Mental Health and Physical Fitness
Linas JuozėnasShare
Mental health & physical fitness
Make movement a source of support. Make room for the whole person.
A walk, a swim, a few comfortable movements or time with a welcoming group can become a valuable part of life. Exercise can also feel difficult, unrewarding or out of reach when someone is exhausted, distressed, unwell or under pressure.
Both experiences deserve an honest place in a guide to mental health. The aim is to understand where physical activity can help, choose an approach that fits your circumstances, and recognise when another kind of support matters more.
This guide connects current research with practical choices about starting, resting, body image, relationships and professional care. Your worth is already present, whatever your fitness, appearance or ability.
Begin with something that matters to you: a little company, time outside or a manageable activity.
You do not have to feel happier after every session or turn every day into progress.
Time, money, safety, health and other people's behaviour affect what is possible.
Mental health belongs in the context of a life
Mental health involves how we experience life, relate to others and manage its demands. It can change over time. Feeling distressed does not establish a diagnosis, and a diagnosis does not describe everything about a person.
WHO describes mental health as shaped by interacting individual, social and structural conditions. Violence, poverty, discrimination and inequality can increase risk; supportive relationships and safe living conditions can offer protection. No single factor reliably predicts an individual's outcome.[1]
Ask what is happening around the difficulty
A person who feels depleted after repeated humiliation at work may need protection from that treatment. Someone living with pain may need appropriate care and practical assistance. A person who has become isolated may want a relationship in which they feel heard.
Exercise can sit alongside those needs. It cannot make unfair treatment acceptable or remove a housing problem by itself. When advice overlooks the source of someone's difficulty, even a well-meant suggestion can become another demand.
Keep the aim personal
“I want to join my friend for a short outing” and “I want to enjoy dancing again” are useful aims. So is “I need enough rest to get through this week.” You do not have to adopt somebody else's picture of a healthy or successful life.
Approach movement as one available resource. There is room for curiosity about what helps without making the person responsible for every obstacle they face.
Exercise can help with depression, with important limits
A Cochrane review published in 2026 included 73 studies involving at least 4,985 adults with depression. It concluded that exercise may reduce depressive symptoms compared with no therapy or a control intervention. Confidence is limited by weaknesses in the studies, and the longer-term effects remain uncertain.[2]
Some trials compare exercise with psychological therapies. Those comparisons are relatively few and small; they do not establish that the options are interchangeable for every person. The review searched for studies through November 2023, which is different from its publication date.[2]
Make a decision with the person involved
A useful conversation considers preference, previous experiences, current capacity, available support and other care. Someone may welcome a supervised programme; someone else may need help making food, sleep or appointments manageable before adding another commitment.
If you already receive mental health care, discuss where activity might fit. Agree on what you hope it will help with and how you will review the experience. You do not need to abandon existing support to try movement.
Recovery is bigger than a completed workout
A session can count as something you chose and managed even if your mood does not lift. Persistent symptoms deserve attention; they are not evidence that you failed to exercise enthusiastically enough.
Anxiety may improve without every session feeling calming
A 2026 umbrella review brought together 63 reviews and found average reductions in anxiety and depression symptoms with exercise. It included both diagnosed and subclinical symptoms, across different ages. The studies varied, and reviews focused exclusively on chronic physical conditions were excluded.[3]
This supports exercise as a potentially useful option. It does not identify one programme that treats every anxiety disorder, or show that every participant feels calmer immediately afterwards.
Understand what is making the activity difficult
Perhaps the venue is crowded, the instructions are confusing, or the class makes you feel watched. Perhaps you would enjoy the activity with a familiar person or in a quieter space. These are practical details worth changing.
You can ask how a session works before attending, visit without joining in, choose a place near the exit, or agree that you may leave early. Consider these as options for making an activity accessible, rather than rules everyone needs.
Do not make immediate calm the only measure
Notice whether the activity is manageable, whether you feel respected, and whether its demands fit the rest of the day. Enjoyment may be uneven. Some sessions may simply feel ordinary.
If anxiety repeatedly limits your life, seek an assessment from a qualified mental health professional. Understanding the difficulty can help you choose support; it also keeps a fitness plan from carrying a task it was never designed to handle alone.
There is more to the relationship than “feel-good chemicals”
Researchers investigate several possible pathways between activity and depression: brain plasticity, inflammatory and stress-response processes, self-efficacy and social support. A review of these mechanisms emphasises that the explanation remains incomplete.[4]
These proposed pathways help researchers ask better questions. They do not establish that a particular workout repairs the brain or resolves emotional distress. A biological measurement and a person's recovery are different outcomes; evidence about one cannot automatically establish the other.
Notice what the activity actually adds
For one person, the useful part may be the chance to leave a demanding room. For another, it may be practising a skill, sharing a familiar route, or having an hour in which work cannot interrupt. These are experiences you can describe without needing to assign them to a single molecule.
Ask a specific question: “Which part of this do I value?” If the answer is the company, keep the company in the plan. If the answer is a quiet space, protect that space. If you cannot find anything useful in the present arrangement, change it.
You do not need a dramatic rush of happiness to justify an activity you enjoy. You also do not need to keep doing something unpleasant because an explanation about brain chemistry says it should feel good.
Choose a starting point that leaves room for the rest of life
Physical activity includes everyday movement, transport, wheeling, recreation and exercise. WHO emphasises that some activity is better than none for general health, with at least 150 minutes of moderate activity per week, or an equivalent amount of vigorous activity, as part of its adult guidance.[5] That population target is not a personalised treatment dose for depression or a requirement to meet in your first week.
Reduce the effort of getting started
Choose somewhere accessible and an activity you already understand. Lay out what you need, agree on a meeting place, or choose a route with somewhere to sit. The preparation should make participation easier.
A few minutes of comfortable movement may be a practical beginning for someone whose health allows it. You can stop at the planned point, even if you could do more. Later decisions can take account of both the activity and the recovery it requires.
Adapt for illness, pain and changing energy
A seated option, assistance, a different movement or a shorter session may fit better. Ask a physiotherapist or an appropriately qualified exercise professional for help when a health condition or injury makes those choices unclear.
For people with ME/CFS, exertion can cause a delayed, prolonged worsening of symptoms. CDC guidance emphasises individual limits and pacing of physical and mental activity; standard exercise advice can be harmful in this setting.[6] If activity produces this kind of flare, seek an informed clinical plan rather than increasing activity automatically.
The useful starting point is the one that respects your actual capacity. It may change from day to day.
Choose for access, interest and a workable setting
Different forms of exercise appear in mental health research, but an average result cannot choose your route, class or equipment for you. Begin with what you might willingly return to and what your circumstances permit.
The options below illustrate practical choices. They are not ranked treatments, and the adaptations should be adjusted to the person.
| Option | What may appeal | Details to consider |
|---|---|---|
| Walking, wheeling or an easy outing | A familiar route, a change of surroundings or time with someone. | Surface, access, weather, lighting, seating and a manageable return journey. |
| Strength exercises | Learning movements or working towards a personally chosen task. | Suitable resistance, clear instruction and adaptations for pain or limited movement. |
| Swimming or another water activity | Enjoyment of water or a preferred way of moving. | Pool access, changing facilities, cost, supervision and water confidence. |
| Dance, music or a movement class | Rhythm, expression, play or a shared experience. | Seated choices, noise level, pace and freedom to pause without explanation. |
| Yoga, tai chi or gentle mobility | A slower pace, coordination or attention to movement. | A teacher who offers choices and respects comfort, balance and physical limits. |
| A game, club or adapted sport | Skills, cooperation and something interesting to practise. | A welcoming culture, appropriate competition and flexibility around attendance. |
Include the hidden costs
A free class may still require transport, childcare, suitable clothing or energy for the journey. A home session may require privacy you do not have. Count those demands when deciding what is realistic.
You may prefer indoor movement during icy Lithuanian winters, or an outdoor route during comfortable weather. Choose a place where participation is comfortable and practical, with alternatives available when conditions change.
Mindfulness is an invitation, not a requirement to relax
Mindfulness practices involve bringing attention to present experience. Research suggests possible benefits for some symptoms, but findings vary and many studies have limitations. NCCIH also notes that unpleasant experiences can occur; meditation is not universally calming.[7]
A brief practice during a walk is different from a structured mindfulness programme used in research. Treat it as something to explore, without promising yourself a particular emotional result.
Try an outward point of attention
WHO's stress guide includes grounding as one way to reconnect with the present.[8] For an optional everyday version, choose a comfortable position and notice a few colours in the room, a sound, or an object nearby. Let attention return to that detail when you want to.
Keep your eyes open if that feels better. There is no need to control your breathing, scan your body or continue when the exercise is uncomfortable. You can listen to familiar music or speak with someone instead.
During movement, protect choice and safety
You might notice the rhythm of an easy movement or the surroundings on a safe route. Keep attention available for traffic, terrain and other people. A mindful session does not require shutting out useful information.
If a teacher asks for something you do not want to do, an alternative is appropriate. The quality of the experience includes your freedom to participate on terms that make sense for you.
Your body is part of your life, not a public scorecard
Body image includes thoughts, feelings and attitudes about the body.[9] It can involve appearance, comfort, identity and the experience of being seen by others. A person's visible shape tells us very little about that private experience.
Body image concerns can affect people of different genders, ages and abilities. Avoid assuming that someone who looks athletic feels confident, or that someone needs to change their appearance before they can belong in an activity.
Choose conditions that make participation more comfortable
Wear clothing that fits and allows the movement you want. Ask for a place away from mirrors if you prefer. Choose instructors who explain skills without insulting bodies or turning everyone into a comparison.
You can set a boundary around comments: “Please give me feedback on the movement, rather than on my weight or shape.” Another person may welcome a different kind of feedback. Consent matters more than guessing what should be encouraging.
Allow mixed feelings
You do not have to love every part of your body. Pain, ageing, disability, illness or unwanted changes can bring grief and frustration. Respect can take the form of comfortable clothing, adequate food, rest, access or care even when positive feelings are absent.
Belonging does not depend on improvement
You deserve respectful treatment before, during and after any change in fitness. Appearance, strength, independence and productivity do not determine your value.
Appreciation and self-compassion can be practised without forced praise
Body-functionality research looks beyond appearance to experiences such as sensing, communicating and creative expression, as well as movement. A review emphasises that functionality is broad and that its meaning differs across people's lives.[10]
In a small randomised trial, 81 women with negative body image completed either a functionality-focused writing programme or a comparison task. The programme improved several body-image measures, with follow-up lasting one week.[11] That encouraging finding does not establish long-term benefit for everyone, or require anyone to become more physically capable.
Notice something meaningful
If it feels useful, describe an experience your body lets you have: hearing a voice, feeling warm water, making a mark on paper or participating in a conversation.
If this brings up loss or comparison, leave the exercise aside. Acknowledging what is difficult can be a more honest starting point.
Choose a kinder response
After a difficult day, try asking: “What would make the next step more manageable?” The answer may be assistance, a smaller plan or rest.
You do not need to replace every critical thought with praise. You can choose a respectful action while the thought is still present.
A systematic review found associations between self-compassion and fewer eating and body-image concerns, alongside promising intervention findings. The evidence includes correlational studies, which cannot establish cause and effect.[9]
These approaches are options for relating to yourself differently. They should never become a new test in which a person must display gratitude, positivity or impressive bodily function to deserve care.
Fitness content can influence the experience of your own body
In an experiment involving 130 female undergraduates, viewing “fitspiration” images produced more immediate body dissatisfaction and negative mood than viewing travel images. It was a brief study in a specific population, not evidence that all fitness content causes lasting harm.[12]
Judge content by its effect on your life
After viewing a feed, do you have a useful idea, or do you feel pushed to inspect and correct yourself? Does the account teach a skill clearly? Does it rely on shame, extreme comparison or the suggestion that everyone should have the same body?
You can mute accounts, remove progress-photo reminders, follow interests outside fitness or set aside a period without appearance-focused content. These are practical choices about your attention, not obligations to manage a perfect feed.
Keep other people's stories in perspective
A photograph cannot show an entire life, health history or relationship with exercise. A transformation story may leave out resources and circumstances that matter. You do not need to match its timetable.
For clubs and coaches, permission should come before photographs, measurements or public progress updates. Being part of a class should not require turning your body into promotional material.
If content repeatedly intensifies distress or rigid behaviour, make that pattern part of a conversation with an appropriate professional. You do not have to wait until it looks serious to somebody else.
Rest and flexibility belong in a healthy relationship with movement
Regular exercise can be enjoyable and important to someone without being compulsive. The amount alone does not settle the question. A clinical proposal developed in eating-disorder care focuses on rigid, driven patterns and the harm or interference they cause.[13]
Patterns worth discussing
- Feeling compelled to follow exercise rules despite injury or illness.
- Using activity to compensate for eating or prevent a feared consequence.
- Finding that the routine repeatedly crowds out relationships, responsibilities or recovery.
These examples are conversation starters, not a self-diagnosis. If exercise feels difficult to choose or stop, seek support from a clinician with relevant experience, especially when eating concerns are involved.[13]
Make room for an ordinary change of plan
A missed session does not create a debt. Food does not have to be earned through activity. A celebration, a difficult workday or a need for rest can change what you do next.
If you enjoy tracking, consider what the record is for. A useful log might help you remember an activity you liked or explain symptoms at an appointment. It need not become a demand to protect an unbroken streak.
Keep parts of life that have no exercise target attached: reading, conversation, music, creative work or doing nothing in particular. These experiences do not need a fitness justification.
Support should make participation easier and preserve your agency
Social connection involves the support and quality of relationships as well as how many contacts someone has.[14] A welcoming partner or group may make an activity more appealing; simply adding people does not guarantee that experience.
Look for respectful behaviour
Helpful companions ask what you want, accept a shorter outing and allow a refusal. They do not demand your diagnosis, monitor your body or use embarrassment as motivation. A good invitation leaves you free to decide.
If you are supporting someone, offer something concrete: company on a familiar route, a lift, help checking access or a quiet visit. Ask whether suggestions are wanted before producing a plan.
Address harmful conditions directly
WHO's workplace guidance recommends changing organisational risks, alongside support for individuals.[15] When bullying, unrealistic workloads, unsafe conditions or repeated humiliation are involved, a relaxation class alone cannot resolve the problem.
Consider what practical support is available: a trusted colleague, a worker representative, a confidential reporting route or help documenting specific incidents. Choose an approach that takes your safety and circumstances seriously.
Protect privacy and choice
A person may need space from criticism or unwanted control. Support can include boundaries about messages, attendance tracking, photographs or who receives personal information.
At the same time, preserve access to trustworthy people where possible. A boundary can be selective: less contact with someone who belittles you, and more room for a relationship in which you are listened to.
When life is constrained, the next useful step may be elsewhere
Illness, money, caring responsibilities, inaccessible surroundings or other people's behaviour may limit physical activity. A useful plan acknowledges those limits rather than treating them as a lack of determination.
Keep a place for meaningful experiences
Reading, studying, making something, listening to music, meditation or a conversation may offer something you value. Choose an amount that fits your attention and energy. Learning does not have to become another productivity target, and rest can be the most appropriate use of available time.
These options can help fill a day with personally meaningful choices. They are not promises to cure depression or substitutes for assistance with unsafe or harmful conditions.
Match the professional to the task
A fitness professional can help with exercise instruction and an appropriate activity plan within their qualifications. Diagnosis, psychological therapy and complex mental health care call for professionals trained for those roles. EuropeActive's personal-trainer standard describes professional boundaries and referral; it is an industry standard, not the law of every country.[16]
When distress persists, substantially affects everyday life or makes exercise and eating feel rigid or frightening, an assessment can help clarify what support is appropriate. You can describe experiences in ordinary language: what is difficult, when it happens and what you have already tried.
A starting point in Lithuania
Lithuania's National Health Insurance Fund describes access to primary mental health care without a referral through the mental health centre serving an insured patient's registration. Check your registered centre, coverage and appointment options; your family medicine practice can help identify the service.[17]
Elsewhere, use your local primary care or mental health service. It is reasonable to ask about qualifications, approach, cost, accessibility, language and privacy before deciding whether the service fits.
Build a plan you can revise without blame
You do not need to redesign your whole routine. Choose one part of life that might become easier, then make the smallest useful arrangement around it. These examples illustrate planning choices, not clinical exercise prescriptions.
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Name what you want support with.
For example: “I want some company after work,” “I miss moving to music,” or “I need an activity that fits my current energy.”
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Check the conditions.
Include access, cost, safety, privacy, health, recovery and the time required for getting there. Decide what help would make the plan possible.
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Choose one manageable option.
Arrange a short outing, ask about an adapted class or practise a familiar activity. Leave room to stop, shorten or change it.
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Notice the whole experience.
Consider comfort, enjoyment, pressure, recovery and whether the arrangement served its purpose. A brief note is optional; a happiness score is unnecessary.
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Keep, adapt or replace the arrangement.
Continue what is useful. Change what is awkward. If the difficulty needs another kind of support, make that the next step instead of increasing the demands.
| Situation | One possible step | What to review |
|---|---|---|
| You want company but organised classes feel overwhelming | Invite one trusted person for a familiar, manageable outing. | Did the company feel supportive? Would a shorter visit or a different place fit better? |
| The gym makes you feel watched or judged | Ask about a quieter time, a different instructor or an activity in another setting. | Were your preferences respected? Did the setting become more comfortable? |
| Your capacity is limited by illness or pain | Use an existing clinical plan, or seek help adapting activity and rest. | How did symptoms and recovery respond, including later? What needs adjustment? |
| Work or caring demands leave little room | Ask for one practical change, or arrange a short period for rest or something meaningful. | Did time actually become available? Which conditions still need support? |
If the plan repeatedly fails to fit, examine the plan and its surroundings. A missing bus route, unsafe venue or unreliable break calls for a practical change or support.
Practical answers, with room for your circumstances
Can exercise cure depression?
Exercise can reduce symptoms for some people, but the evidence does not justify promising a cure. Longer-term effects remain uncertain.[2] Discuss its place alongside your needs, preferences and other care.
How much exercise do I need for mental health?
There is no single treatment dose established for everyone. General adult activity guidelines provide a public-health reference.[5] Your starting point should reflect your health, capacity and circumstances; see section 5.
Which kind of activity is best for anxiety?
The review evidence supports average improvements across varied programmes without establishing one answer for every person or anxiety disorder.[3] Preference, access and how the activity feels are useful starting considerations.
What if I do not feel happier after a workout?
You do not need to produce a particular emotion. Consider whether the session was manageable and worthwhile for another reason. If it repeatedly feels unpleasant or exhausting, review the activity, setting and recovery.
Do I have to exercise outdoors or join a group?
No. A safe, accessible indoor setting or an activity on your own may fit well. Company can be welcome when you choose it. Use the setting that suits your needs and available options.
What if mindfulness makes me uncomfortable?
Pause or stop. Unpleasant experiences are possible, and findings do not support treating meditation as universally helpful.[7] You can try an outward focus, another activity or suitable professional guidance if you want it.
Do I have to love my body to treat it well?
No. Respect can mean food, rest, comfortable clothing, access and appropriate care while difficult feelings remain. You do not have to prove gratitude, beauty or physical capability to deserve those things.
When does commitment become a concern?
Discuss patterns that feel rigid or driven, continue despite harm, or repeatedly interfere with life.[13] A strong interest in exercise alone is not a diagnosis; the experience and consequences matter.
What can I do if exercise is not currently possible?
Make room for rest, care and experiences you value, within your capacity. That may include conversation, music, creative work or learning. Practical assistance with the conditions limiting you may matter more than an activity target.
How can I support someone without pressuring them?
Ask what would help and offer something specific. Accept a refusal or change of plan. Keep comments about their body and performance out of the conversation unless they invite them, and respect their privacy.
Sources, study types and practical limits
Sources checked: 5 September 2026. Numbered references connect the research claims to their sources. Review publication dates may be later than the searches they report. Reviews can also include overlapping trials, so their participant totals should not be added together.
Clinical trials, reviews, public-health guidance and professional standards answer different questions. Small or brief studies can be informative without establishing lasting benefit for everyone. The planning examples, reflective questions and suggested wording in this guide are practical illustrations, not a tested treatment programme.
- World Health Organization. Mental health. Fact sheet, 8 October 2025.Public-health overview of interacting personal, social and structural influences. It does not attribute an individual's condition to one cause. Return to text ↑
- Clegg AJ and colleagues; Cochrane. Exercise for depression. Cochrane Database of Systematic Reviews, 2026; CD004366.pub7.Updated review: 73 studies in the current plain-language summary; searches through November 2023. Study limitations and uncertain longer-term effects restrict conclusions. Return to text ↑
- Munro NR and colleagues. Effect of exercise on depression and anxiety symptoms: systematic umbrella review with meta-meta-analysis. British Journal of Sports Medicine, 2026; 60:590–599.Umbrella review of 63 reviews; searches through July 2025. Populations and programmes varied; reviews exclusively about chronic physical conditions were excluded. Linked author repository. Return to text ↑
- Kandola A and colleagues. Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity. Neuroscience & Biobehavioral Reviews, 2019; 107:525–539.Mechanistic review of biological and psychosocial pathways. Proposed pathways are not proof that a particular session causes an individual's recovery. Linked author repository. Return to text ↑
- World Health Organization. Physical activity. Fact sheet, 26 June 2024.General population guidance, including everyday movement. Adult weekly targets are not personalised mental health treatment doses or starting prescriptions. Return to text ↑
- Centers for Disease Control and Prevention. Manage ME/CFS. Clinical information for the public, 10 May 2024.Condition-specific guidance on post-exertional malaise, activity limits and pacing. It explains why generic exercise progression can be inappropriate for ME/CFS. Return to text ↑
- National Center for Complementary and Integrative Health. Meditation and Mindfulness: Effectiveness and Safety. Evidence overview.Summarises varied findings and possible unwanted experiences. Brief self-directed exercises should not be equated with the structured programmes studied. Return to text ↑
- World Health Organization. Doing What Matters in Times of Stress: An Illustrated Guide. Practical guide, 29 April 2020.Evidence-informed coping guide with grounding exercises. Official resources include Lithuanian materials. This article's optional example is independently worded. Return to text ↑
- Turk F and Waller G. Is self-compassion relevant to the pathology and treatment of eating and body image concerns? A systematic review and meta-analysis. Clinical Psychology Review, 2020; 79:101856.Review of 59 studies, including associations and interventions. Correlations do not establish causation; methods and populations varied. Linked author repository. Return to text ↑
- Alleva JM and Tylka TL. Body functionality: A review of the literature. Body Image, 2021; 36:149–171.Broad review of functionality, body image and interventions. Functionality includes more than physical performance; experiences differ across social identities. Linked author repository. Return to text ↑
- Alleva JM and colleagues. Expand your horizon: A programme that improves body image and reduces self-objectification by training women to focus on body functionality. Body Image, 2015; 15:81–89.Randomised writing intervention involving 81 women with negative body image; one-week follow-up. This was not an exercise trial. Linked author repository. Return to text ↑
- Tiggemann M and Zaccardo M. “Exercise to be fit, not skinny”: The effect of fitspiration imagery on women's body image. Body Image, 2015; 15:61–67.Controlled brief image exposure in 130 female undergraduates. Immediate responses cannot establish lasting effects across all users or content. Linked author repository. Return to text ↑
- Dittmer N, Jacobi C and Voderholzer U. Compulsive exercise in eating disorders: proposal for a definition and a clinical assessment. Journal of Eating Disorders, 2018; 6:42.Clinical definition and assessment proposal developed in eating-disorder care. It is not a validated self-diagnosis checklist for the general public. Return to text ↑
- World Health Organization. Social connection. Questions and answers, 30 June 2025.Distinguishes the structure, support and quality of relationships. Contact numbers alone do not capture the experience of connection. Return to text ↑
- World Health Organization. Mental health at work. Fact sheet, 2 September 2024.Guidance includes addressing harmful working conditions alongside individual support. The article's practical options are illustrations, not guaranteed workplace entitlements. Return to text ↑
- EuropeActive. EuropeActive Standards: Personal Trainer, EQF Level 4. Professional education standard, January 2025.Describes exercise services, professional scope and referral. This industry education standard does not replace national law or verify an individual's qualifications. Return to text ↑
- Valstybinė ligonių kasa (Lithuania's National Health Insurance Fund). Kur kreiptis, kai sunku? Nemokama psichologinė pagalba kiekvienam. Service information, 21 May 2025.Lithuanian-language information on publicly funded psychological support and primary mental health centres. Confirm current registration, insurance coverage and appointment arrangements with the relevant service. Return to text ↑