MENTAL HEALTH

The Fourth Mental State

Our symbol is a big dark cloud covering everything.

A mental disorder (or mental illness) is very different from everyday distress or the more serious mental distress.

Mental illness is when changes happen in the brain.
Mental illnesses are MEDICAL illnesses, in the same way that diabetes is a disturbance in the pancreas, mental illnesses are disturbances of usual brain function.

Whenever you feel unsure - ask for help

Our brain is like our own onboard computer that controls the body's functions.

Our nervous system is like a network of electrical circuits that relays messages to parts of our body.

When you touch something hot, you quickly move your hand away - your brain sending a message before you burn yourself.

This is one example of how our brains are connected to our bodies.

We all have times when our mood is happy, sad, or irritable.
We need a mental health professional to find out if a person is experiencing is more than a mood swing.

For a start:

• you will be asked about your thoughts, feelings, and behaviour and how long these have been causing you distress.
• there might be a blood test needed to check if there could be a physical condition that is causing the problem.

• Doctors use a special manual that is made up of a list of symptoms that are common to various disorders.
• If your symptoms closely match those on the official list, they will make a diagnosis.

So, quite a few things need to happen before a mental health disorder is diagnosed (by a health care professional)

Because these disorders affect a how you function at home, at school and in relationships, each step is important for the right diagnosis and treatment.

• Mood changes - Rapid or dramatic shifts in emotions or depressed feelings
• Sleep or appetite changes - Dramatic sleep and appetite changes or decline in personal care
• Withdrawal - Recent social withdrawal and loss of interest in activities previously enjoyed
• Drop in functioning - An unusual drop in functioning, at school, work or social activities, such as quitting sports, failing in school or difficulty performing familiar tasks
• Problems thinking - Problems with concentration, memory or logical thought and speech that are hard to explain
• Increased sensitivity - Heightened sensitivity to sights, sounds, smells or touch; avoidance of over-stimulating situations
• Apathy - Loss of initiative or desire to participate in any activity
• Feeling disconnected - A vague feeling of being disconnected from oneself or one’s surroundings, a sense of unreality
• Illogical thinking - Unusual or exaggerated beliefs about personal powers to understand meanings or influence events; illogical or “magical” thinking, typical of childhood in an adult
• Nervousness - Fear or suspiciousness of others or a strong nervous feeling
• Unusual behaviour - odd, uncharacteristic, peculiar behaviour
• Changes in appearance - sudden weight loss, brown teeth, etc

Whenever you feel unsure - ask for help.

Mental illnesses (or disorders) are not a choice.

They are medical conditions that affect the brain and come from a complicated mix of:

• a person’s genes (inherited from their family),
• their environment,
• and their personality.

Like diabetes, cancer and heart disease, mental disorders are caused by a combination of factors.

Mental illnesses can be managed – much like physical illnesses.

A young person with depression is likely to feel sad and empty.

They might lose interest in things that they enjoyed doing before. They may feel irritable and have angry outbursts or become withdrawn.

There are different types of depression.

Major depression is the term that is used to describe the most common type of depression. Symptoms can range from mild, to moderate and severe.

Depression is caused by a chemical imbalance in the brain.

This imbalance is caused by:

• environmental (what is around us)
• psychological (our feelings)
• biological (genetic factors)

Name: DEPRESSION (Mood disorder)

Possible Signs:

• Feelings of sadness, tearfulness, emptiness, or hopelessness
• Anxiety, agitation or restlessness
• Angry outbursts, even over small matters
• Feeling misunderstood and extremely sensitive
• Loss of interest or pleasure in most or all normal activities
• Social withdrawal
• Inability to return calls, messages, emails
• Staying in bedroom/isolating
• Sleep disturbances, including insomnia or sleeping too much
• Tiredness and lack of energy
• Poor self-care
• Failure to do chores/participate in housekeeping tasks
• Not doing homework
• Missing class
• Reduced appetite and weight loss or increased cravings for food and weight gain
• Unexplained physical problems, such as back pain or headaches
• Slowed thinking, speaking, or body movements
• Feelings of worthlessness or guilt
• Fixating on past failures or self-blame
• Trouble thinking, concentrating, making decisions and remembering things

Ask for help – the sooner you get treatment, the better.

Cause:

A chemical imbalance in the brain.

Caused by:

• environmental (what is around us)
• psychological (our feelings)
• biological
• genetic factors Family history (genetic)
• psychosocial stressors

Treatment:

Medication
Psychotherapy
CBT, DBT or combination treatment

TIPS:

Be kind to yourself
Take small steps
Try something new
Challenge negative thoughts
Practice mindfulness
Connect with others

Suicide Crisis Help line
0800 567 567

MOST people respond well to treatment. The sooner you get treatment – the better.

Mental health challenges are experienced by pregnant teenagers as a consequence of adolescent pregnancy itself, as well as other factors such as poverty, intimate partner violence, family rejection, social isolation, stigma, and in some cases chronic illnesses.

These stressors lower resilience and make depression more likely.

NAME: POST-PARTUM DEPRESSION (PPD)
or Post-Natal Depression (PND)

PPD is more common among adolescent mothers than adult mothers.

Possible signs:

• Feelings of sadness, tearfulness, emptiness, or hopelessness
• Anxiety, agitation, or restlessness

Additional symptoms of postpartum depression include:

• difficulty bonding with your baby
• overwhelming fatigue
• feeling worthless
• anxiety
• panic attacks
• thinking of harming yourself or your baby
• difficulty enjoying activities you once did

Causes/risks:

When pregnancy happens at a time when the adolescent brain is rapidly changing, the additional physical, emotional, and mental demands that pregnancy brings can be overwhelming.

Poverty, abandonment by the partner, family isolation, and gender-based violence all contribute to possible depression after the baby is born (and before).

Adolescents face higher risk of complications of pregnancy and childbirth including pre-eclampsia/eclampsia and obstructed labour.

Treatment:

Medication
Psychotherapy
CBT, DBT or combination treatment.
Support from community, family and friends

There is a big difference between baby blues and post-partum depression
The sooner you get treatment – the better.

SADAG Mental Health Helpline
0800 456 789
SMS 31393

Up to 80% of new mothers get what’s called the “baby blues”. These are short-term dips in mood caused by all of the changes that come with a new baby. You’re likely to feel better by the time your baby is 1 or 2 weeks’ old.

Treatment is usually lifelong and often involves a combination of medications and psychotherapy. Treatment can help, but this condition can't be cured. Chronic: can last for years or be lifelong. Requires a medical diagnosis.

With Bipolar Disorder, a person’s mood and energy levels will swing between being very happy or ‘up’ with more energy than usual (manic episode) and very sad or ‘down’ with little energy (depressive episode). There is no single cause of bipolar disorder.

The exact cause of bipolar disorder isn’t known, but a combination of genetics, environment and altered brain structure and chemistry may play a role.

Manic episodes may include symptoms such as high energy, reduced need for sleep and loss of touch with reality.

Depressive episodes may include symptoms such as low energy, low motivation and loss of interest in daily activities.

Mood episodes last days to months at a time and may also be associated with suicidal thoughts.

Treatment is usually lifelong and often involves a combination of medications and psychotherapy. Treatment can help, but this condition can't be cured – it is Chronic: can last for years or be lifelong.

Requires a medical diagnosis.

Name: BIPOLAR DISORDER (MOOD DISORDER)
Signs/symptoms:

Elevated mood:

• The person feels extremely high, happy and full of energy. The experience is often described as feeling on top of the world and being invincible.
• Increased energy and over-activity.
• Reduced need for sleep.
• Irritability – The person may easily and frequently get angry and irritable with people who disagree or dismiss their sometimes-unrealistic plans or ideas.
• Rapid thinking and speech – thoughts are more rapid than usual. This can lead to the young person speaking quickly and jumping from subject to subject.
• Lack of inhibitions – This can be the result of the person’s reduced ability to foresee the consequences of their actions. For example, spending large amounts of money buying things they don’t really need.
• Grandiose plans and beliefs – It is common for people experiencing Mania to believe that they are unusually talented or gifted or are kings, movie stars or political leaders.
• It is common for religious beliefs to intensify or for young people with this illness to believe they are an important religious figure.
• Lack of insight – A person experiencing Mania may understand that other people see their ideas and actions as inappropriate, reckless or irrational. However, they are unlikely to recognise the behaviour as inappropriate themselves.
• Psychosis – Some people with mania or depression experience psychotic symptoms such as hallucinations and delusions.

Depression:
Common symptoms include varying degrees of the following:

• Lowered mood – Many people with Bipolar Mood Disorder experience depressive episodes. These are similar in nature to those experienced by people who have depression.
• Withdrawal – The person loses interest and pleasure in activities they previously enjoyed. They may withdraw and stop seeing friends, avoid social activities and cease simple tasks such as shopping and bathing.
• Loss of appetite or weight – They may become overwhelmed by depression, lose their appetite, lose weight, become unable to concentrate, and may experience feelings of guilt.
• Feelings of hopelessness – Some attempt suicide because they believe life has become meaningless or they feel too guilty to go on.
• Delusions – Others develop false beliefs (delusions) of persecution or guilt or think that they are evil.

Cause:

No single cause
Genetic factors
Family history

Treatment:

Medication
Psychotherapy or combination treatment

Mental illnesses are not always accepted in communities and sometimes people with mental health conditions are hidden away because the family is ashamed.

Plea to the community!

Take people with mental health issues to a health facility, support them and encourage them to take their medication.

With access to appropriate treatment and support, most young people with Bipolar disorder lead full and productive lives.

Treatment is usually lifelong and often involves a combination of medications and psychotherapy. Treatment can help, but this condition can't be cured. It is Chronic: can last for years or be lifelong. Requires a medical diagnosis.

It is not unusual to feel anxious about exams or going on a date. But an anxiety disorder is much more than just a passing fear or worry.

People with an anxiety disorder feel anxious all the time. Instead of going away, their anxiety just gets worse until it begins to interfere with everyday life.

There are different types of anxiety disorders:

• social anxiety disorder,
• generalised anxiety disorder
• panic disorder.

A person who has panic attacks will not necessarily develop a panic disorder. Even though they are not life-threatening, panic attacks often come out-of-the-blue and can be very scary. There are many different signs of a panic attack, but these usually go away after a few minutes.

Name: ANXIETY DISORDERS

Generalised Anxiety Disorder:
Excessive, unrealistic worry with no reason

Panic Disorder:
Feelings of intense discomfort and fear
Associated with physical symptoms such as:

• sweating
• shaking
• chest pain
• chills or feeling hot

Social Anxiety Disorder:
Self-conscious about everyday situations; fears humiliation, embarrassment or judgement.

Anxiety can make you feel:

• tense or nervous
• a sense of dread
• like you can't stop worrying or bad things will happen
• worried that people are angry or upset with you
• like the world is speeding up or slowing down
• low mood

Anxiety can cause you to ruminate - think a lot about bad experiences or go over and over a situation in your mind.

Panic Attacks are a type of fear response, and they can be very scary.

You might feel:

• your heart racing
• faint or dizzy
• nauseous (feeling sick)
• very hot or very cold
• pain in your chest or stomach
• you can’t breathe
• like your legs are shaky, like jelly
• like you’re losing control

Caused by:

No single cause
Genetic factors
Family history

Treatment:

Medication
Psychotherapy, or combination treatment

People with anxiety disorders respond well to a combination of interventions

TIPS:

Go for a quick-paced walk
Clean and organise the house/ room
Do something in nature (grow veggies, gardening, birding)
Get involved in a hobby

Remember that recovery is a journey, and it won't always be uncomplicated.
Eg: you might find it more helpful to focus on learning more about yourself and developing different ways to cope, rather than trying to get rid of all your symptoms.

The sooner you get treatment, the better.

Try the 54321 Trick if you’re feeling anxious.

Find:

• five things you can see
• four things you can touch
• three things you can hear
• two things you can smell
• one thing you can taste

Hopefully sitting quietly and breathing deeply will help you feel a bit calmer.

Some signs are obsessive unwanted thoughts and urges (obsessions) that won’t go away.
To get rid of these distressing thoughts certain behaviours are repeated over and over (compulsions).

A person is diagnosed with OCD when the obsessive-compulsive cycle gets in the way of day-to-day functioning.

Name: OBSESSIVE COMPULSIVE DISORDER (OCD)

Symptoms:

OCD often centres on themes such as a fear of germs or the need to arrange objects in a specific manner.

Obsessive thoughts and worries about:

• Health issues (germs, poisons, body fluids etc.)
• Losing control or acting on impulses

Compulsions – repeating rituals like:

• Counting
• Washing
• Cleaning rooms or items multiples times
• Washing body parts over and over

Caused by:

No single cause
Genetic and environmental factors

Treatment:

Medication
Cognitive Behavioural Therapy

Exercise and activities that require intensive concentration may also help.

Obsessions and compulsions can take over your life and leave you feeling helpless. There are things you can try to help manage your OCD and improve your wellbeing. Remember that different things work for different people at different times.

This disorder usually starts in childhood and can continue into adulthood.

A person with ADHD is on the go all the time and can act without thinking (impulsive) or finds it very hard to pay attention.

SYMPTOMS:

On-the-go all the time
Difficulty paying attention
Restlessness
Daydreaming
Slow to complete tasks
Impulsivity
Inattention
Forgetfulness
Poor time management
Poor organisational skills
Poor listening skills
Lack of focus
Low frustration tolerance
Poor social skills

Anxiety and adhd have some common symptoms.

Average age diagnosed: 7 years
Symptoms shown from 3 years

Risk Factors:

Mainly genetic but there may be other risks such as traumatic birth process, toxins, or brain injuries.

Girls may be more likely to display inattentive symptoms, like daydreaming or losing things, whilst boys may display more hyperactive-impulsive behaviours, such as fiddling or disturbing others.

Treatment:

Medication and therapy (CBT)

Support groups, social skills training are other useful interventions

A young person with Conduct Disorder will have problems following rules and can behave in a way that causes harm to themselves and others. They may lie, steal, or become aggressive. Conduct disorders usually begin between the ages of 10-19 years and have different causes.

Name: CONDUCT DISORDERS
Behaviour and emotional problems

Possible signs:

Won’t follow rules
Disregard for others
Aggressive behaviour
Destructive behaviour
Deceitfulness
Physically violent behaviour

More common in boys
Usually starts in late childhood or early teens

Causes/risk factors:

Environment (abuse, traumatic experience, substance abuse, inconsistent parenting)
Brain defects or injuries
Inherited
Psychological
Social

Treatment:

Therapy - and medication for symptoms

Nurturing, supportive, and consistent home environment with a balance of love and structure may help reduce symptoms and prevent episodes of disturbing behaviour.

A dangerous, very scary, or shocking event can result in Post-Traumatic Stress Disorder (PTSD). With this disorder a person will re-live a traumatic experience and feel stressed and frightened even if there is no longer any danger. PTSD can develop at any age and can be caused by serious events like witnessing or experiencing physical or sexual assault, abuse or an accident.

Name: POST-TRAUMATIC STRESS DISORDER
Not recovering after experiencing or seeing a terrifying event

Possible signs:

Nightmares
Flashbacks (reliving the event mentally)
Anxiety
Depressed mood
Heightened reactivity to stimuli
Avoiding places or situations that bring back the trauma
Pain
Sweating
Nausea
Trembling

Causes/risk factors:

Witnessing or experiencing a traumatic event
Accident
Violence
Childhood physical violence
Assault
Threatened with a weapon
Threatened death
Sexual violation

Treatment:

Different types of Psychotherapy
Medications to manage symptoms

Condition may last months or years.
Triggers can bring back intense, vivid, memories of the trauma.

Not everyone will experience PTSD after trauma
Symptoms don’t start straight away
Symptoms don’t start straight away
Caregivers can develop symptoms too

EATING DISORDERS
These include:
ANOREXIA NERVOSA and BULIMIA NERVOSA

A young person with an eating disorder will be obsessed with food, their weight, and their body. They might starve themselves, over-eat (binge) and then vomit, or over-exercise to avoid weight gain. Eating disorders can be serious and may be life-threatening.

Physical signs/ symptoms of bulimia may include:

Preoccupation with body shape and weight
Repeated episodes of eating huge amounts of food in one sitting

Loss of control overeating
Forced vomiting or exercising after bingeing

Use of laxatives, diuretics or enemas
Fasting, restricting calories or avoiding certain foods between binges
Using products excessively for weight loss

Causes/risk factors:

The exact cause is unknown. Many factors could play a role in the development of eating disorders, including genetics, biology, emotional health, societal expectations and other issues.

Treatment:

Combining psychotherapy with antidepressants may be the most effective for overcoming the disorder.

Treatment generally involves a team approach that includes family, the primary care provider, a mental health professional and a dietitian.

Here's a look at bulimia treatment options and considerations:

Different types of psychotherapy include:

• Cognitive behavioural therapy: Helps normalise eating patterns and identify unhealthy, negative beliefs and behaviours and replace them with healthy, positive ones.
• Family-based treatment helps parents intervene to stop their teenager's unhealthy eating behaviours.
• Interpersonal psychotherapy, addresses difficulties in close relationships, helping to improve communication and problem-solving skills.

Effective treatment can help you feel better about yourself, adopt healthier eating patterns and reverse serious complications.

This is a mental health condition where a young person believes that their body is flawed or that there is something wrong with their body.

Name: BODY DISMORPHIC DISORDER

Intense focus on appearance and body image.
Repeatedly checking the mirror.
Grooming or seeking reassurance, sometimes for many hours each day impacting ability to function in daily life.
Seeking out numerous cosmetic procedures to try to and fix the flaw.
Anxiety often returns and search resumes.

Obsessive and repetitive behaviours are a central part of BDD.
They are not self-obsessed even though they focus on appearance.
Suffers from a lot of shame.

Causes/risk factors:

Body dysmorphic disorder may result from a combination of issues, such as a family history of the disorder, negative evaluations or experiences about body or self-image, and abnormal brain function or abnormal levels of the brain chemical called serotonin. Societal pressure/expectations of beauty contribute greatly.

Treatment:

Treatment may include Cognitive Behavioural Therapy and medication

Identifying the disorder early and starting treatment may be of some benefit.

TOURETTE’S SYNDROME (TS) (not a mental disorder)

It’s a condition of the nervous system that causes sudden and repeated twitches, movements, or sounds and occur with:

Attention Deficit Hyperactivity Disorder (ADHD)
Obsessive Compulsive Disorder or Behaviours (OCD/OCB)
Anxiety
Learning disabilities
Behavioural or conduct issues

Name: TOURETTE’S SYNDROME (TS)
A condition of the nervous system

Possible signs:

TS causes people to have “tics” that happen when your brain makes your body move or say something that you might not want to. Tics are sudden twitches, movements or sounds that people do repeatedly. People who have tics cannot stop their body from doing these things.

Tics usually start at 5 - 10 years old. The first tics are usually motor tics, but everyone’s tics are different. They’re usually worse during times of stress or excitement. They tend to improve when a person is calm and focused on an activity. People can’t stop their tics. They can sometimes hold them in (suppression), but eventually have to release them, very much like a sneeze.

Causes/risk factors:

Risk factors for and causes of TS are unknown.
Research shows that genes play an important role where multiple genes interacting with other factors in the environment.

Common co-occurring conditions include:

Attention Deficit Hyperactivity Disorder (ADHD)
Obsessive Compulsive Disorder or Behaviours (OCD/OCB)
Anxiety
Learning disabilities
Behavioural or conduct issues

Tourette Syndrome affects more boys than girls.
Less than 10% of people swear (coprolalia).

Treatment:

Tics are often mild and don't need to be treated.
Medication is used in some cases.
Counselling, behaviour and talk therapy can also be helpful.

Most people with TS experience their worst tic symptoms in their early teens, but tics typically lessen and become controlled by the late teens to early 20s.

TS can be a chronic condition with symptoms that last into adulthood for some, and tics may worsen in adulthood.

Billie Eilish and Lewis Capaldi both have Tourette’s. “How I’m Feeling Now” is Capaldi’s documentary on Netflix and is bringing attention to the disorder.

Tips:

There are some simple things you can do that may help to improve tics:

• Try to avoid stress, anxiety and boredom – try to find a relaxing and enjoyable activity to do (such as sport or a hobby.
• Try to ignore a child's tic and not talk about it too much – drawing attention to it may make it worse.
• Do not tell a person off when their tic occurs, reassure them that everything’s okay and there's no reason to feel embarrassed.
• People you're in regular contact with should know about tics, so they're aware of them and know not to react when they occur.

If a child is finding school difficult, talk to their teacher about ways of dealing with it, like letting them leave the classroom if their tics are particularly bad.

Suicide is the act of taking one’s own life. There are many reasons why a young person might want to die, often it is because they feel overwhelmed by difficult emotions and situations and suicide seems the only way out. Many people who commit suicide have depression. They don’t recognise that it is the depression and not the situation that is driving them to end their lives.

Suicidal Gesture

A suicidal gesture is when a person does not want to die but they want to alert others to their emotional pain they are going through.

Suicidal Ideation

The term suicidal ideation is used to describe a person who has thoughts about suicide.

Name: SUICIDE

When people harm themselves with the goal of ending their life, and they die as a result.

Possible signs:

Warning signs that someone may be at immediate risk:

Talking about wanting to die or wanting to kill themselves
Talking about feeling empty or hopeless or having no reason to live
Talking about feeling trapped or feeling that there are no solutions
Feeling unbearable emotional or physical pain
Talking about being a burden to others
Withdrawing from family and friends
Giving away important possessions
Saying goodbye to friends and family
Putting affairs in order, such as making a will
Taking great risks that could lead to death, such as driving extremely fast
Talking or thinking about death often

Other serious warning signs:

Displaying extreme mood swings,
Making a plan or looking for ways to kill themselves (searching for lethal methods online,
stockpiling pills, or buying a gun)
Talking about feeling great guilt or shame
Using alcohol or drugs more often
Acting anxious or agitated
Changing eating or sleeping habits
Showing rage or talking about seeking revenge

Causes/risk factors:

A history of suicide attempts
Depression, other mental disorders, or substance use disorder
Chronic pain
Family history of a mental disorder or substance use
Family history of suicide
Exposure to family violence, including physical or sexual abuse
Presence of guns or other firearms in the home
Having recently been released from prison or jail
Exposure, either directly or indirectly, to others’ suicidal behaviour, such as that of family members, peers or celebrities

Treatment:

Effective, evidence-based interventions are available to help people who are at risk for suicide:

Cognitive Behavioural Therapy (CBT)
Dialectical Behaviour Therapy (DBT)
Brief Intervention Strategies
Collaborative Care

If you notice warning signs of suicide—especially a change in behaviour or new, concerning behaviour – get help as soon as possible.

Family and friends are often the first to recognise the warning signs of suicide, and they can take the first step toward helping a loved one find mental health treatment.

Do not leave them alone.

Do not promise that you will keep their suicidal thoughts a secret - tell a trusted friend, family member or other trusted adult.

Call 10111 if there is an immediate life-threatening situation.

SADAG: 0800 567 567
AKESO Crisis Helpline: 0861 435 787
Love Life: 0800 121 900
Childline: 116

Deliberately harming your own body by cutting, burning or hitting yourself is known as self-injury. Self-injury is not usually meant as a suicide attempt. Rather it is a way to try and cope with, and (temporarily) release emotional pain, sadness, or anger.

Name: SELF-HARM/ SELF-INJURY/ CUTTING

Examples of self-harm include:

• Cutting, scratching or stabbing with a sharp object
• Burning with lit matches, cigarettes or heated, sharp objects such as knives
• Carving words or symbols on the skin
• Self-hitting, punching, biting or head banging
• Piercing the skin with sharp objects
• Inserting objects under the skin

Possible signs:

Symptoms of self-injury may include:

• Scars, often in patterns.
• Fresh cuts, scratches, bruises, bite marks or other wounds.
• Excessive rubbing of an area to create a burn.
• Keeping sharp objects or other items used for self-injury on hand.
• Wearing long sleeves or long pants to hide self-injury, even in hot weather.
• Frequent reports of accidental injury.
• Difficulties in relationships with others.
• Behaviours and emotions that change quickly and are impulsive, intense and unexpected.
• Talk of helplessness, hopelessness or worthlessness.

The arms, legs, chest and belly are mostly the targets of self-injury. But any area of the body may be a target, sometimes using more than one method.

Causes/risk factors:

There's no one single or simple cause. In general, self-injury may result from:

• Poor coping skills - non-suicidal self-injury is usually the result of an inability to cope in healthy ways with stress and emotional pain.
• Difficulty managing emotions - having a hard time controlling, expressing or understanding emotions may lead to self-injury.

Risk factors include:

• Having friends who self-injure
• Life issues (neglect, sexual, physical or emotional abuse, or other traumatic events, growing up and remaining in an unstable family environment, questioning personal or sexual identity and social isolation)
• Mental health issues - borderline personality disorder, depression, anxiety disorders, post-traumatic stress disorder and eating disorders.
• Alcohol or drug use.

Treatment:

Psychotherapy, Talk therapy or psychological counselling
Cognitive behavioural therapy (CBT)
Dialectical behaviour therapy (DBT)
Mindfulness-based therapies
Medicines to treat the underlying condition that's linked with self-injury to self
Inpatient care

If there's a focus on thoughts of suicide, do something to get help right away.

The release that you can feel is temporary, those feelings come back. The only way to feel better is by dealing with the cause of those feelings, using different treatments.

People who experience BPD feel emotions intensely and for extended periods of time. It is difficult for them to return to a ‘stable baseline’ after an emotionally triggering event. This can lead to impulsivity, poor self-image, turbulent relationships and powerful emotional responses to stressors. BPD can result in dangerous and impulsive behaviors.

Possible signs:

Uncertainty about identity (interests and values can change quickly)
View things in extremes (eg: either all good or all bad).
Intense and unstable relationships (often from their changing views of the person)
Impulsive and risky behaviour (misuse of alcohol/drugs, binge eating or sexual relationships)
Distorted sense of self
Intense fear of being abandoned or not wanting to be alone
Feelings of emptiness
Frequently and inappropriately angry
Acts of self-harm
Moves from crisis-to-crisis

A mental illness that affects about 1% of the population. It interferes with mental functioning and behaviour.

It can present in adolescence or early adulthood as psychosis* with:

• Delusions (thinking things that are not true)
• Hallucinations (seeing or hearing things that aren’t there)

Psychosis may or may not develop into schizophrenia.

Name: SCHIZOPHERENIA

Schizophrenia is a serious mental disorder in which people interpret reality abnormally.

Schizophrenia may result in some combination of hallucinations, delusions, and extremely disordered thinking and behaviour that impairs daily functioning. It can be disabling.

Possible signs:

• Delusions - These are false beliefs that are not based in reality. Delusions occur in most people with schizophrenia.
• Hallucinations - These usually involve seeing or hearing things that don't exist. Hallucinations can be in any of the senses, but hearing voices is the most common hallucination.
• Disorganised thinking (speech) - Disorganised thinking is inferred from disorganised speech. Effective communication can be impaired, and answers to questions may be partially or completely unrelated.
• Extremely disorganised or abnormal motor behaviour - Childlike silliness to unpredictable agitation.
• Negative symptoms - Inability to function normally, neglecting personal hygiene or appear to lack emotion, may lose interest in everyday activities, socially withdraw or lack the ability to experience pleasure.

Causes/risk factors:

Causes of schizophrenia are unknown but researchers believe that a combination of genetics, brain chemistry and environment contribute to development of the disorder.

Treatment:

The treatment team may include a psychiatrist, a psychologist, social worker, psychiatric nurse.

Treatment with medications and psychosocial therapy can help manage the condition.
In some cases, hospitalisation may be needed.

Schizophrenia requires lifelong treatment, even when symptoms have subsided.

People with schizophrenia require lifelong treatment. Early treatment may help get symptoms under control before serious complications develop and may help improve the long-term outlook.

Suicidal thoughts and behaviour are common among people with schizophrenia. If your child is in danger of attempting suicide or has made a suicide attempt, make sure someone stays with that person. Call your local emergency number immediately. Or take the person to the closest emergency room if you think it is safe to do so.

SADAG Mental Health Helpline
0800 456 789
SMS 31393

This is when a person struggles to know what is real and what is not.

They might:

• see or hear things that others do not (hallucinations)
• believe things that are not true (delusions)

This can be very frightening and may cause a person experiencing a psychotic episode to hurt themselves or others.

The causes of psychosis are not always obvious but, in some cases, may be linked to drug and alcohol abuse.

Bereavement is the word used to describe the sadness that a person feels after someone they love has died.

Bereavement is the word used to describe the sadness that a person feels after someone they love has died. Grief is about how a person reacts to their loss.

It can be very painful and may take a long time before they adjust to the emotional and life changes that happen when someone dies.
>br> However, Complicated Grief is a chronic form of grief that can impair someone’s life.

Don’t forget that Mental Distress happens when the level of stress is higher, and reactions are stronger and more intense. Grief and bereavement are massive stressors for our mental health. Remember that there are ways to get help before your grief becomes debilitating:

• Support groups
• Counselling

• Group counselling
• CBT
• DBT
• Friendship bench

Grief can make you feel many different emotions, and it’s normal to feel anger, deep sadness, despair, afraid, scared and anxious after someone you love passes away. It may take a long time for you to feel consistently a bit better. This does not mean you have a mental illness.

Grieving for a loved one is important, but by seeking help when you’re in Mental Distress and getting the right support, you’ll start to have more days that are a little brighter and sunnier.

Name: COMPLICATED GRIEF

Possible signs:

Complicated grief often dominates a person’s life, interfering with their daily functioning.
Prolonged symptoms may include:

• Intense sadness and emotional pain
• Feelings of emptiness and hopelessness
• Yearning to be reunited with the deceased
• Preoccupation with the deceased or with the circumstances of the death
• Difficulty engaging in happy memories of the lost person
• Avoidance of reminders of the deceased
• A reduced sense of identity
• Detachment and isolation from surviving friends and family
• Lack of desire to pursue personal interests or plans

Causes/risk factors:

The exact causes are unknown, but it is thought to be a combination of genetic, environmental and psychological factors.

Risk factors:

Losing a loved one suddenly or tragically
A history of anxiety or depression
Having a close relationship with the deceased
A lack of social support or community
A history of trauma or abuse

Treatment

Treatment usually involves therapy, medication, or a combination of both.

The experience of grief is something that a person comes to terms with gradually. It’s a slow process out of grief and it’s important to be patient and kind to yourself.