Mental Health

Definition

noun – psychological well-being and satisfactory adjustment to society and to the ordinary demands of life.

Mental health is not just the absence of mental disorder. It is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.

World Health Organisation

Anger

What is Anger?

Anger results from feeling powerless in the face of a situation or interaction that seems unfair; we often use anger as a ‘quick fix’ to fight back at the injustice we are having to face.

Anger Management

Learn how to:-

Recognise and express your anger in a healthier way;
  • Dissipate your anger, then modify your thoughts and behaviours accordingly;
  • Externalise and reasses your anger and try and see it from a more positive perspective– e.g. change statements like ‘I’m an angry person’ to ‘anger sometimes causes a problem for me’;
  • Relax to release your ‘fighting energy’ and stop you verbally attacking another’s person;
  • Step back from the situation; breathe deeply (find out more about breathing exercises) and count to 10 before responding;
  • Respond in an assertive way, rather than by being aggressive; respond with concrete statements about what you heard and saw.
  • Use ‘I feel…’ statements.
Re-evaluate;
  • Did the person really mean what they said?
  • Is the situation really as bad as I thought?
  • Did the person intentionally mean to hurt me?
  • Have I been misunderstood by the other person?
  • Am I taking what they said too literally?
  • Is it possible to see the situation from the other person’s point of view?
  • Look for a solution to the problem rather than focussing on winning;
  • Take away the other person’s power by reminding yourself, no one has the ability to make me feel angry: It is an emotion that I generated.
Become less angry generally;
  • Start practicing some form of meditation; learn visualisation or guided-imagery techniques; distract yourself with music to reduce your level of physical stimulation; or do some physical exercise, in order to become a calmer person;
  • Having less anger in your life will make you feel more relaxed and happier.

Anxiety

What is Anxiety?
  • Anxiety is the body’s normal response to danger, and can be helpful in certain situations, such as when we need to perform well; It is normal for young people to feel anxious on their first day at school, when going to the dentist, or giving a speech on front of their class mates, for example.
  • Anxiety triggers a hormone called adrenaline into our bloodstream that activates our body, enabling us to fight or flight (run away); Anxiety can become a problem when there is an over activation of ‘fight or flight’ responses over a long period of time.
  • Young people who regularly suffer from heightened anxiety, are more hyper-alert, and constantly look for danger; Chronic anxiety is a mirror image of depression, so both symptoms often go hand in hand.
Signs of Anxiety

Psychological

  • Being more argumentative, snappy and irritable than usual;
  • Being restless, not being able to sit still, and not being able to focus on normal everyday tasks;
  • Talking more quickly than usual.

Physical

  • Heart racing and breathing faster, causing light headedness, dizziness, blurred vision and tingling in your fingers and toes;
  • Muscles tensing perhaps causing pain, aching and shaking;
  • Excessive sweating, nausea, butterflies and dry mouth;
  • Pupils dilating.

Behaviour

  • Avoiding “normal” situations/busy times, such as crowded places, avoiding friends, or being stressed at the thought of going to school, or simply leaving the house;
  • Not being able to go to places without someone else accompanying you;
  • Not being able to finish tasks you started;
    Pacing up and down, or running away from situations;
  • Using coping strategies when going to a feared situation, such as smoking, avoiding eye contact, fiddling with your hair, or already having an escape plan in your head.
Causes of anxiety
  • Past trauma, such as an assault or attack, bullying, bereavement, difficulties at school, relationship breakdown, family break up or divorce;
  • Unhelpful thought patterns, such as thinking something terrible is always going to happen, known as catastrophizing;
  • Having unrealistic expectations being put upon you, or on yourself;
  • Comparing yourself negatively to others, having low confidence, low self-image, low self-esteem;
  • Anxiety runs in families, so if you have an anxious parent, you may be prone to anxiety yourself.
Strategies to help with anxiety
  • Make a plan to gradually do the things you are avoiding, known as exposure therapy;
  • Safety behaviours, such as avoiding crowded places, if you are socially anxious, will only make you feel worse in the long term;
  • Stop and take a deep breath (see breathing techniques-hyperlink), and practice using mindfulness, visualisations, or relaxation techniques, so you can respond to a situation, rather than react;
  • Ask yourself what is the worst that could possibly happen in a difficult situation?
  • Ask yourself am I overestimating the danger, and visualise yourself coping with the difficult situation you are faced with instead.
  • Understanding the reason for your anxiety will help you take control of it and make you feel better;
  • Take up a new hobby or activity, do some exercise, or join a gym to improve your confidence or self-esteem;
  • Lead a healthier lifestyle and get plenty of sleep, leaving all mobiles and TV monitors out of the bedroom. Reading or listening to some relaxing music may help before bedtime, as might a warm milky drink.

Assertiveness

What is Assertiveness?
  • Assertiveness is being able to stand up for yourself, making sure your opinions and feelings are considered, and not letting other people always get their way;
    • Not about getting angry in situations and losing our temper (being aggressive)(see what is aggressive behaviour below-hyperlink);
    • Not about saying nothing or giving in to everyone around them (being passive)(see what is passive behaviour below-hyperlink);
  • Assertive messages are expressed in a polite and clear way, always being respectful of self and others;
  • In being assertive, there is a belief that all individuals are equal, each deserving respect, no one being more entitled than others;
  • Assertiveness can be learnt, and is a way of communicating with, and behaving towards others, that helps a person become more confident and self-aware.
Where does assertiveness come from?
  • As we grow up we learn to adapt our behaviour to the environment around us;
    • We model our behaviour on parents, relatives, teachers, friends, and other influences, such as what we see on TV, or through social media;
  • If we were brought up in a healthy, supportive, empathetic, stable environment, assertiveness will probably come quite naturally to us.
    • If we were bullied at school, or abused by our parents as a child, we are more likely to react on a passive or an aggressive way- hyperlink).
  • We can all behave passively, aggressively, or assertively depending on the situation we’re in, but probably have a preferred style of operating in relation with others.
What are the positive results of assertive behaviour?
  • Maintaining positive healthy relationships with others in an honest an open manner;
  • Achieving social harmony, from believing that everyone is equal, each deserving respect, with no one being more entitled than anyone else;
    • Getting your needs met without compromising others rights, whilst allowing others to know what we want;
    • Assertiveness is not about winning, but is about being able to walk away feeling we have put across what we want to say in a non- aggressive way.
  • Increases the person’s confidence, and respect from others;
  • Assertiveness is about being able to change your mind;
    • Not about being responsible for the thoughts, feelings or behaviours of others.
  • Assertiveness is about being able to say no in a polite way – such as ‘I’m quite busy now. Perhaps another time.’
What is passive behaviour?
  • Being compliant, submissive or non-committal;
  • Bottling up feelings, or expressing them in indirect or unhelpful ways;
    • Avoiding eye contact, or looking down, hunching shoulders or stooping, in order to make your body smaller;
    • Being fidgety, perhaps feeling clammy.
  • Assuming the other person’s needs and opinions are always right and more important than yours and that you have little or nothing to contribute;
    • Giving in to others, and not getting what we want.

Negative results

  • Loss of confidence, self-worth and self-esteem;
  • Increased stress, anger, or depression;
  • Not getting what you want or need;
    • Ultimately having self-critical thoughts.
What is aggressive behaviour?
  • Aggressive behaviour is the opposite of assertive behaviour;
    • Getting your needs met without respecting other people’s needs, rights, opinions, feelings;
    • Includes finger pointing or clenching fists.
  • Results in making enemies and upsetting others;
    • The aim of aggressive behaviour is to win.

Negative results

  • Initially, may lead to reduced tension and feeling more powerful;
    • It places the responsibility of your anger onto others.
  • In the long term, may lead to guilt and shame;
    • Ultimately leads to decreased self-confidence and lower self-esteem.
  • Creating unhealthy relationships, with those around the aggressive person becoming resentful of them.

Bereavement

We all respond to bereavement in different ways:
  • The intense pain suffered around grief and loss of a loved one varies from person to person, but typically lasts around 2 years;
  • Sadness, anger, disbelief, shock, distress, guilt, pain, depression, sleeplessness and longing are also all normal responses to loss;
  • It is also normal to feel sad angry and scared one day, then feel happy and able to enjoy life again on another.

We never get over the loss of a close loved one; we just learn to adjust

It’s important to
  • Talk to loved ones – friends and family – about how you feel;
  • Don’t let the hurt grow until you break down;
  • Comfort and be comforted by those around you;
  • Share happy memories of times spent with the person you have lost;
  • Be prepared that special times such as birthdays, anniversaries, Christmas Day and New Year will be extra difficult and may trigger emotions.
You could try
  • Writing a poem or a letter the person you have lost; keep a diary of how you are feeling;
  • Creating a memory box and collect together photographs, possessions and keepsakes of the loved one;
  • Regularly visit the loved one’s grave or the special place where their ashes were scattered.

And remember, take one day at a time

Depression

Being depressed, or experiencing low mood from time to time, is a normal part of the human condition; Depression becomes a problem when it becomes very deep or lasts for a prolonged period of time, over several weeks or months.

Causes of depression?
  • Being overwhelmed by life’s pressures, such as exams or school;
  • A result of sickness, particularly if suffering from a chronic condition, which prevents you doing the things you used to;
  • Unhealthy family relationships, family breakdown, or divorce;
  • Bereavement in the family, or loss of a friend;
  • Relationship breakdowns;
  • Inability to accept others who don’t live up to your expectations;
  • Having abnormal expectations being placed in you either by others or yourself;
  • Having to ‘parent’ a family member due to physical illness or a mental health condition;
  • Depression can also occur when a young person is unable to express their anger towards others, then internalises the negative feelings.
Signs of depression
  • Regularly dwelling on negative thoughts, such as thinking everything is hopeless;
  • Constant feelings of tiredness and lethargy;
  • Changes in sleeping habits – either sleeping more or less, or waking up frequently in the night;
  • Having difficulty concentrating, such as in lessons, or doing homework;
  • Changes in eating habits – either eating more or having a loss of appetite;
  • Loss of interest in hobbies or activities;
  • Isolation from friends or family;
  • Lack of self-care such as not showering regularly or not taking care of your appearance.
How to overcome depressed feelings
  • Try to identify things that make you feel better, and avoid things that make you feel worse;
  • Remember you have a choice to do things that will make you feel better, or the things that leave you feeling depressed;
  • Develop a healthy balance of daily activities, which will give you a sense of achievement and enjoyment;
  • Spend more time with family and friends rather than isolating yourself in your bedroom;
  • Take up a new activity or do some physical exercise, such as going to the gym, walking, swimming or cycling;
  • Learn mindfulness, or make time to practice relaxation techniques on a daily basis (see basic techniques-hyperlink);
  • Talk positively to yourself, repeating to yourself you are strong, capable and confident;
  • Stop using a negative filter, by looking through ‘gloomy specs’, and seeing things in the worst possible way.
  • Pamper yourself – do something that you really enjoy;
  • Imagine yourself doing and enjoying the things that you used to do, or would like to do in the future;
  • Remind yourself that depressed feelings are only temporary – they will go away with time!

Obsession & Compulsion

What are Obsessions and Compulsions?
  • They are a pattern of extreme behaviours carried out by an individual in order to avoid perceived danger or threats;
    • Consider them as an extreme form of superstitious behaviour, such as avoiding walking under ladders to avoid misfortune;
  • Obsessions are related to unwanted invasive thoughts or images entering our heads, which result in compulsive behaviour;
    • These thoughts cause individuals to have heightened levels of anxiety, resulting in the carrying out of repetitive time-consuming rituals, to try and relieve the distress suffered.
  • Initially, the rituals relieve the distress suffered, but then become distressing in themselves, when they become more and more time consuming, and obsessive;
    • The individual becomes convinced that the only reason that they have avoided danger so far, is because they have constantly carried out their ritualistic behaviour to prevent it.
  • Individuals suffering from this disorder may also avoid situations or doing something that may trigger unwanted, invasive thoughts, further limiting their lives.
Examples of obsessive compulsive thoughts?

Fear of;

  • Forgetting to do something, such as not locking the door, leaving the iron or cooker on;
  • Being contaminated by germs, such as from drinking out of a dirty glass, or from having dirty hands;
  • Harming others, such as thoughts of attacking someone with a knife.

Being obsessive about order, making sure everything is always in its correct place;

  • Having superstitions around numbers, such as making sure the loudness of their TV is always turned to an ‘even’ rather than an ‘odd’ volume setting;

Being excessively clean, by constantly taking a shower, or obsessively cleaning and tidying their home;

  • Carrying out ritualistic behaviour, such as following a strict bedtime routine, always doing things strictly in the same order.
What are some signs of Obsessive Compulsive Disorder?

Feelings

Anxiety or panicky; guilty or ashamed; dirty or unclean.

Physical symptoms

Dizziness or light headedness; tenseness or having muscular pain; nausea, heart racing or perspiring.

Thoughts

“I did not lock the door when I left the house”; “I am contaminated with germs”; “I will hurt someone”; or “someone could break in to my house”.

Behaviours

  • Constantly checking that a task has been completed properly;
  • Repeatedly showering or excessively washing your hands;
  • Avoiding touching any objects that may be dirty;
  • Carry out ritualistic behaviour, such as making sure everything is always in its correct position.
Causes of obsessions and compulsions
  • Having less healthy thought patterns, where a person always assumes the very worst will happen- catastrophizing;
  • If something bad happens they will be responsible and held to blame for it;
  • Having the belief that their unwanted thoughts have great significance and meaning;
  • Believing that there is something abnormal about them for having such thoughts;
  • Suffering from a stressful life event, such as a family or relationship break up, or a bereavement;
  • Learnt behaviour from a parent or other biologically inherited factors.
How can you control obsessive thoughts and behaviours?
  • Gradually confront your thoughts and behaviours by not engaging in the relief seeking rituals attached to them;
  • Realise that the anxiety created by the thoughts will disappear of its own accord, usually within 30 minutes, if you are able to sit quietly;
  • Confront and challenge the least anxiety inducing thoughts first, focussing on one ritual at a time;
  • Repeatedly challenge your behaviour until the invasive thought attached to it causes you no further anxiety, such as resisting the need to check you have locked the front door as you leave the house;
  • Do not try and block or push away the invasive thoughts, as that will only make them worse, just remind yourself they are meaningless and random, and allow them to float away.
  • Try relaxation exercises or visualisations, in order to reduce your stress (see basic techniques below-hyperlink;
  • Maintain a healthy lifestyle, take up a hobby, sport or interest.

Self-esteem

Do I have positive self-esteem?
  • I generally have positive thoughts about myself;
  • I know what sort of person I am and what my strengths and weaknesses are;
  • I am able to cope with life’s difficulties without them having a long-term negative impact on me;
  • I do not worry about lots of small details of my day;
  • I think I can generally succeed in life;
  • I do not compare myself unfavourably to others;
  • I can make friends easily and adapt to new situations;
  • I am assertive and able to ask to get my needs met;
  • I can admit to my mistakes and learn from them;
  • I believe I am doing the best I can in life.
Why do young people suffer from low self-esteem?
  • Negative life experiences, such as bullying, or being overly criticised by parents, teachers, or peers;
  • Stressful events, such as home financial problems, parental separation, or the unexpected death of loved one.

Self Harm

What is self harm?

Self-harm is any behaviour such as cutting, self-strangulation, or overdosing, in order to cause actual bodily harm.

  • It is not normally considered to be attention-seeking behaviour, though can be a symptom of an underlying personality disorder in adults;
  • Self-harm can also be linked to the desire of the individual to take their own life, so any act of self-harm must be taken seriously by parents, carers, school staff;

Self-harm often expresses a deep sense of despair, and can help relieve the individual from deep emotional pain and wounding, even if only temporary;

In some cases, a young person may accidentally take their own life through self-harm, by not receiving help quickly enough, after an act of self-harm.

Why do young people self harm?

There are a number of factors which may lead a young person to self-harm;

  • Individual factors, such as depression or anxiety, or low self-esteem;
  • Family factors, such a poor parental relationships, or unreasonable expectations placed on the young person;
  • Social factors, such as the inability to make friendships, or bullying;
  • School or exam pressures;
  • The break-up of a significant relationship.

Self-harm temporarily takes away the young person’s pain, and distracts them from their problems;

  • The temporary relief a young person gets from self-harm, can result in a cycle of cutting, as an escape from emotional pain;

Young people often suffer from shame and guilt for self-harming.

Warning signs of possible self-harm
  • Risk-taking behaviour, such as misuse of drugs or alcohol;
  • Changes in sleeping habits/sleeplessness;
  • Becoming withdrawn from family or friends;
  • Changes in mood, such as uncharacteristic angry outbursts, or through expression depressive thoughts;
  • Poor achievement at school;
  • Expressing feelings of hopelessness or poor self-worth;
  • Talk of suicide or self-harm.
Strategies to help reduce self-harm
  • Do something physical, such as go to the gym, or meet up with friends for a coffee, or go to the movies;
  • Be creative, such as keep a diary of your feelings, write poetry or draw or paint in order to express your feelings in a more positive way; take up a hobby or interest;
  • Displace the need to cut by snapping an elastic band on your wrist; draw lines on your arms with a pen, or hold ice-cubes on the areas of your skin where you would ordinarily be tempted to cut;
  • Think about the long-lasting negative effects of scarring through self-harm;
  • Spend less time in your bedroom isolated from your family; take part in family activities, instead;
  • Take a cold shower or go for a walk.
Help for self-harm
  • Professional individual counselling can help a young person improve their self-esteem, work though their problems, and help them manage their emotions in a healthier way;
  • Professionally trained counsellors are accessible in all schools within the East Riding.
  • Family support is an important part of the healing process, as parents with an understanding of the causes of self-harm will be more supportive of the problem, and encourage the young person to express their concerns and worries to them.

All copy provided by Cornerhouse

Suicidal Thoughts

Facts about suicidal ideation
  • Most persons thinking of suicide want help to stay alive;
    • People thinking of suicide find ways to invite help from others;
    • Invitations are often missed or avoided.
  • The best way to find out if someone is thinking of suicide is to ask them directly;
    • Asking directly about suicide will not give them the idea to take their own lives;
    • Avoiding direct and open talk about suicide is not helpful and could be dangerous.
  • Anyone could have thoughts of suicide;
    • Thoughts of suicide are usually temporary.
  • Everyone can learn how to help support young people with suicidal thoughts.

 

Signs a young person may have suicidal ideation?

(See) ACTIONS

  • Does the young person have a care-less attitude?
  • Are they uncharacteristically moody or withdrawn?
  • Are there signs of drug or alcohol abuse?

(Hear) TALK

  • Does the young person appear to be more secretive, and talk about preferring to being alone?
  • Do they consider themselves a burden on family or friends?
  • Do they talk about having no purpose; no future?
  • Do they talk about escaping?

(Sense) FEELINGS

  • Do they appear desperate?
  • Do they express hopelessness?
  • Do they say they feel numb and disconnected from family and friends?
  • Do they appear shamed by previous actions?
Learn more about ‘The Young Person’s Life Situation’
  • Has there been any abuse or trauma in the young person’s life, including bullying?
  • Has the young person suffered a recent relationship breakdown?
  • Has the young person suffered any other significant loss – bereavement?
  • Has the young person attempted to take their own life before?
Assess the risk of the young person acting out on any suicidal thoughts
  • What are the frequency of their thoughts (scale 0 to 10)?
  • Do they have a plan?
  • Do they have the means to act out on such thoughts (access to pills, for example)?
  • Do they have an intention to act on such thoughts?
  • What are their life-preserving resources (reasons not to act on the thoughts, such as family relationships)?
  • What has changed in the young person’s outlook (since a previous suicide attempt)?
If you are concerned, it is important to put a safeguarding plan in place
  • If you feel a young person is at significant risk of taking their own life, report your concerns to EHASH (East Riding of Yorkshire Council, Early Help & Safeguarding Hub) 01482 395500 (01482 395530 out of hours); Call CAHMS Crisis Point for advice and support 01482 301704;
    • Also ask for support from the young person’s school, their social worker and GP).
    • Give the young person Childline’s number 0800 1111.
  • Suicide-proof your home (remove access to knives, ropes, cords, pills, vacuum hoses, belts, toxic liquids);
  • Put in a 24-hour supervision roster in place for the young person;
  • Encourage the young person to use a traffic light system to indicate when they don’t feel safe (using red, yellow, and green wrist bands, for example);
  • Encourage the young person to practice relaxation techniques (see general techniques below-hyperlink);
Any family will need emotional support after a suicide – perhaps from a qualified counsellor
  • They may need to talk about their feelings: of being alone; their sadness; their devastation, unresolved anger; fear of their feelings; feelings of shame, guilt, abandonment; confusing feelings of relief;
  • They may need to talk about their thoughts: thoughts of disbelief; their ambivalence; not knowing how to cope, constantly re-playing the story in their minds, searching for answers; denial of the loss.

Calming Techniques

Breathing Exercises
  • You can do the exercises while standing, sitting or lying down;
    • If standing, stand upright with both feet on the floor, hip’s width apart;
    • If sitting, sit upright in your chair, both feet on the ground, your arms resting on the chair arms;
    • If lying down, place your arms by your side, with your legs straight and feet slightly apart.
  • Make yourself as comfortable as possible, e.g. removing tight belts, for example;
  • Take a slow deep inhalation of breath in to your stomach, counting slowly 1 to 5 as you do so;
  • Hold your breath for a few seconds, then slowly breath out, again counting 1 to 5;
  • Breathe in through your nose, and out through your mouth, gently and regularly;
  • Continue doing this for 3 to 5 minutes.

 

Visualisations
  • Find a quiet, safe space, such as your bedroom, and make yourself comfortable;
  • Quietly play some relaxing ‘mood’ music, such as the sounds of a rainforest;
  • Take a few slow deep breaths (see breathing techniques above);
  • Lye on the floor, with arms by your sides, palms up, legs straight in front of you, feet slightly apart;
  • Lightly close your eyes;
    • Imagine yourself in a beautiful location, perhaps in the mountains, or in a forest, or on a beach you were once at on holiday where you felt happy and contented;
    • Imagine yourself there now feeling calm and relaxed, happy and enjoying yourself;
    • Focus on your different senses. If on the beach, imagine the smell of the sea, the warmth of the sun on your skin, the sound of the waves, the wind, and the seagulls flying overhead;
    • Remain in this place for 5 to 10 minutes, developing your imagination and senses more intensely as the time passes.
  • When you feel relaxed, slowly open your eyes and re-connect with the world;
  • Remember you can return to this space any time you feel upset, angry or stressed in the future.

Useful Contacts

MIND: 01482 240200
Text: 07520 633447

Samaritans:01482 323456

Childline: 0800 1111

Humber NHS Foundation Trust: 01482 303810
www.humber.nhs.uk

Camhs: 01482 303810
Camhs Crisis: 01482 301701

The Campaign Against Living Miserably thecalmzone.net

Papyrus – Prevention of Young Suicide
Call: 0800 068 41 41 or Txt: 07786 209 697
papyrus-uk.org