View source for Coping with psychological problems

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== What, Why & When ==
The contents of this entry are meant to provide you with support in psychologically challenging times. We'll give you a structured way of getting help as well as provide tips on what you can do for yourself.

== Goals ==
Help you to be well.
<br><br>
'''Disclaimer'''
This article is based solely on our own experience and research. When using the first person singular below, it is the authors own experience, whereas ‘we’ means that the Wiki team sprinkled in their experiences. Thus, this page can and should not be a substitute for professional support. Nonetheless, we hope to provide you with some valuable resources that can provide some help in challenging times. It is also mainly written for students in Lüneburg, and therefore has local context. We hope it might still be helpful to others.

If you have urgent and acute psychological problems, please contact one of the professional points of contact below!

'''Institutsambulanz der Psychiatrischen Klinik Lüneburg (PKL)'''<br>
Am Wienebüttler Weg 121339 Lüneburg<br>
Tel. (04131) 601 16 00 oder<br>
Tel. (04131) 601 16 22 (Aufnahme)

'''Psychiatrischer Krisendienst am Wochenende'''<br>
Tel. (04131) 602 60

'''Sozialpsychiatrischer Dienst Lüneburg'''<br>
Am Graalwall 4
21339 Lüneburg
Tel. (04131) 26 14 97

== Introduction ==

Sometimes, changes beyond our own control can impact our mental well-being to the extent that we are unable to cope with it just by ourselves. Many of us have never been taught how to cope with mental hardship, and societal norms of individualism and toughness can make it hard to acknowledge that at some point, we can simply not carry on with our lives using our usual coping mechanisms. 

The pandemic amplified these issues manyfold, and we know how many students are currently struggling with their mental health, especially when university, jobs and life are still setting high demands on our ability to "function". We know this is for many parts a societal problem. Nevertheless, if you feel depressed, anxious or overwhelmed at any one moment, you have little options but to start with yourself. This is why we want to provide this article: as a means to help you get through difficult times.

We offer two resources here.

The first is a guide on how to get professional help. From our experience, this can be one of the hardest things to do when you're already down, and the existing health care systems don't make it easier to actually find support. Here, we tried to collect resources and mould them into a step-by-step instruction to help you find professional help as straightforwardly as possible.

The second is a set of practices and perspectives we found helpful to cope with mental issues ourselves, which you can start implementing right now. This is important for two reasons. For one, they can help you get a little better. Additionally, they may help you to find the strength which you need to get professional help.

This is a personal topic, and it might feel a bit awkward to use university resources for this. We can't really circumvent that, but still hope that this might provide you with some kind of help. We wish you all the best!

== Getting professional support ==

Getting professional help is by no means easy, but it is very possible. Below, we tried to draw an overview on how this can work. The truth is that the medical system is messy and reality might be a little different. Still, sticking to some form of structured process should help you in getting professional support. Here's an overview:

<br>[[File:Finding a therapist.png|600px|center|finding_a_therapist_overview]]<br>

There’s three things you can do besides going for a full therapy which may already help: 

A) Finding a frame for yourself to better understand that having a mental illness is not your responsibility or fault. 

B) Getting psychological counselling from the Studierendenwerk (if you’re a student in Lüneburg)

C) Talking to your doctor. He or she will be able to talk you through the process as well, and give you a recipee which can help you to find a therapist faster.

These three things don’t have any prerequisites and you can do them at any time. They will however not directly result in you getting therapy, which is what the numbered blocks (1-4) below are for. Hereafter, we describe each individual step from A to C and 1 to 4.

=== I) Immediate Steps ===

==== A) Find a frame for yourself ====

The first thing besides all the technical and organisational stuff is finding a way to think about this that doesn't make you feel worse about your situation than it needs to. For me personally, it was really helpful to understand that **psychological problems are an illness that we bear no more personal responsibility for than for a cold - possibly a lot less**. Before looking for a therapist, I started reading and watching some content about the topic which helped me to somewhat normalise the situation. A conversation I found really empowering was between Thorsten Sträter and Kurt Krömer here: [https://www.youtube.com/watch?v=ZxL1lJnHJNQ Link to Youtube]

However, it’s possibly sensible to not sink yourself into too much content about mental illness - some of it might also drag you down. 

==== B) Psychological Counselling for students ====

If you're a ''student'' in Lüneburg, you have the right to get counselling from the psychological counsel of the Studierendenwerk. They offer open walk-ins which you can attend rather spontaneously when calling upfront, and up to 8 sessions of individual counselling. Note, however, that they cannot provide a diagnosis or therapy and are therefore no full substitute for a therapist. Still, they can confidentially listen to what you have to say and are struggling with, and can support you in making decisions on the next steps.

Unfortunately, the demand is usually very high, so it is not necessarily faster to get an appointment here than with a professional therapist. Nonetheless, we think it is worth a try, also because at least from our experience, the threshold to just "talk to someone" is a lot lower than consulting an actual therapist. Below, you will find the webpage and contact data.

* [https://stw-on.de/l%C3%BCneburg/beratung/pbs Psychologische Beratungsstelle] <br>
* Go to open hours (currently Tuesday, 12-14, appointment via mail ([http://mailto:pbs.lg@stw-on.de pbs.lg@swt-on.de]) or phone ([tel://(04131)%20789%2063%20-%2025 (04131) 789 63 - 25])<br>
* There is also an option to do group workshops: [https://stw-on.de/l%C3%BCneburg/beratung/pbs/workshops-gruppen Link]

==== C) Talk to your doctor ====

Your doctor (”Hausarzt”) is typically mentioned as one of the first points of contact in usual therapy guidance. If you have one and sufficiently trust him or her, you can absolutely make an appointment and talk things through with them. They will also be able to hand out a recipee which can speed up the process of finding a therapist, and may forward you to other specialists e.g. for medication. 

However, it is not necessary to immediately see a “normal” doctor. At some point you will have to meet one since they are required to ensure that your mental illness is not caused by any somatic problems (such as a lack of vitamins or neurological problems). Still, this can also happen when you have already found a therapist, but before you start the actual therapy. 

=== II) Finding a Therapist ===

Basically, finding a therapist is like finding any other specialist medical practitioner: you look them up, you call them, you make an appointment. The only problem is that the supply of therapy slots is very thin, and there’s no good system in place that makes it easy to find open slots. So you kind of have to just call a lot of therapists and find out whether or not they have a slot available. Below, we try our best to give you useful tips for the process.

Before you start, you might want to think about the kind of therapy you want. There are many different sub-disciplines, cognitive behavioural and analytical therapy being the predominant ones. It might make sense to [look up the differences](https://hellobetter.de/blog/therapieformen/) and decide for yourself which sounds the most promising to you. However, it is commonly said that the relation between therapist and patient is a much stronger success factor than the specific type of therapy you do. So probably, you might just want to take whichever therapist has a slot open and you kind of click with. 

==== 1) Look up nearby therapists ====

The first step is to look up therapists nearby. There’s basically four sources you can use to find them which we listed below. Unfortunately, there’s no unified register that contains all therapists and is fully up-to-date, so you might have to draw on all these sources one by one. We tried to order them descending by exhaustiveness, but this is rather subjective. If you feel overwhelmed, it’s probably enough to stick to the first and second options.

# '''The public [https://www.eterminservice.de/terminservice eTerminService]'''. It is probably the most exhaustive search engine with only a few problems here and there. If you have a recipee from a doctor or therapist that includes a code, this is where you can enter it. If you have been told by anyone to call 116 117 to get a slot: don’t. From our experience, all they do is look at the same website, but you have to wait an extra 30-45 minutes in the phone queue for them to do it for you. 
# '''[https://psych-info.de/ psych-info.de]''' is a register for therapists. It might not be available in your region, and it is not working super-smooth. We did however have the experience that some therapists listed here are not listed in the eTerminservice above. 
# '''[https://www.jameda.de/ Jameda]''' also offers a search engine for therapists, but this should probably only be a last resort. The ratings can be rather misleading.  
# '''Use a search engine''' of your liking, be it Google or Ecosia or DuckDuckGo or anything. 

Additionally, you have the opportunity to contact institutes where you may get slots with therapists in training. This need not be a downside, because they may have more time and they might also be closer to the current state of research. We compiled this non-exhaustive list in the Hamburg/Lüneburg area for you:

* [https://zap-nord.de/hamburg.html ZAP Nord (TP)]<br>
* [https://www.mova-institut.de/ MoVA Institut]<br>
* [https://www.ivah.de/ IVAH]<br>
* [https://www.gzstpauli.de/dgvt---ausbildungszentrum.html DGVT]<br>
* [https://www.psy.uni-hamburg.de/arbeitsbereiche/klinische-psychologie-und-psychotherapie/psychotherapeutische-hochschulambulanz.html Uni HH]

==== 2) Call therapists ====

This part is, unfortunately, just a big chunk of work. Because there’s no central service for appointments, you simply have to call or mail all potential therapists. This is especially annoying because usually therapists have differing times when they are available, and many either have no slots or a year-long waiting list. Unfortunately, you can’t really see that on any webpage, so you plainly have to call. There are however some things you can do that may make it easier:

* '''Ask friends and family.''' You don’t need to call all therapists on your own to find out whether or not they have open slots.
* '''Talk to your medical insurance''' Some insurances have a service that calls therapists for you and notifies you if they found one. It’s also important to keep them in the loop because at some point, if you can document that you were unable to find a therapist for some time, your public insurance will also have to pay for a private therapist. The amount of time differs between insurances.
* '''Use a system to keep track of all the therapists''' Below, we give you some templates which you may use as a basis. Speaking from experience, it is a good idea to have some central place where you collect information like consultation hour times, whether you already tried calling, and so on.

As a sidenote, and this is just our experience: the waiting list times can differ significantly from what the therapist tells you at first. They might be longer, but they might also be significantly shorter. So don’t be discouraged, and let yourself be registered on the list.

==== 3) Have preliminary sessions ====

You have the right to five preliminary sessions with each therapist. This is on the one hand useful to get a first diagnosis, and on the other to see if you can confide in the person you’re talking to - recall that one of the most important factors for successful therapy is the relationship between therapist and client.

Many therapists will offer you preliminary sessions, but don’t have a full therapy slot available. Therefore, don’t be tempted to do too many preliminary sessions with different therapists and ask beforehand if there’s a realistic chance to get a full treatment within a reasonable timeframe. 

==== 4) Get a slot ====

Ideally, all of the above leads you to finding a therapist that can actually offer you a treatment within a few weeks. You may end up on waiting lists, but if you’ve called enough therapists, you should be able to move your insurance to pay for a private therapist if the wait time is too long. 

From here on, your therapist will discuss everything relevant with you.

=== III) Managing the process ===

As alluded to above, there’s a lot of information to handle at the same time, and it can get overwhelming very quickly. Therefore, we’d advise to somehow keep track of your long list of therapists, who you’ve called when and whether or not they have slots available. To support you in this, we provide both a Notion and an Excel template which you may use to manage the process. Feel free to use them either directly or as inspiration for your own system - digital or analog. 

'''Important:''' We cannot guarantee for the information in the tables to be up-to-date. The list is from 2021, and information such as consultation hours or telephone numbers may have changed. 

==== Notion page ====

You may use this Notion page as a basis: https://www.notion.so/25a5980e10e3402da19b3d254db6381d. If you have your own Notion account already, you should be able to duplicate the page into your own workspace by pressing the “Duplicate” button to the top right. 

If you do not yet know what Notion is, feel free to glance over our article here: [[Notion]]. We found the tool to be particularly useful because of the rich functionality, but doing the same via a normal table will probably also be fine. 

==== Spreadsheet ====

If you don’t want to use Notion, you may also use this spreadsheet as a basis: https://docs.google.com/spreadsheets/d/1CiBIILxfJK4H3_c22Ty-mJ7gESbSDDEi093-bTLZr94/edit?usp=sharing

=== IV) What you can do on your own ===

As we stated above, there are a few things that can help you to lift yourself out of the worst phases. Here’s what we found helpful. 

=== Practices ===

'''Meditation''' can help you get out of negative thought spirals and liften your mood. If you haven’t tried meditation yet, it might be easiest to download an app or listen to guided meditations on YouTube. Apps we tried out and found helpful are [https://www.headspace.com/ Headspace] and [https://www.tenpercent.com/ 10% Happier]. You can try them for free!

An '''appreciation journal''' might also be helpful in lightening your mood. It’s rather trivial: just take a few minutes everyday to write down what you’re thankful for. This might feel awkward, or stupid, and you might find it hard to find things you’re sincerely thankful for. But with time, you might be able to direct your focus to the things that are actually good, even if they are comparably small.

'''Journalling''' might also generally be helpful to get thoughts out of your head and onto a piece of (digital) paper. Just sit down every evening for 10 minutes or so and write down whatever is going through your head. If you find it hard to start, just write down what happened on that day. 

'''Confide in people you trust.''' It might be hard at first, but our experience is that not only does it help to explicate your thoughts and feelings, but also to understand that you are not alone in how you feel.

===  Lifestyle choices ===

A friend once called these lifestyle choices the “Kleines 1x1 der Psychohygiene” (Psychological Hygiene 101):

# '''Sleep regularly and long enough.''' For most people, this means at least 7 and no more than 9 hours of sleep every day, at the same time. From personal experience I would say this makes all the difference in the world. 
# '''Eat & drink regularly.''' Try to eat good, healthy food, and drink at least 2 litres of water per day. 
# '''Do sports.''' Seriously, whatever it is. Walking for 30 mins, jogging, climbing, doing Yoga, going to the Gym, doing jumping jacks. Whatever it is, it’s almost certainly helpful.  
# '''Regularity.''' This is a big one. Structures help a lot. If you have to study or work, try to do it at a place outside of your home, every day at the same time. The place does not really matter as long as it is not your own room, be it the university or a café or a friends place. 

These might seem trivial, and they certainly do not solve any underlying causes of whatever problem you might have. They do however help to get out of the hole and into a state where you can actually do something about your situation, and that is incredibly important.

=== The student perspective on lifestyle choices ===

As a student, this can be especially frustrating. People might be partying and you don’t want to leave at 11 to go to bed. After all, this is supposed to be the time of your life. Everyone else might seem like they just live into their day and do whatever feels right at the moment, and having a structured everyday life might prevent you from doing the same. What might help you is to think about this as a transitional phase: you’re not going to do this forever. It’s a phase you need in order to get back up on your feet and enjoy life again. It might suck, but it won’t suck forever. 

We wish you all the best.

=== Links & Further reading ===

* '''Das Kind in dir muss Heimat finden''' von Stefanie Stahl: https://www.stefaniestahl.de/buecher_daskind_page1/ (Recommendation by the team)


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[[Category:Skills_and_Tools]]
[[Category:Personal Skills]]
[[Category:Team Size 1]]

The [[Table_of_Contributors| author]] of this entry is Matteo Ramin.