On a Skype connection that is unusually consistent, a 31-year-old man is describing his anxiety attack to Doctor Sirfraz Hussain. “Big headache, sweating … I got really scared, I was going in and out of the toilet every five minutes.” He pressed his heart, to indicate the fear that mustered around it like a physical pain. His cat got up off the windowsill and moved towards him; for those of a romantic bent, it looked as though it were trying to comfort him. He only half the time made eye contact, the rest of the time casting his eyes towards the ceiling, evasively, as though he were ashamed of having to ask for help.”But I can tell he’s not depressed,” Doctor Hussain said afterwards, “because depressed patients don’t look at you, there’s no trace of emotion from them. Stress and anxiety come first; then when people reach the point of thinking, this is never going to end, they become depressed. Then they think, if I wasn’t here I wouldn’t be such a burden on everybody, and they become suicidal. This is a well-trodden path, and I needed to see where he was on it. He isn’t depressed yet, he’s anxious about a problem at work. A simple sensitivity on his employer’s part and he wouldn’t be here.” Then, with an upswing, as though he’d just found a fiver in the pocket of his jacket, he added: “That cost less than a phone call, and yet it told me so much more.”
http://www.theguardian.com/society/2013/oct/04/the-gp-will-skype-you-now