfriend. I have a new diagnosis of post traumatic stress disorder as well as bpd in remission. I have a loving boyfriend who reminds me every single day of my worth and how beautiful I am. I have just landed myself a job as a mental health recovery worker. I am so lucky to have overcome everything I have been through, I’d like to thank every single person who was involved in my care and helped me see the light in my darkest of days.

Anon.

Illness=Wellness

Humans are creatures whom thrive when in a group and have support. We like to think we can tackle this work alone but this has a limited life span. In order for us to progress, strive for excellence and succeed, we require the support, knowledge and presence of others.

When we feel ill, we tend to want to cuddle up on the sofa with junk food and be comforted by our loved one such as your mum.

When you face a mental illness, something which many can’t relate too and strains relationships. The support and love can diminish. Not at fault of anyone’s. Mental illness can either strengthen or weaken relationships.

Working within mental health, I’ve seen the effect the illness can have on the individual and those around them. Parents, siblings, spouses, children all get affected. If we have a community around us, we can battle anything.

Being there for someone, allowing them to feel what they are going through, allowing the to feel what they want to feel is the most powerful method of support. Trying to impose or manipulate them into your reality is detrimental. Once we realise that if we remove ourselves completely and focus on the person as a human being separate to us, we support them to be who they are and experience their reality, to which we can then be wholly apart of.

The method of being person-centred will help someone more than if you try and say “helpful quotes” or compare to situations you’ve been through. This tactic doesn’t help, as you as the supposedly listener aren’t listening, your perceiving and marking assumptions on what you think you hear. But if you actually stop and really listen to other person, be in their world, you will understand what they are going through and feel what they are feeling.

Just being there in their reality with them, sharing in their experience, wholly, gives them comfort and confidence. It can increase self esteem, self worth, being comfortable in themselves and aiding them to understand themselves and experience their reality truly in a safe space; free from judgment, perception, opinion, assumptions or feeling like they are being analysed.

This notion is difficult to ascertain and comprehend, as you have to almost be very self aware of yourself, to detach from oneself to become part of another human being, but still keeping your own self identity.

It’s easy to give up and walk away. The situation may be messy, complicated or very emotionally triggering. But by being there, being the listener can help in more ways you may not even fathom.

Male suicide!

Suicide kills more men under the age of 50 than anything else. In the UK someone takes their life every 90minutes. Estimated that for every person who dies by suicide twenty more attempt it. Many people who attempt suicide either want to end it all, or some are grateful that they may be unsuccessful attempts. To prevent suicide, we have to intervene early on. But to do this we have to understand how a person gets to the point of suicidal crisis. Everyone goes through things such as bad relationships, guilt over their children, financial or employment crisis etc, and these all can make you relate to suicidal thoughts. Therefore no one is immune to the effects of suicidal thoughts.

Typically research into the cause of suicide mainly looks into mental illness as the main explanation. It is seen if you have family members whom have a mental illness such as depression etc, or an unstable up-bringing this can make you more susceptible to mental health issues and possibly suicidal ideation. Children as young at 6-7yrs old can experience a first episode of psychosis; auditory or visual hallucinations and paranoid thoughts etc. At this age they often keep it to themselves as they are scared, but this can lead to mental breakdowns. Also other disorders like depression&anxiety or bipolar can occur. This can mean young children will often feel low for periods of time, and if not treated they can develop into suicidal ideations, which they may act upon. Suicidal thoughts don’t just occur for adults who’ve lived a life, it can occur in anyone, at any age. Many people live their life daily, with suicidal ideations, but it’s how they manage these thoughts which is the important point. According to research, people with a mental illness are 30 times more likely to commit suicide than the general population. The Beck’s cognitive triad is often what see occurring in individuals whom struggle with suicidal ideations.

Trying to predict and prevent suicidal attempts is unfortunately heartbreakingly difficult. Even though mental illness is a major factor, many people with a diagnosed mental illness may never have suicidal ideations. A worrying notion is there maybe twice as many people in the general population whom have suicidal thoughts, but aren’t in contact with mental health services. A survey conducted by Men’s Health magazine in November 2017, had 15,000 male responders. 56% admitted to having suicidal thoughts. This does not mean that 56% of the men whom responded are mentally ill. Nonetheless, it highlights that men are struggling with these thoughts, and something needs to change in the current services and society. 70% of the respondents admitted that their own physical health is not good. One conclusion from the survey was, there is a conflict in masculinity; that men today pride themselves in the idea of the “new man”. But men are in general struggling to reconcile that, with the old thought that men are tough and strong. Men identify themselves with their career and this helps with their self esteem. Some men still believe they should be the main breadwinner of the family and struggle to reconcile these ideas together. This can lead to panic, isolation and withdrawal from society. However , despite these difficulties, men aren’t unaware of these issues and the effect upon them. 69% were good at identifying markers in their mental health, family, friends and intervening to help remedy it. Whilst being unable to identify they have an issue and acknowledge it. It is seen, people are aware of the type of services available in the local community, but men often feel unable to approach such services; battling an internal dialogue between the man they feel they should be, compared to the man they want to be. Men often find it harder in general to ask for help than women.

Furthermore trying to understand the cause of suicide, can be difficult as the there are differing rates of suicide across the UK. Interestingly, the northern part of England has the highest suicidal rate. Therefore, can your risk of suicide be linked to where you live or were brought up? Statistics show if you live in the north east, you are 35% more likely to die by suicide than if you live in London. The main reasons for suicide found in the North were attributed to; bereavement, finance and relationships breaking down. But these are not the sole causes. Research shows that individuals within the lowest socio- economic group in the most deprived areas are 10times more likely to die by suicide than those in the highest socio-economic groups in the most affluent areas. Also, if someone doesn’t have protective factors and a strong network of people around them, they are likely to feel alone and isolated, which can lead to suicide. One major factor as a cause of suicide, is if you know of someone who is close to you, that has taken their own life.

Men often feel like they are living a double life; a confident stable person vs someone who is struggling daily with personal issues. Because of this men find it hard to articulate how they are feeling, bottling everything up. It has been found even though more women attempt suicide than men, more men die by suicide compared to women. Research highlights that men use more lethal and life ending methods of suicide than women. Men’s physical pain capacity and tolerance is higher than women. Overtime a males pain tolerance increases overtime. So if men engage in risky behaviours like self harm and experience traumatic events, this may elevate their pain tolerance. Men can become more emotionally isolated than females, as they invest emotionally to a smaller set of people compared to females, whom often have a larger network of support.

However, knowing all these risk factors, it doesn’t help us understand who will take their own life. Therefore without this foresight, it can be difficult in preventing suicidal deaths. Different people require different methods of help. Research looking into the interactions between multiple risk factors and the chance of suicidal death, are able to predict the likelihood of successful/unsuccessful attempts of suicide up to 90% accuracy. This can help us understand when to intervene to prevent suicide. However this is based upon a computer algorithm, which analyses a vast amount of date and factors. Therefore, can a healthcare professional rely solely on a machines diagnosis?

Changing the general populations outlook towards suicide, may help reduce suicidal rates. In America, they have a system where they ask the primary healthcare professional to screen each patient every time they see them, to find out if they have had any suicidal thoughts. Each patient who is seen as a risk is then referred onto the appropriate care/service. In addition, the patient formulates “Rescue Plans” for when they reach crisis point. It was found, that the suicide rate in the local community decreased by 80% and for a few years it was 100% effective, with no suicides reported. If we are more proactive and change the attitude towards suicide, we are more likely to prevent suicidal rates increasing. However, individuals in the lower socio-economic groups who often don’t visit any health services in the US, are still at a higher risk than those whom are able to afford healthcare.

Currently in the UK the governments target is to reduce the deaths by suicide by 10% before 2020. But many believe we should have a bigger goal than 10%. Zero suicidal alliance has the goal of bringing the initiate the US are using of ‘zero suicide’ to the UK. It’s aim is to apply and use the resources we currently have in a more useful way, to prevent people reaching a crisis point. So far nearly all the NHS trusts across the county have signed up for this initiative. However, there is still a lack of funding for research in the mental health sector and for suicide research.

One preventive method in helping others is talking and asking questions like “are you ok?” or “are you suicidal?”. By starting this open conversation, people feel supported and protected. People than feel listened to and their feelings are validated. As small as asking these questions, may save someone’s life.

Let’s face it together!

To learn and progress in life we have to sometimes do things that are outside our comfort, confront difficult situations and emotions. However, the more we face, the more likely we will find it easier the next time. All these “pills” are hard to swallow but even accepting one can lead to a chain reaction of being able to cope with the rest. Each one is making a small change to our lives, which will benefit us for the long term.

When someone has a mental illness such as depression and anxiety these steps can seem impossibly large and unattainable. This can be for many reasons such as past experiences, lack of support around them or current situations.

If we offer help, guidance and an ear to listen to them, we can help those whom need encouragement to take steps, take the first step.

Misconceptions of mental illness

Mental illness is more than what you see. Mental illness is deeper than it’s felt. Mental illness is harder than people know.

In today’s society, even with all the knowledge the world can offer, at our fingertips. We can still be ignorant to some topics. Mental illness is one vast area which still is shrouded in questions, misjudged, but everyone thinks they understand it.

We use throw away comments like “I feel depressed”. But what actually does it mean to “feel depressed”.

If we stop and think, learn about illnesses which are becoming more and more prevalent in our communities. We will find a large amount of people facing difficulties we never knew existed, feeling isolated in a crowded place and struggling to find hope.

As with physical health conditions, mental illness is equally as complex.

Lets look beyond what we see and think.

You never know…

As humans we judge a book by its cover before we open the pages and explore it further. If we did, we would find their are deeper layers, complex thoughts and intense feelings that are shaping the outcome of the book. This analogy can be used in how we perceive others in our lives. They say it takes 10secs for an individual to make up their mind about another person. 10secs?? Is this fair?

This innate judgement is within us, we often have little control over it. But like the book if we take the time to get to the know the person, understands their thoughts, feelings and personality, we may find we change our view on them.

Change is something we are privy to and can do with ease. It doesn’t cost anything, but does require a sacrifice. This is something we can control.

For example when meeting a person for the first time, automatically we will judge how they look in relation to ourselves. But than we start talking to them and find they may not be what we expected. I can almost say this is 100% fact for every single person and it’s happened to everyone.

But the real test is how we then go on treating that individual. Do we realise our misjudgment and go out of our way to be kind and befriend the individual. Or do we stick with our initial thoughts and treat that person accordingly.

The saying goes we are all onions with many layers. Humans are very complex people. We have no idea what is going on in anyone else’s life other than our own. So why do we think we do know and make assumptions. I go through life on this premise, that we are more than surface deep, so give people time and get to know them. However I have observed that this notion is ignored many people, they only look superficially and this I find is where problems arise. I don’t expect everyone to explain their life story to others to avoid judgment. But for people to be more open minded and understanding.

“ often the loudest person in the room is often the most hurt and fragile”

This oxymoron that shouldn’t make sense, makes complete sense. Think about it.

It Hurts’

Trigger Warning!
Contains sensitive information, topics discussed such as suicide and self-harm. Read with caution. If anything causes you concern, you are welcome to email me or reach out to a mental health helpline. 

As we grow and develop, we identify our strengths, weaknesses and strive to make improvements. In doing so, we learn and develop coping strategies which help us cope with daily life and certain situations. These strategies can be learned in a variety of ways; taught, instinct, or copied from another individual. Most of our behaviours are adaptations of other peoples’ behaviour. As humans we survive by seeing what others do and adapt it to ourselves, to make it work in our reality. We learn, implement and adapt the behaviour to the circumstance/environment around us, a survival technique. This highlights our basic human instinct to survive and cope in an ever-changing world.

One coping strategy, which is self-destructive in nature and irrational is self-harming. The act of self-harm is to relieve pain, distract current thoughts and feelings. It is a learned behaviour, with the intent of either gaining attention of others and/ or cope with feelings. Self-harming behaviours can be misinterpreted as someone who is actively suicidal, this is not always the case. This behaviour is a cry for help, an indictor the individual is unable to cope and needs support. It’s not easy for someone to ask for help, so they find other ways to communicate this, and unfortunately, harming oneself can be one way. In addition, the inability to cope with, or regulate emotions, can trigger someone into thinking and acting upon self-harming.

As you can see there is not one reason why someone self-harms or a clear answer to the cause.

Self-harming is an external representation to an inner conflict or pain an individual is feeling. The behaviour is symbolic in nature. The abrasion of skin causes pain, which is a re-focus of current thoughts/feelings or to numb emotional pain. The release of blood is a representation of relief from the pain and releasing it from your body. Finally the instant reinforcement following the behaviour, leads to regular occurrence of the behaviour.

Here it’s important to recognise the individual is suffering. However, this psychological symbolism can become addictive and often leads to vicious cycle of self-harm.

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As with anything in life we become habituated to it, so we increase the intensity of the behaviour to continue to feel the same sensation and emotional release. So, understanding why an individual self-harms, contributes a major part in supporting an individual in crisis.

There is not an exhaustive list of types of self-harm but the common few are: – tying ligatures, headbanging, lacerations to forearms and upper thighs (other parts of the body also). Other types which may be less obvious are: – refusing medication, self-neglect, excessive or absent in eating, drinking fluid or attending to personal hygiene.

Self-harming is not a mental illness, it’s a behaviour related to emotional pain associated often with a mental illness. As stated previously, its an irrational coping mechanism, learned from others. It’s very difficult to change this behaviour pattern once learned and engaged in. As the therapeutic nature the individual gains from engaging in the behaviour, is often impossible to achieve from other coping strategies. But does not mean we condone self-harming behaviours.

Behaviour change is one of the most difficult challenges humans may face. Barriers to change include; not feeling the need to change, fear of consequences and being comfortable with current behaviours. The main reasons behaviour can be changed is because the individual is willing to change and recognises the need. If these components aren’t present you can’t expect someone to change their behaviour, upon request. A method which is used, in replace, is to hinder the individual from conducting in the behaviour. This may be to remove any items, which can be used inappropriately, monitoring the individual closely and intervening when they engage in the behaviour. However this is effective in the short term, its ineffective long term.

Therefore, understanding this, when supporting an individual whom is self-harming the goal is to help them recognise its an irritational coping mechanism, and how it can be changed.

Pause
Think about your coping mechanisms, would you willingly change them, and how easy would that be?
Answer- Probably wouldn’t want to change them, so remember this when you assume another person should change theirs. Understand the difficulty and work within the constraints of this.

Why fix something which isn’t broken?

The argument here is as much as the behaviour works for the individual, self-harming can cause an individual to feel more pain, guilt, emotional anger and torment and the individual can lose themselves to self-harming. When an individual is self-harming, they feel instant gratification and the behaviour is rein-enforced at this point.

Understanding the reasons for self-harm is one hurdle, understanding the cause/triggers can be difficult. Many situations, feelings and thoughts can trigger someone to engage in self destructive behaviours. Causes which may lead to self-harming are: – Bullying, PTSD, psychosis, visual/auditory hallucinations, unable to regulate emotions, trauma, depression and anxiety, stress and fear. This list is by no means exhaustive.

Self-harm is associated with females but is equally as prevalent in males. This lack of awareness may mean male individuals don’t ask for help, due to the fear of being judged. As self-harm is commonly associated with the inability to regulate emotions, and historically males are seen to be the stronger gender who aren’t as emotional as females. Interestingly, males whom self-harm may not be taken as seriously as a female whom is self-harming. Which may lead to a rapid decrease in mental state, and often suicide. As discussed in a previous blog about suicideBanned from speaking about Suicide!!!, male suicides are increasing.

Self-harm can lead to suicide in some cases. This is due to many factors, like the one discussed above. But also, because the gratification we first feel, goes away so the intensity increases to harm more frequently and more seriously to recreate the feeling. For example, if an individual begins with lacerating their forearm, they may cut deeper each time using sharper objects to achieve the relief, as they become numb over time. This can present as a rapid decline in mental state, as more serious attempts to self-harm, the individual may begin to have suicidal ideations. These can than manifest and attempts on their life will occur.

As much as self harming is used to escape pain or trauma. It’s also used in the intent to cause pain as a form of punishment. Often when an individual is feeling guilty, upset or angry towards a certain situation, overtime the feeling of resentment can occur, causing it to be directed upon oneself. For example if an individual has suffered abuse in their past they initially will be upset when they think about the memory. But overtime and with overthinking, they redirect the sadness and it turns into anger. This anger is associated with the abuser, but the individual will begin to think and convince themselves into being angry at oneself. This anger towards themselves, that for example it is their fault they got abused, causes inner pain that is difficult to cope with and confront. As the individual is unable to cope with this inner conflict, irrational behaviours are conducted to help solve the issue. One such behaviour is self harming. As described above it allows the individual to feel gratification but also a sign of punishment.

This scenario is very common, it’s often the driving force for many incidents. It’s not often obvious that the individual is self- punishing. But with support and understanding this can become clear. Here the way in which to support someone is to deal with the inner conflict first and make steps towards solving the problem. Until this has begun the punishment behaviour may not subside.

It’s the one thing I have control over!

Today’s society is fast paced, instantaneous and unfulfilling. People are judged and criticised more easily. Knowledge is at our fingerprints. But in amongst all of this we have little control of our lives. Most people are preoccupied with what next rather than what’s happening now.

For an individual with mental health issues, their ability to cope may be limited. Understanding and maintaining strategies can be impossible. So they seek areas in their lives they can control, only they have the power and no one can take this away. We see in individuals with eating disorders, it’s control of one aspect of their lives where they have the power to control. This is the same for individuals whom self harm, they are in control of this behaviour. They steer it and power it’s intensity.

When someone is self harming they are in control of the narrative; how deep to go, where they self harm, type of self harm etc. As much as self harming can be impulsive and an urge to be fulfilled. It also gives the individual power, power which they know another person can’t take from them. This can be used to their advantage, using self harm to their benefit and gain. In addition, it’s a form of emotional blackmail.

{It’s important to note that people who self harm aren’t being judged or critiqued for their behaviour}

Associations

As described at the beginning of the blog, there is a psychological symbolism linked to self harming. An irrational cycle is formed and difficult to break.

As human beings our behaviours are learned very much through positive and negative associations. We are more likely to engage in behaviours which have positive associations than negative. This may be obvious but we need to mindful that not all positively associated behaviours are actually “positive” behaviours. This notion stems from the infamous study conducted by Pavlov “Pavlov’s dog”. Here Pavlov created a positive association between hearing a bell, leading to a bodily reaction, with a positive outcome. This simple notion is the basis for all our behaviours. So using the same framework we can apply it to self harm; urge/impulse to self harm, engage in self harming behaviours, leading to instant gratification. The outcome here is positive as the urge/impulse has been fulfilled and you no longer have the desire. But for how long?

 

An attempt to break the cycle can cause further anguish and distress, so the individual reverts back to self harming to cope with the distress of change. However breaking the cycle isn’t impossible. Consistent and persistent. These are the two most important elements to any behaviour change. Anything we do in life we will succeed if we remain consistent in our actions and motivations and continue with it no matter. To be consistent you have good persistence. In order to be persistent you have to be consistent. Here I’m not trying to trick you with a philosophical idea , I’m showing the two go hand-in-hand.

Distraction Techniques

  • Keeping a diary
  • Listening to music
  • Safe self harming
  • Art/crafts
  • Doing some exercise
  • Going for a walk
  • Talking to someone
  • Breathing techniques/ Mindfulness
  • Grounding techniques
  • Delaying self harm

All the above and many more can be used as effective techniques to refocus your thoughts and train your mind to think differently.

Delaying self harm

Here you wait five minutes before you self-harm. This can be very challenging but very rewarding. Overtime you gradually increase the time gaps between each time you self harm. This is used to help resist the urge or sudden impulse to self harm. Re-training your mind and the associations made to self harm.

Grounding Techniques

  • Name 5 things you can hear
  • Name 4 things you can see
  • Name 3 things you can smell
  • Name 2 things you can feel
  • Name 1 thing you can taste

This technique, though vey simple is very effective. It works by re-focusing the individual back into the enviorment they are in. Breking the cycle of thoughts they may be lost within.

Breathing Techniques

  • Take a deep breath in, hold for 3 secs and take a deep breath out ( repeat as many times as needed
  • Tense all the muscles in your body, than slowly focus attention on one muscle and relax it. Work you way throuh the entire body relaxing each part. During this take slow controlled breaths.

 

Mental health helplines

Whether you’re concerned about yourself or a loved one, these helplines and support groups can offer expert advice.

Anxiety UK

Charity providing support if you’ve been diagnosed with an anxiety condition.

Phone: 03444 775 774 (Mon to Fri, 9.30am to 5.30pm)

Website: www.anxietyuk.org.uk

Bipolar UK

A charity helping people living with manic depression or bipolar disorder.

Website: www.bipolaruk.org.uk

CALM

CALM is the Campaign Against Living Miserably, for men aged 15 to 35.

Phone: 0800 58 58 58 (daily, 5pm to midnight)

Website: www.thecalmzone.net

Men’s Health Forum

24/7 stress support for men by text, chat and email.

Website: www.menshealthforum.org.uk

Mental Health Foundation

Provides information and support for anyone with mental health problems or learning disabilities.

Website: www.mentalhealth.org.uk

Mind

Promotes the views and needs of people with mental health problems.

Phone: 0300 123 3393 (Mon to Fri, 9am to 6pm)

Website: www.mind.org.uk

No Panic

Voluntary charity offering support for sufferers of panic attacks and obsessive compulsive disorder (OCD). Offers a course to help overcome your phobia/OCD. Includes a helpline.

Phone: 0844 967 4848 (daily, 10am to 10pm)

Website: www.nopanic.org.uk

PAPYRUS

Young suicide prevention society.

Phone: HOPElineUK 0800 068 4141 (Mon to Fri,10am to 5pm & 7 to 10pm. Weekends 2 to 5pm)

Website: www.papyrus-uk.org

Rethink Mental Illness

Support and advice for people living with mental illness.

Phone: 0300 5000 927 (Mon to Fri, 9.30am to 4pm)

Website: www.rethink.org

Samaritans

Confidential support for people experiencing feelings of distress or despair.

Phone: 116 123 (free 24-hour helpline)

Website: www.samaritans.org.uk

SANE

Emotional support, information and guidance for people affected by mental illness, their families and carers.

SANEline: 0300 304 7000 (daily, 4.30 to 10.30pm)

Textcare: comfort and care via text message, sent when the person needs it most: http://www.sane.org.uk/textcare

Peer support forum: www.sane.org.uk/supportforum

Website: www.sane.org.uk/support

YoungMinds

Information on child and adolescent mental health. Services for parents and professionals.

Phone: Parents’ helpline 0808 802 5544 (Mon to Fri, 9.30am to 4pm)

Website: www.youngminds.org.uk

Abuse (child, sexual, domestic violence)

NSPCC

Children’s charity dedicated to ending child abuse and child cruelty.

Phone: 0800 1111 for Childline for children (24-hour helpline)

0808 800 5000 for adults concerned about a child (24-hour helpline)

Website: www.nspcc.org.uk

Refuge

Advice on dealing with domestic violence.

Phone: 0808 2000 247 (24-hour helpline)

Website: www.refuge.org.uk

Crime victims

Rape Crisis

To find your local services phone: 0808 802 9999 (daily, 12 to 2.30pm, 7 to 9.30pm)

Website: www.rapecrisis.org.uk

Victim Support

Phone: 0808 168 9111 (24-hour helpline)

Website: www.victimsupport.org

Eating disorders

Beat

Phone: 0808 801 0677 (adults) or 0808 801 0711 (for under-18s)

Website: www.b-eat.co.uk