First appointments are short, and a great deal rides on them — whether you get referred, how urgently, and what gets written down. Fifteen minutes of preparation the night before changes the outcome more than anything you can do in the room.
Total effort: about twenty-five minutes. It is the highest-return preparation available for any appointment in this process.
Dated. What happened, intensity out of ten, how long it took to settle, what it affected. Six or seven entries is plenty. Dated specifics are treated differently from summaries, and this is the single most effective thing on the page.
Exactly what you will say first, in full. The opening is when nerves are highest and the temptation to minimise is strongest, and a written sentence survives both.
In priority order. Appointments overrun and get cut short; if only one thing gets said you want it to be the right one.
A referral, an assessment, a discussion about medication, a sick note, or simply to be believed. Being asked 'what would you like from today' with no answer prepared wastes the appointment.
Not as a script — as a backstop. Reading two dated lines aloud is entirely acceptable and it is far more effective than performing composure and leaving out the important half.
One entry a day, seven lines each, for the fortnight before the appointment. If you have less time than that, a week is still worth considerably more than nothing.
Almost all of them are versions of the same instinct: making it sound more manageable than it is.
Because you are in a calm room with a stranger, and the state you came to describe is not present. It is nearly universal. The written record exists precisely to counteract it — you are not reporting how you feel now, you are reporting the fortnight.
You can, and lead with the pattern rather than the label. 'My moods shift several times a day, it is set off by things in relationships, it takes hours to settle, and it is affecting my work' gets taken more seriously than a self-diagnosis, and it points at the same conclusion.
It happens constantly and it is not a failure. This is another reason for the paper — handing it over is a legitimate way of communicating, and most clinicians will simply read it.
Ask directly what they think is happening and what they suggest doing about it. If the answer is nothing, ask what would need to change for a referral, and write the answer down. If it goes nowhere, a different clinician is a reasonable next step rather than an escalation.
Often ten minutes with a GP, longer for a specialist assessment. Assume short. That is the entire argument for having three prioritised points rather than a full account.
It can help, particularly if speaking is hard. Decide in advance whether they come in or wait outside — someone present changes what you are willing to say, sometimes usefully and sometimes not.