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Royal College of Psychiatrists - Celebrating 180 years
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  • Become a psychiatrist

    Become a psychiatrist

    • Choose Psychiatry

      Choose Psychiatry

      • What is psychiatry?
      • How to become a psychiatrist
      • Why choose psychiatry?
      • Career essentials
      • What next?
    • Sixth formers and school students
    • Medical students

      Medical students

      • Becoming a student associate
      • Psychiatry attachments
      • Awards, prizes and bursaries
      • PsychSocs
      • National conference
      • Summer and autumn schools
      • FuturePsych – the student associate magazine
    • Foundation doctors

      Foundation doctors

      • Foundation doctor associates
      • Making the most of your psychiatry placement
      • Opportunities for foundation doctors
      • FuturePsych - the associate magazine
    • Help us promote psychiatry

      Help us promote psychiatry

      • How can I help?
      • Ideas to inspire you
      • Resources to help you promote psychiatry
      • Our strategy
    • Choose Psychiatry: Guidance for Medical Schools
    • Choose Psychiatry
      • What is psychiatry?
      • How to become a psychiatrist
      • Why choose psychiatry?
      • Career essentials
      • What next?
    • Sixth formers and school students
    • Medical students
      • Becoming a student associate
      • Psychiatry attachments
      • Awards, prizes and bursaries
      • PsychSocs
      • National conference
      • Summer and autumn schools
      • FuturePsych – the student associate magazine
    • Foundation doctors
      • Foundation doctor associates
      • Making the most of your psychiatry placement
      • Opportunities for foundation doctors
      • FuturePsych - the associate magazine
    • Help us promote psychiatry
      • How can I help?
      • Ideas to inspire you
      • Resources to help you promote psychiatry
      • Our strategy
    • Choose Psychiatry: Guidance for Medical Schools
  • Training

    Training

    • Curricula and guidance

      Curricula and guidance

      • GMC approved curricula
      • Curricula review project
      • Specialty guides
      • Dual Training
    • Your training

      Your training

      • Psychiatric Trainees Committee: supporting you
      • Time out of training
      • Training resources
      • Run-through training
      • Prizes and bursaries for trainees
      • Leadership and management training
      • Training less than full time
      • Routes to Registration
      • Cost of Training
    • Exams

      Exams

      • Can I take an exam?
      • Contact the exams team
      • Preparing for exams
      • Applying for your exam
      • Exam results
      • Special notices
      • Exam FAQs
      • A fair exam
      • MRCPsych examinations and COVID-19
      • Webinar: MRCPsych Exam - Changes to exam delivery this autumn
      • Capacity reached for September 2020 CASC
    • Neuroscience in training

      Neuroscience in training

      • About the project
      • Neuroscience events
      • Who is on the commission?
      • Latest news from the neuroscience project
      • Neuroscience history
      • Neuroscience videos
      • Neuroscience resources
    • Information for Local Education and Training Boards (LETBs)
    • Medical training initiative (MTI)
    • Undergraduate education forum
    • International Medical Graduates

      International Medical Graduates

      • Shortage Occupation List
    • Quality Assurance in Training
    • Curricula and guidance
      • GMC approved curricula
      • Curricula review project
      • Specialty guides
      • Dual Training
    • Your training
      • Psychiatric Trainees Committee: supporting you
      • Time out of training
      • Training resources
      • Run-through training
      • Prizes and bursaries for trainees
      • Leadership and management training
      • Training less than full time
      • Routes to Registration
      • Cost of Training
    • Exams
      • Can I take an exam?
      • Contact the exams team
      • Preparing for exams
      • Applying for your exam
      • Exam results
      • Special notices
      • Exam FAQs
      • A fair exam
      • MRCPsych examinations and COVID-19
      • Webinar: MRCPsych Exam - Changes to exam delivery this autumn
      • Capacity reached for September 2020 CASC
    • Neuroscience in training
      • About the project
      • Neuroscience events
      • Who is on the commission?
      • Latest news from the neuroscience project
      • Neuroscience history
      • Neuroscience videos
      • Neuroscience resources
    • Information for Local Education and Training Boards (LETBs)
    • Medical training initiative (MTI)
    • Undergraduate education forum
    • International Medical Graduates
      • Shortage Occupation List
    • Quality Assurance in Training
  • Members

    Members

    • Supporting you

      Supporting you

      • Psychiatrists Support Service
      • New consultants (StartWell)
      • Mentoring and coaching
      • Revalidation
      • Assessing and managing risk of patients causing harm
      • Leadership and management
      • Working less than full time
      • If a patient dies by suicide
      • Writing clinic letters
    • Submitting your CPD

      Submitting your CPD

      • CPD Submissions FAQs
      • Alterations to CPD during coronavirus pandemic
    • CPD Online
    • Membership

      Membership

      • Members login
      • Receipts
      • Pay Your Subscription
      • Direct Debit
      • Your subscription
      • Grades of membership
      • Benefits of membership
      • Fellowship and other Honours
      • Applying for Fellowship
      • Nominations for Honorary Fellows
      • Nominations for National Honours
    • Your Faculties

      Your Faculties

      • Academic psychiatry
      • Addictions psychiatry
      • Child and adolescent psychiatry
      • Eating disorders psychiatry
      • Forensic Psychiatry Faculty
      • General adult psychiatry
      • Intellectual disability psychiatry faculty
      • Liaison psychiatry faculty
      • Medical psychotherapy faculty
      • Neuropsychiatry faculty
      • Old age psychiatry faculty
      • Perinatal psychiatry faculty
      • Rehabilitation and social psychiatry faculty
      • Faculty job descriptions
    • Devolved Nations

      Devolved Nations

      • RCPsych in Scotland
      • RCPsych in Wales
      • Coleg Cymraeg
      • RCPsych in Northern Ireland
      • Executive Committee job descriptions
    • English Divisions

      English Divisions

      • Eastern
      • London
      • Northern and Yorkshire
      • North West
      • South Eastern
      • Trent
      • West Midlands
      • South West
      • Executive Committee job descriptions
      • NW and NY mentorship
    • International members

      International members

      • International strategy
    • Special Interest Groups

      Special Interest Groups

      • How to join a SIG
      • Adolescent forensic psychiatry
      • Arts psychiatry
      • Evolutionary psychiatry
      • History of psychiatry
      • Neurodevelopmental psychiatry
      • Occupational psychiatry
      • Philosophy
      • Private and independent practice PIPSIG
      • Rainbow SIG
      • Spirituality
      • Sport and exercise psychiatry (SEPSIG)
      • Transcultural psychiatry
      • Volunteering and international
      • Women and mental health
      • Special Interest Group Job Descriptions
      • Digital psychiatry
    • Committees of Council
    • RCPsych Insight magazine
    • Publications and books
    • Your monthly eNewsletter

      Your monthly eNewsletter

      • Members' update 8 April 2021
      • RCPsych eNewsletter March 2021
      • Members' update 11 March 2021
      • RCPsych eNewsletter February 2021
      • Members' update 11 February 2021
      • RCPsych eNewsletter January 2021
      • Members' update 14 January 2021
      • RCPsych eNewsletter December 2020
      • RCPsych eNewsletter November 2020
      • Members' update 12 November 2020
      • RCPsych eNewsletter October 2020
      • Members' update 8 October 2020
      • RCPsych eNewsletter September 2020
      • Members' update 11 September 2020
      • Members' update 1 September 2020
      • Members' update 14 August 2020
      • RCPsych eNewsletter July 2020
      • Members' update 10 July 2020
      • RCPsych eNewsletter June 2020
      • Update 12 June 2020
      • COVID-19 Update 29 May 2020
      • RCPsych eNewsletter May 2020
      • COVID-19 Update 7 May 2020
      • COVID-19 Update 1 May 2020
      • RCPsych eNewsletter April 2020
      • COVID-19 Update April 2020
      • RCPsych eNewsletter February 2020
      • RCPsych eNewsletter January 2020
      • RCPsych eNewsletter December 2019
      • RCPsych eNewsletter November 2019
      • RCPsych eNewsletter October 2019
      • RCPsych eNewsletter September 2019
      • RCPsych eNewsletter July 2019
      • RCPsych eNewsletter June 2019
      • RCPsych eNewsletter May 2019
      • RCPsych eNewsletter April 2019
    • Posts for members
    • Public members list
    • Jobs board
    • Specialist and Associate Specialty Doctors

      Specialist and Associate Specialty Doctors

      • A message from the Chair
      • Who are SAS Doctors?
      • How to enter the SAS grade
      • SAS career development
      • SAS doctors resources
      • College SAS training and events
    • President's lectures

      President's lectures

      • Declaration of competing interests (President's lectures)
      • List of president's lectures competing interests
      • Past President's lectures
    • Retired members
    • New Members Ceremonies
    • Obituaries

      Obituaries

      • Submit an obituary
      • Remembering Dame Fiona Caldicott
    • About CPD Online - elearning
    • Supporting you
      • Psychiatrists Support Service
      • New consultants (StartWell)
      • Mentoring and coaching
      • Revalidation
      • Assessing and managing risk of patients causing harm
      • Leadership and management
      • Working less than full time
      • If a patient dies by suicide
      • Writing clinic letters
    • Submitting your CPD
      • CPD Submissions FAQs
      • Alterations to CPD during coronavirus pandemic
    • CPD Online
    • Membership
      • Members login
      • Receipts
      • Pay Your Subscription
      • Direct Debit
      • Your subscription
      • Grades of membership
      • Benefits of membership
      • Fellowship and other Honours
      • Applying for Fellowship
      • Nominations for Honorary Fellows
      • Nominations for National Honours
    • Your Faculties
      • Academic psychiatry
      • Addictions psychiatry
      • Child and adolescent psychiatry
      • Eating disorders psychiatry
      • Forensic Psychiatry Faculty
      • General adult psychiatry
      • Intellectual disability psychiatry faculty
      • Liaison psychiatry faculty
      • Medical psychotherapy faculty
      • Neuropsychiatry faculty
      • Old age psychiatry faculty
      • Perinatal psychiatry faculty
      • Rehabilitation and social psychiatry faculty
      • Faculty job descriptions
    • Devolved Nations
      • RCPsych in Scotland
      • RCPsych in Wales
      • Coleg Cymraeg
      • RCPsych in Northern Ireland
      • Executive Committee job descriptions
    • English Divisions
      • Eastern
      • London
      • Northern and Yorkshire
      • North West
      • South Eastern
      • Trent
      • West Midlands
      • South West
      • Executive Committee job descriptions
      • NW and NY mentorship
    • International members
      • International strategy
    • Special Interest Groups
      • How to join a SIG
      • Adolescent forensic psychiatry
      • Arts psychiatry
      • Evolutionary psychiatry
      • History of psychiatry
      • Neurodevelopmental psychiatry
      • Occupational psychiatry
      • Philosophy
      • Private and independent practice PIPSIG
      • Rainbow SIG
      • Spirituality
      • Sport and exercise psychiatry (SEPSIG)
      • Transcultural psychiatry
      • Volunteering and international
      • Women and mental health
      • Special Interest Group Job Descriptions
      • Digital psychiatry
    • Committees of Council
    • RCPsych Insight magazine
    • Publications and books
    • Your monthly eNewsletter
      • Members' update 8 April 2021
      • RCPsych eNewsletter March 2021
      • Members' update 11 March 2021
      • RCPsych eNewsletter February 2021
      • Members' update 11 February 2021
      • RCPsych eNewsletter January 2021
      • Members' update 14 January 2021
      • RCPsych eNewsletter December 2020
      • RCPsych eNewsletter November 2020
      • Members' update 12 November 2020
      • RCPsych eNewsletter October 2020
      • Members' update 8 October 2020
      • RCPsych eNewsletter September 2020
      • Members' update 11 September 2020
      • Members' update 1 September 2020
      • Members' update 14 August 2020
      • RCPsych eNewsletter July 2020
      • Members' update 10 July 2020
      • RCPsych eNewsletter June 2020
      • Update 12 June 2020
      • COVID-19 Update 29 May 2020
      • RCPsych eNewsletter May 2020
      • COVID-19 Update 7 May 2020
      • COVID-19 Update 1 May 2020
      • RCPsych eNewsletter April 2020
      • COVID-19 Update April 2020
      • RCPsych eNewsletter February 2020
      • RCPsych eNewsletter January 2020
      • RCPsych eNewsletter December 2019
      • RCPsych eNewsletter November 2019
      • RCPsych eNewsletter October 2019
      • RCPsych eNewsletter September 2019
      • RCPsych eNewsletter July 2019
      • RCPsych eNewsletter June 2019
      • RCPsych eNewsletter May 2019
      • RCPsych eNewsletter April 2019
    • Posts for members
    • Public members list
    • Jobs board
    • Specialist and Associate Specialty Doctors
      • A message from the Chair
      • Who are SAS Doctors?
      • How to enter the SAS grade
      • SAS career development
      • SAS doctors resources
      • College SAS training and events
    • President's lectures
      • Declaration of competing interests (President's lectures)
      • List of president's lectures competing interests
      • Past President's lectures
    • Retired members
    • New Members Ceremonies
    • Obituaries
      • Submit an obituary
      • Remembering Dame Fiona Caldicott
    • About CPD Online - elearning
  • Events

    Events

    • Conferences and training events

      Conferences and training events

      • Faculty of intellectual Disability Spring Conference 2019
      • Faculty of Forensic Psychiatry Annual Conference 2020 - Register your interest
      • Section 12 and AC – Update for Trainers - Training Day Course Resources
      • Resilience & Wellbeing Course for SAS Doctors
      • Present State Examination Course 17 April - Register your interest
      • Present State Examination Course 1 September - Register your interest
      • Section 12 and Approved Clinician Training
      • Perinatal Psychiatry Masterclasses
      • Women and Mental Health Special Interest Group Annual Conference
      • Faculty of Medical Psychotherapy Annual Conference 2021 - Register your interest
      • Register your interest - Clinical and Educational Supervisor Training future dates
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trainee)
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trust)
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trust)
    • Events held by other organisations
    • Terms and conditions
    • In house training

      In house training

      • In house training: working with us
      • Health of Nation Outcome Scales
      • Competing interests
    • Highlights from International Congress 2020 - Webinar Series

      Highlights from International Congress 2020 - Webinar Series

      • Registration
      • Programme
      • FAQs
    • Accommodation List
    • Recruitment events
    • Claiming Expenses
    • International Congress 2021

      International Congress 2021

      • Congress FAQs
      • Exhibition Opportunities 2021
      • Registration
      • IC21 Keynote speakers
      • Programme
      • Presenter information
      • Your guide to Congress
    • Free webinars

      Free webinars

      • Free webinars for members
    • Speaker guidance for online events
    • Conferences and training events
      • Faculty of intellectual Disability Spring Conference 2019
      • Faculty of Forensic Psychiatry Annual Conference 2020 - Register your interest
      • Section 12 and AC – Update for Trainers - Training Day Course Resources
      • Resilience & Wellbeing Course for SAS Doctors
      • Present State Examination Course 17 April - Register your interest
      • Present State Examination Course 1 September - Register your interest
      • Section 12 and Approved Clinician Training
      • Perinatal Psychiatry Masterclasses
      • Women and Mental Health Special Interest Group Annual Conference
      • Faculty of Medical Psychotherapy Annual Conference 2021 - Register your interest
      • Register your interest - Clinical and Educational Supervisor Training future dates
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trainee)
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trust)
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trust)
    • Events held by other organisations
    • Terms and conditions
    • In house training
      • In house training: working with us
      • Health of Nation Outcome Scales
      • Competing interests
    • Highlights from International Congress 2020 - Webinar Series
      • Registration
      • Programme
      • FAQs
    • Accommodation List
    • Recruitment events
    • Claiming Expenses
    • International Congress 2021
      • Congress FAQs
      • Exhibition Opportunities 2021
      • Registration
      • IC21 Keynote speakers
      • Programme
      • Presenter information
      • Your guide to Congress
    • Free webinars
      • Free webinars for members
    • Speaker guidance for online events
  • Improving care

    Improving care

    • College Centre for Quality Improvement (CCQI)

      College Centre for Quality Improvement (CCQI)

      • What we do in the CCQI
      • Quality Networks and Accreditation
      • National Clinical Audits
      • Multi-source feedback
      • Using quality improvement
      • CCQI resources
      • CCQI Who we are
      • Research and evaluation
    • Campaigning for better mental health policy

      Campaigning for better mental health policy

      • The Mental Health Act (MHA)
      • Five Year Forward View
      • Integrated care and mental health
      • Children and young people's mental health Green Paper
      • RCPsych in Parliament
      • Join our Research Panel
      • College Reports
      • Position statements
      • Process for College publications
      • Other policy areas
      • Mental Health Watch
      • COVID-19: Guidance for clinicians
      • The Mental Health Act White Paper 2021
    • Planning the psychiatric workforce

      Planning the psychiatric workforce

      • What we do
      • Job planning and recruitment
      • Our workforce census
      • Campaigning for the mental health workforce of the future
      • Workforce strategy
    • Physician Associates

      Physician Associates

      • About Physician Associates
      • Employing Physician Associates
      • Becoming a Physician Associate
      • Support for Physician Associates
      • Physician Associates network
    • National Collaborating Centre for Mental Health

      National Collaborating Centre for Mental Health

      • About the NCCMH
      • Mental health care pathways
      • Mental health quality improvement programmes
      • Other programmes
      • Reducing restrictive practice
      • National suicide prevention programme
      • Sexual Safety Collaborative
      • COVID-19 Mental Health Improvement Network
      • RCPsych Enjoying Work Collaborative
    • Invited Review Service
    • Public Health and its role in mental heath
    • Sustainability and working sustainably

      Sustainability and working sustainably

      • In your community
      • In your practice
      • In your trust
      • Green care
      • Sustainability scholars
      • About sustainability in mental health care
      • Sustainability resources
      • Working sustainably (old)
    • RCPsych Course Accreditation
    • College Centre for Quality Improvement (CCQI)
      • What we do in the CCQI
      • Quality Networks and Accreditation
      • National Clinical Audits
      • Multi-source feedback
      • Using quality improvement
      • CCQI resources
      • CCQI Who we are
      • Research and evaluation
    • Campaigning for better mental health policy
      • The Mental Health Act (MHA)
      • Five Year Forward View
      • Integrated care and mental health
      • Children and young people's mental health Green Paper
      • RCPsych in Parliament
      • Join our Research Panel
      • College Reports
      • Position statements
      • Process for College publications
      • Other policy areas
      • Mental Health Watch
      • COVID-19: Guidance for clinicians
      • The Mental Health Act White Paper 2021
    • Planning the psychiatric workforce
      • What we do
      • Job planning and recruitment
      • Our workforce census
      • Campaigning for the mental health workforce of the future
      • Workforce strategy
    • Physician Associates
      • About Physician Associates
      • Employing Physician Associates
      • Becoming a Physician Associate
      • Support for Physician Associates
      • Physician Associates network
    • National Collaborating Centre for Mental Health
      • About the NCCMH
      • Mental health care pathways
      • Mental health quality improvement programmes
      • Other programmes
      • Reducing restrictive practice
      • National suicide prevention programme
      • Sexual Safety Collaborative
      • COVID-19 Mental Health Improvement Network
      • RCPsych Enjoying Work Collaborative
    • Invited Review Service
    • Public Health and its role in mental heath
    • Sustainability and working sustainably
      • In your community
      • In your practice
      • In your trust
      • Green care
      • Sustainability scholars
      • About sustainability in mental health care
      • Sustainability resources
      • Working sustainably (old)
    • RCPsych Course Accreditation
  • Mental health

    Mental health

    • Problems and disorders

      Problems and disorders

      • ADHD in adults
      • Alcohol and depression
      • Alcohol and older people
      • Anorexia and bulimia
      • Anxiety, panic and phobias
      • Bereavement
      • Bipolar disorder
      • Cannabis
      • Club drugs
      • Coping after a traumatic event
      • Debt and mental health
      • Delirium
      • Depression
      • Depression in older adults
      • Depression and men
      • Eating well and mental health
      • Feeling on the edge
      • Feeling overwhelmed
      • Feeling stressed
      • Hoarding
      • Learning disabilities
      • Medically unexplained symptoms
      • Memory problems and dementia
      • Obsessive-compulsive disorder (OCD)
      • Perinatal OCD
      • Perinatal OCD for carers
      • Personality disorder
      • Physical illness
      • Postnatal depression
      • Postnatal depression key facts
      • Postnatal depression: information for carers
      • Postpartum psychosis
      • Postpartum Psychosis in Carers
      • Post Traumatic Stress Disorder (PTSD)
      • Problem gambling
      • Schizoaffective disorder
      • Schizophrenia
      • Seasonal Affective Disorder (SAD)
      • Self harm
      • Shyness and social phobia
      • Sleeping well
    • Support, care and treatment

      Support, care and treatment

      • Alzheimers drug treatments
      • Antidepressants
      • Antipsychotics
      • Being sectioned
      • Benzodiazepines
      • Bipolar medications
      • Cognitive Behavioural Therapy (CBT)
      • Complementary and alternative medicines: herbal remedies
      • Complementary and alternative medicines: physical treatments
      • Depot medication
      • Deprivation of Liberty Safeguards
      • Electroconvulsive therapy (ECT)
      • Electronic health records in mental health services in England
      • Guide to mental health tribunals
      • Liaison psychiatry services
      • Mental capacity and the law
      • Mental health rehabilitation services
      • Mental health services and teams in the community
      • Planning a pregnancy
      • Psychotherapies and psychological treatments
      • Spirituality and mental health
      • Stopping antidepressants
      • Talking to your GP
      • What to expect of your psychiatrist in the UK
      • Antipsychotics in Pregnancy
      • Lithium in Pregnancy and Breastfeeding
      • Mother and Baby Units (MBUs)
      • Children's Social Services and Safeguarding
      • Valproate in women and girls who could get pregnant
      • What are Perinatal Mental Health Services?
      • Mental health in pregnancy
      • Medication for mental health and COVID-19
      • Remote consultations and COVID-19
      • Attending hospital and COVID-19
      • Monitoring health at home and COVID-19
      • Alcohol and COVID-19
      • Eating disorders and COVID-19
      • Perinatal care and COVID-19
      • COVID-19: Self-harm in young people 
      • COVID-19: Self-harm and suicide 
      • COVID-19: Looking after your mental health – for young people and their parents and carers 
      • COVID-19: Using drugs
      • COVID-19: ASD
    • Young people's mental health
    • Translations

      Translations

      • Arabic عربى
      • Bengali বাঙালি
      • Bulgarian български
      • Chinese 中文
      • French Français
      • German Auf Deutsch
      • Greek Ελληνική γλώσσα
      • Gujurati ગુજરાતી
      • Hindi हिंदीहिंदी
      • Italian italiano
      • Japanese 日本語
      • Lithuanian Lietuvių kalba
      • Pashto پښتو
      • Persian (Farsi) فارسی
      • Polish Polski
      • Punjabi ਪੰਜਾਬੀ
      • Romanian Română
      • Russian Pусский
      • Somali
      • Spanish Español
      • Turkish
      • Tamil தமிழ்
      • Urdu اردو
      • Welsh Cymraeg
    • Mental health FAQs
    • Order mental health leaflets
    • About our mental health information
    • Disclaimer about our mental health information
    • Choosing Wisely - a national campaign
    • BSL translations
    • MindEd: web tools for those working with young people
    • Order mental health packs for schools
    • Audio resources
    • Problems and disorders
      • ADHD in adults
      • Alcohol and depression
      • Alcohol and older people
      • Anorexia and bulimia
      • Anxiety, panic and phobias
      • Bereavement
      • Bipolar disorder
      • Cannabis
      • Club drugs
      • Coping after a traumatic event
      • Debt and mental health
      • Delirium
      • Depression
      • Depression in older adults
      • Depression and men
      • Eating well and mental health
      • Feeling on the edge
      • Feeling overwhelmed
      • Feeling stressed
      • Hoarding
      • Learning disabilities
      • Medically unexplained symptoms
      • Memory problems and dementia
      • Obsessive-compulsive disorder (OCD)
      • Perinatal OCD
      • Perinatal OCD for carers
      • Personality disorder
      • Physical illness
      • Postnatal depression
      • Postnatal depression key facts
      • Postnatal depression: information for carers
      • Postpartum psychosis
      • Postpartum Psychosis in Carers
      • Post Traumatic Stress Disorder (PTSD)
      • Problem gambling
      • Schizoaffective disorder
      • Schizophrenia
      • Seasonal Affective Disorder (SAD)
      • Self harm
      • Shyness and social phobia
      • Sleeping well
    • Support, care and treatment
      • Alzheimers drug treatments
      • Antidepressants
      • Antipsychotics
      • Being sectioned
      • Benzodiazepines
      • Bipolar medications
      • Cognitive Behavioural Therapy (CBT)
      • Complementary and alternative medicines: herbal remedies
      • Complementary and alternative medicines: physical treatments
      • Depot medication
      • Deprivation of Liberty Safeguards
      • Electroconvulsive therapy (ECT)
      • Electronic health records in mental health services in England
      • Guide to mental health tribunals
      • Liaison psychiatry services
      • Mental capacity and the law
      • Mental health rehabilitation services
      • Mental health services and teams in the community
      • Planning a pregnancy
      • Psychotherapies and psychological treatments
      • Spirituality and mental health
      • Stopping antidepressants
      • Talking to your GP
      • What to expect of your psychiatrist in the UK
      • Antipsychotics in Pregnancy
      • Lithium in Pregnancy and Breastfeeding
      • Mother and Baby Units (MBUs)
      • Children's Social Services and Safeguarding
      • Valproate in women and girls who could get pregnant
      • What are Perinatal Mental Health Services?
      • Mental health in pregnancy
      • Medication for mental health and COVID-19
      • Remote consultations and COVID-19
      • Attending hospital and COVID-19
      • Monitoring health at home and COVID-19
      • Alcohol and COVID-19
      • Eating disorders and COVID-19
      • Perinatal care and COVID-19
      • COVID-19: Self-harm in young people 
      • COVID-19: Self-harm and suicide 
      • COVID-19: Looking after your mental health – for young people and their parents and carers 
      • COVID-19: Using drugs
      • COVID-19: ASD
    • Young people's mental health
    • Translations
      • Arabic عربى
      • Bengali বাঙালি
      • Bulgarian български
      • Chinese 中文
      • French Français
      • German Auf Deutsch
      • Greek Ελληνική γλώσσα
      • Gujurati ગુજરાતી
      • Hindi हिंदीहिंदी
      • Italian italiano
      • Japanese 日本語
      • Lithuanian Lietuvių kalba
      • Pashto پښتو
      • Persian (Farsi) فارسی
      • Polish Polski
      • Punjabi ਪੰਜਾਬੀ
      • Romanian Română
      • Russian Pусский
      • Somali
      • Spanish Español
      • Turkish
      • Tamil தமிழ்
      • Urdu اردو
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Into a dream

Cultural blog, Gaming the mind blog

11 August, 2020

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Filipe F. Thomaz discusses portrayal of depression in his game Into A Dream


Into a Dream is a game set within the mind of Luke, a man experiencing severe depression. The player assumes the role of an outsider who has been sent into Luke’s dreaming mind, with the task of rescuing him from this depressed state. The player visits Luke’s memories while speaking to mental representations of Luke and various characters from his life, in order to understand the roots of his depression and help him recover.

Clearly this form of intervention has no equivalent within modern medicine, so the game’s initial conceit is one we accept as either fantastical, or as a complex analogy for support and therapy. However, once the story is fully told, we find that the story is more grounded than we were initially led to believe.


The creator of the game, Filipe F. Thomaz, wanted to approach the topic of mental health due to his interest in other people. “I've always been a very observant person,” he said. “I’m fascinated by people, how they act, how they emote and why they emote, and how different people have different ways of processing and dealing with information.” While he didn’t do in-depth research for the game’s content, he did use his own observations. “It's difficult not to just look around and see how many people are struggling,” he said. “It's becoming a lot more evident that people have all sorts of mental health-related issues that are preventing them from being happy or achieving their potential.” 

Filipe F. Thomaz made a spectacular leap into game development. With no prior history in the field, he made Into A Dream in under two years


One of Filipe’s inspirations was the 2011 title To the Moon by Freebird Games. “It’s something I really liked because it was very grounded in reality,” he said. “Although you go into someone's mind, it was basically a story of a person. It’s not a game that focuses on mental health; it just touches on mental health through the story of this man and the unveiling of what happened to him.” He praised To the Moon’s focus on character and realism, something he also wanted to convey in Into A Dream in order to develop an emotional connection between the player and the characters.

Raising awareness of depression

The game is intended to have a broad appeal, to raise awareness of depression. “If someone can understand exactly why [Luke] arrived at that state, that would be fantastic,” said Filipe, who wants people to be able to talk about the topic and understand how “people have different ways of responding to certain events.” Filipe agrees that someone who has had depression will not necessarily relate to the experiences within the game. But he stresses, “I don’t talk about what it is to live with depression. I talk much more on what led to the depression, and that is somewhat specific.

The game talks about a big external cause that drives all this, and most people will not identify with what led [Luke] there.” He hopes that players who have not experienced depression will gain some sense of how a person could logically become depressed through their life’s journey. 


What also makes this a game for allies is how much of it is spent helping Luke to open up about what is going on. The initial manifestations of Luke and his inner world are idyllic. The game begins in a tranquil forest and when the player first meets him, Luke does not appear to have any concerns at all. “I did that on purpose,” said Filipe. “When someone starts playing the game and forgets that the person has depression, and in the end understands how everything ties together, that is something I want everyone to experience.”

The Luke you see at first is how he wants to be seen. For Filipe, this represents how it is not always apparent if someone is experiencing mental health issues, because of how society forces them to “put a mask on and say that everything is okay.” In this way, he hopes the game will encourage us to be more attentive to what is happening around us. “Maybe we can do something by being more observant and trying to understand others.”


Characters in Luke’s mind repeatedly assert there are no dangers in the woods, but who are they trying to convince?

 

Exploring Luke's Mind

As the player explores Luke’s mind, they will see memories of his life that are often distorted by how Luke perceives them or wants them to be perceived. Gradually the life events that have led to Luke’s depressive state are revealed. Although depression is multifactorial in aetiology, this game by its nature focuses on the social factors and life events that contribute to Luke’s illness. Filipe planned out Luke’s story to be realistic, though it is not based on the experience of any particular person. The life events Luke experiences are, however, things that could conceivably contribute to depression, with many ranking high on the Holmes and Rahe stress scale. 


Filipe’s portrayal of depression within the game is drawn mainly from life. “I have friends who have suffered from depression and some who struggled with it for long periods of time. Although I have not experienced it myself or done any formal research, I used a lot of my hands-on experience from observing a third person.”  Naturally, this informs the game’s outsider point of view. While some games such as Celeste or Night in the Woods show the perspective of the person experiencing mental health issues, Filipe feels the third-person perspective offered by Into A Dream is also important. “We need to tackle this issue from both sides. To help people to cope better with it and to improve, but also for society to change their behaviour or accept these kinds of issues.”

As the game progresses, the player reaches deeper levels of Luke’s mind where Luke is less able to hide his depression. This is portrayed by changes in the game’s environment, with reduced natural light, gloomier weather, and an oppressive, hostile atmosphere. The appearance of eyes on the walls, and accusatory messages scribbled in the background, hint towards paranoid symptoms which can be present in people with severe depression. These nods towards delusion are further reinforced by Luke’s baseless ideas of his own guilt.

Deeper in Luke’s mind we see evidence of his cognitive distortions, feelings of guilt, and paranoia 


Filipe is aware of reservations people may have about Into A Dream’s overall premise. “People have fears that the game is going to treat depression as something you need to fight away,” he said, “but the truth is it’s nothing like that.” Without giving too much of the ending away, it’s worth noting what does not happen: Luke is not cured of his depression. The real achievement is setting him on the road to recovery. “You help him take the first step,” said Filipe. “You’re basically holding him with one hand when he’s about to enter the darkness and just keep him there for a little longer.”

In the end, we learn that Luke has begun taking medication and started psychological therapy. It’s not a rule that all games dealing with mental health should portray therapy and the recovery process, but it is refreshing to see. But the game does not claim medication and psychotherapy to be a miracle cure: Luke’s ultimate outcome is left unknown. Filipe wanted to be open to the possibility that, as with many illnesses, treatment might not be effective. “Taking the example of cancer,” he said, “I’ve met a lot of people who miraculously survived when everybody thought that they wouldn’t, and I’ve met a lot of people who tried their best but still succumbed to the disease. The reason why you fought for this, the reason why you went searching for help, is not exactly to solve the problem that brought you there in the first place. It’s independent from that.”

All in one experience

Into A Dream can be finished in an evening and is a gripping experience carried by its narrative, visuals, music and voice acting. There are occasional puzzle-platforming elements which the game could’ve done without, but they aren’t too obstructive. The game starts with a fantastical idea, but ends as a sober story of a person reaching through the darkness to begin their path to recovery. To get out of that darkness, he needs to understand how he got there in the first place. As such, the game promotes understanding that behind any mental illness there is a life story, and that mental illness is not a moral failing, but rather something that can happen, in part, because of what we’ve been through.

Authored by Sachin Shah

Into a Dream is available for Microsoft Windows, Linux, and macOS systems
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