I'm looking for a recommendation of a good mental health care professional. I have a friend who believes he is suffering from depression. He has tried numerous things, including changing his diet and yoga, but there is a blockage. I believe he really needs to see a recommended mental health care professional but he despairs of finding anything over here. He is a long-term resident of France and speaks good French. He lives in the Haute-Pyrénées but would travel. Thanks.
It is a tough cookie. We used to have a group on SFN 'Mind Matters' in which this question did arise. The group was started by a manic depressive, bi-polar if you must. Some of us who have or have had depression problems of any kind were in the group got into this. Before I say what it is, the same thing as I am about to say also happens elsewhere. I have a Down Syndrome daughter who has no mental health problems but gets the same treatment.
Mental health and 'special needs' are medicalised here in France. Donna gave a brilliant answer BUT it is not that way here. If people go to their doctor, as one should to be passed on, the first solution from him/her is likely to be a prescription for lots of anti-depression medication. Then one might get the prescription for a psychiatrist or psychologist. However both will tend to treat mental health issues as an illness. Which is what they also do with my daughter's genetic disorder. It is something ingrained in a medical system that makes me grate my teeth although I consider French health services generally second to none (with some exceptions).
We stuck with how conditions of the mind which are beyond medicine are viewed. In the UK the psychoanalysis school in the line of Freud dominates, it has generated extensive and highly contested debated with regard to its therapeutic efficacy. Psychiatry uses that to complement its medication as therapy which aims to control and aid cure wherever that is possible. France is imbued with Jacques Lacan's use of and at the same time opposition to Freud. In the UK psychiatry uses interdisciplinary approaches that combine social, biological and psychological perspectives in attempt to understand the nature and treatment of mental conditions. In France they are less likely to include the social aspect, thus are less concerned with the causality and more with the therapy. For the therapy to work the patient must be subdued in order to follow the direction chosen by the psychiatrist who will then set the direction and method for therapy. Both, however are by degrees generous with medication. France more so.
So, the solution is to shortcut the system and go for psychotherapy directly. That means paying since unless the prescribed route that starts with your medical practitioner gets one there through the psychiatry or medical psychology route. It is, I gather, very expensive and finding a good one requires patience and finding out from people who have had the experience. We had people in the group say things about that. I could only be thankful that my own, stupidly self-induced by use of a popular substance that went wrong in the 1960s, was taken on by an excellent analyst whose Laingian methods were then considered controversial but got me there in the end. What Donna is describing as a diary was one of the things I had to do, indeed not that difficult except when I was up and manic and all but running around walls at times, but eventually became a routine that my analyst got to grips with from the word go. I have been anti-medication since my bad experience, refused all uppers and downers and had to repeatedly tell myself not to just curl up, stare at the ceiling and give up. It cost me a marriage because it is not easy for somebody living with it.
So, my message is to try to keep your friend out of French psychiatry unless all other hope is lost. Try to find a way to help him get a good analyst/therapist without being sent to your nearest CMP at least. I still reflect on what my analyst said, which was that so-called mental health is not about any form of illness but is about conditions of the mind that come about for a multitude of reasons, that share few common attributes (symptoms as medical people will call them) and all require hard work from the person with a condition that is examined, analysed, understood and guided by the therapy. Well over 90% can be resolved but, as he also said, we hear too often about the people we refer to as 'insane' who are very often dangerous and not those who recover.
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I can give you details of a great cognitive/gestalt therapist who does sessions via Skype if that's of interest.
Email me for details.
http://www.nhs.uk/conditions/Cognitive-behavioural-therapy/Pages/Introduction.aspx
http://www.counselling-directory.org.uk/gestalt-therapy.html
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In Haute Savoie it's the Centre Medico-Psychologique which is operated by the Etablissement Public de Sante Medicale. I don't know whether the same regime exists throughout France, but I did notice another CMP when travelling in the Vosges
Thanks, Chris, for such a positive response! What is the CMP, please?
No need to despair! I was struggling with depression 3 years ago and was advised by my French GP to self-refer to our local CMP. There I was speedily assessed by a mental health nurse and in a short time saw a psychiatrist who diagnosed bi-polar disorder and prescribed medication which I'm still taking. At the same time I started a course with a psychologist who offered weekly sessions of 45 minutes which continued until I left France recently. Both treatments were free of charge on production of my carte vitale. I had had problems before I went to France, but found the response and treatment available there far superior to that offered in the UK. So find out where your local CMP is and contact them to discuss the options.
Thank you Donna
My daughter suffers from depression and it is so difficult to watch her exhaustion. Summer was ok because she kept busy with various non school activities but on Friday after only 4 days in the internat she came back home wiped out. Her psyciatre or how ever you spell it doesn't offer her any practical solutions.
Thanks, John. I will have a look.
Thanks so much for this, Donna. I will send all this to my friend x
Hello
Sorry to hear your friend is suffering from depression. It is a very black and debilitating illness if left and not treated adequately. I only have limited knowledge of mental health services in France and understand that things like mental health multidisciplinary teams are quite sparce in rural areas but in cities your friend may be more lucky.
I am a qualified psychiatric nurse so obviously know a great deal about mental health ( uk ) I would think your friends first port of call is his Gp to ask to be referred to a psychiatrist for a diagnosis ( not that I want to label anyone but to get the right medication if needed ) then ask or seek a good qualified therapist. Cognitive behavioral therapy plus meds have proven effective treatment for depression in the UK.
Physical exercise as well as a healthy balanced diet is also good for depression.
Good sleep hygiene to make sure your friend has an adequate and restful sleep pattern.
Cut down on coffee and or other stimulant drinks ( or gradually stop drinking them all together ) don’t drink these type of drinks after 6 pm. No computer works before bed especially games. Take a nice warm relaxing bath ( if he has one ) before bed.
Our mood is inevitably linked to our thoughts which when depressed can be quite negative and despairing. A change in our mood usually indicates a negative thought. Keeping a dairy of our mood during the day for a few days will pin point the changes. Look back at what you were doing ( I use the term ‘you’ as an instruction guidance ) who you were with, where you were at the time of the change in mood and try and recall what was going through your mind. ( this is difficult to do but gradually you will note a change of mood and you can then recognize the negative thought that just crossed your mind. ) rate this thought out of 100 of how much you believed it at the time. Then again when writing the dairy. You will note the figure will usually come down a bit. Then try and rationalize the thought by questioning your own belief system in that fleeting thought at that moment in time. Again re score and you’ll find the figure has dropped significantly. You will soon realise that when depressed our thoughts are irrational and have no or very little fact to them.
This will then become an instant technique without having to write it down. By doing this our negative thoughts become less and less and replaced with more positive realistic thoughts and hence a more positive mood.
I’m glad you are supporting your friend. This is a great help in its self knowing you are not alone.
Having suffered from depression myself I know first hand the dark cloud that descends around your shoulders and feels a great weight that can’t be lifted. Having emotional support from loved ones is a great comfort and source of encouragement when times get rough.
Hi
The Connexion newspaper has some ads for therapists in various parts of the country
regards
John