You do not have to use crisis as the threshold. A more useful question is whether the problem is beginning to cost you something: more energy spent managing your thoughts or emotions, avoiding people or situations, disrupted sleep, difficulty concentrating, repeated reassurance or checking, struggling to keep up, or feeling that your choices and everyday life are becoming narrower. Support can be useful while you are still functioning — and earlier support may make patterns easier to understand and change.

No. You can start with the experience that most closely describes what is happening. An appropriately qualified practitioner can help you understand the pattern and, where necessary, recommend further assessment or a different level of care. Some concerns — particularly suspected bipolar disorder, psychosis or schizophrenia — warrant specialist assessment rather than trying to work out the diagnosis yourself.

No. Intrusive thoughts are unwanted thoughts, images or urges that enter your mind and may feel frightening, disturbing or inconsistent with what you actually want or believe. Psychosis involves a more significant change in a person’s experience of reality and may include hallucinations, strongly held delusional beliefs or disorganised thinking. Obsessive thoughts can occur alongside different mental health conditions, however, so professional assessment is useful if you are unsure what you are experiencing.

Medication can form part of treatment for some forms of depression and anxiety and is particularly important in the management of some bipolar and psychotic conditions. In South Africa, psychologists do not prescribe psychiatric medication. A medical doctor — such as a GP or psychiatrist — can assess whether medication is appropriate and prescribe within their professional scope. You do not generally need a referral from a psychologist before seeing a doctor or receiving a prescription. Doctors and psychological practitioners may, however, refer to and work with one another when combined care is useful or when symptoms require more specialised assessment.

Seek urgent medical or psychiatric help if there is immediate danger to you or someone else, suicidal intent or serious self-harm risk, severe confusion or agitation, new hallucinations or delusional beliefs, a significant loss of contact with reality, or a marked change in mood, sleep, energy and behaviour that is becoming unsafe. In these situations, a routine Headroom session should not replace urgent care. Please use Headroom’s Emergency Contacts information for appropriate services.