What we treat

Persistent worry that is hard to switch off, often with physical symptoms such as a tight chest, restlessness, poor concentration or disturbed sleep. Anxiety responds well to treatment, and it responds best when the talking work and, where appropriate, medication are used together rather than one at a time.

Intense fear of being watched, judged or embarrassed in front of other people. It often gets misread as shyness or rudeness, and it tends to shrink someone’s life quietly over years. Treatment usually involves gradually rebuilding the situations that have been avoided, with support while that happens.

Sudden surges of intense fear with strong physical symptoms: racing heart, breathlessness, shaking, a sense that something catastrophic is happening. Many people reach a first appointment after being checked for a heart problem and told nothing is physically wrong. Panic is treatable, and understanding the mechanism is a large part of it.

Anxiety tied to a specific situation where you have to perform or be evaluated: presentations, exams, interviews, sport, music. It is common in people who are otherwise confident, and it usually responds to a focused, practical approach.

Low mood that has stopped lifting, along with loss of interest, changes to sleep and appetite, low energy, and difficulty seeing a way forward. Depression is not a character weakness and it is not something to wait out. It is one of the conditions where the combination of therapy and medication has the strongest track record.

A broader group covering persistent low mood, mood that swings more than it should, and mood that does not fit neatly into one diagnosis. Part of the work of a first evaluation is establishing which pattern you are actually dealing with, because the treatment differs.

Episodes of elevated or agitated mood alongside episodes of depression. It is frequently identified late, because people tend to seek help during the depressed phase and the elevated phase does not feel like illness at the time. Careful history taking matters here more than almost anywhere else, and long-term monitoring is part of good care.

Unwanted, intrusive thoughts that cause real distress, and repeated behaviours or mental rituals carried out to reduce that distress. The relief each ritual brings is short, which is what keeps the cycle running. OCD is often hidden for years out of embarrassment about the content of the thoughts. It is a well understood condition with established treatment.

Difficulty regulating emotion, unstable relationships, a shifting sense of self, and strong reactions to real or feared abandonment. It carries an unfair reputation, including among clinicians. It is treatable, people do get better, and the working relationship between client and provider is a large part of why.

Emotional responses that are more intense, longer lasting or harder to settle than the situation calls for, and that are getting in the way of school, work or relationships. It is often the presenting problem in younger clients before anything more specific becomes clear.

Trouble falling asleep, staying asleep, or waking far too early and not getting back. Sleep sits underneath almost every other mental health condition, in both directions: poor sleep makes everything worse, and most conditions disturb sleep. It is worth treating in its own right rather than treating it as a symptom that will clear up on its own.

Sustained pressure that has stopped being manageable, from work, caring responsibilities, money or all three at once. Stress is not a lesser problem than a formal diagnosis. Left long enough it turns into one, and it is easier to address before that happens.

Grief is not a disorder and most people do not need treatment for it. Support helps when grief has become stuck, when it is not shifting at all after a long time, or when it has tipped into depression. There is no schedule you are supposed to be keeping to.

Refusal to attend, falling grades, conflict with staff, or withdrawal from friends. School problems are usually the visible edge of something else, most often anxiety, low mood or difficulty at home. The useful question is what the school problem is telling you.

Mental health concerns connected to hormonal changes, pregnancy and the period after birth, fertility, and the menopausal transition, as well as the particular pressures that fall more heavily on women. These are frequently dismissed or attributed to something else before anyone treats them properly.

Support for the mental health effects of abuse and violence in the home, whether current or in the past, including physical, emotional, sexual and financial abuse. Support here is confidential within the limits set by law, and you will not be pushed to make a decision you are not ready to make.

If you are in immediate danger, call 911. The National Domestic Violence Hotline is available on 1-800-799-7233, or text START to 88788.

Weight and mental health affect each other in both directions. Low mood and anxiety change how people eat and move, several psychiatric medications cause weight gain, and carrying that weight then feeds back into mood and self-image. Weight is treated here as part of the clinical picture, not as a separate issue or a matter of willpower, and any medication plan takes it into account.