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"The options we have are contraception, which helps reduce the symptoms of PMDD. Also you've got the options of treating the actual symptoms with CBT and antidepressants."

Keeping secrets is not necessarily financial infidelity, says Avigail Lev, founder and director at Bay Area CBT Center.

John waited several months for his first CBT appointment through the NHS and was given an initial six sessions.

John said CBT was the starting point of a longer journey that included coaching, training and self-reflection.

CBT might also address thought patterns that perpetuate loneliness, like a person’s expectation of rejection, or their tendency to fixate on negative social experiences from the past, says Anton Käll, a behavioral scientist at Linköping University.