adolescent units.
Places where health professionals work with young people and their
families to try and help them sort out their problems. Most young
people attending adolescent units are expected to continue to live
at home some of the time, particularly at weekends, but there are
some residential units that are more full-time. You are only likely
to be referred to an adolescent unit if you have already tried a
number of other ways of dealing with your problems and not found
them helpful. Adolescent units may cater for young people between
12 and 19 years or for a narrower age band.
adult psychiatric outpatient clinic.
Different parts of the country have different age limits for adult
services and for child and adolescent services. In some areas, if
you need specialist help with your problems and are over 16 and
have left school or are aged 16-18 and still at school, your GP may
suggest that you attend an adult psychiatric outpatient clinic.
However, not all psychiatrists in adult clinics are experienced in
working with young people. If you are unhappy with the advice or
treatment offered, ask your GP whether you can have a second
opinion or whether a child and adolescent psychiatrist could
be consulted.
adult psychiatric ward.
Only a small number of young people are admitted to adult
psychiatric wards in hospitals. You might be admitted to one so
that professionals can assess your problems more thoroughly before
deciding on what treatment you need, or because you are so upset
that you need constant care and support. If you are under 16, you
should be transferred to a more appropriate ward as soon as
possible. Most young people are admitted on a voluntary basis, but
occasionally a compulsory admission may be made or the young person
may be admitted as an emergency. See compulsory
detention and voluntary hospital admission for more
detail.
agoraphobia.
Agoraphobia, which means fear of public places, covers a range of
anxieties. If you have this condition, you may be worried about
using public transport or anxious about being in crowds or fearful
of leaving your home. Agoraphobia sometimes starts in late
adolescence, just when you are expecting to become more
independent. It can be very restricting. Treatment usually involves
some form of behaviour therapy. See also phobias.
alcohol.
Ethyl alcohol (ethanol), the type of alcohol found in drinks, acts
as a depressant or sedative, leading most people to become less
inhibited than usual.
Because it is so widely available and so socially acceptable, it is
easy to forget what a powerful drug alcohol is. Absorbed into the
bloodstream, it has an effect in 5-l0 minutes. Even small amounts
can affect judgement and concentration, and heavy drinking or
getting drunk can significantly affect emotional reactions. For
instance, violence is often associated with alcohol, and people are
also more likely to drive dangerously and have unprotected sex when
they have drunk too much.
Because of the way their livers work, women are generally more
sensitive to the effects of alcohol. And even moderate amounts of
alcohol can be bad for a baby if a woman is pregnant.
You may need to look carefully at your drinking habits if you:
Dependency on alcohol can occur even among people drinking only
moderate amounts each day.
Many people drift into drinking more heavily when they are under
stress or as an attempt to escape from anxiety or
depression. However, regular heavy drinking can lead to
mental health problems, often increasing anxiety and depression and
leaving you less fit to cope. It can also damage your physical
health. If you think you may have a problem with your drinking, see
your GP or contact a helpful organisation.
If you are taking medication for mental health problems, you may
not be able to drink alcohol - check with your doctor. It is also
particularly dangerous to combine alcohol with many recreational
drugs as the interaction between the two substances may be more
powerful than you might expect.
amphetamines.
Also known as 'speed', 'billy', 'whizz' and 'sulphate', these drugs
are powerful stimulants or 'uppers'. They are currently available
on prescription for certain conditions but are also available
illegally in various forms.
The commonest illegal form is amphetamine sulphate powder, which is
usually snorted up the nose but may also be swallowed in a drink,
smoked or injected in solution. However, it is often mixed with
other substances, so injecting can be extremely dangerous. Crystal
methamphetamine - a very strong, pure form of the drug, also known
as crystal, meth or ice - is usually smoked. Amphetamine base, from
which amphetamine sulphate powder is made, is also very strong and
pure. It is injected or wrapped in cigarette papers and
swallowed.
If you take amphetamines, you will probably feel more energetic,
alert and confident. Your breathing and heartbeat will speed up,
your pupils will dilate and you will lose your appetite. These
effects can last for 3-8 hours. However, as they wear off, you may
feel tired, irritable, restless, anxious or depressed.
If taken in high doses over a period of days, the effects can be
more serious. They may include panic, feelings of persecution and
hallucinations, as well as physical effects such as tremors,
sweating, palpitations and, occasionally, seizures. It is
particularly dangerous to take amphetamines if you have breathing
or heart problems or high blood pressure. It is also very dangerous
to mix amphetamines with other uppers such as nitrites
(poppers), cocaine or ecstasy as this will increase
the strain on the heart.
If you are a long-term user, you may find that your general health
is also adversely affected. If you want to stop using amphetamines,
make sure you have plenty of support. You are likely to feel very
tired, apathetic and continually hungry for a time.
anorexia
nervosa.
This eating disorder consists of an extreme fear of being fat that
does not decrease even if the person becomes dangerously thin. It
frequently starts in adolescence but may begin earlier or later. It
is more common among girls, but boys can be affected, too. The
causes are not fully understood but may include anxieties about
growing up, being teased about being overweight, pressures at home
or school or a reaction to an upsetting event.
The person with anorexia can go for long periods without eating and
then eat only minimal amounts. They will make excuses to miss
meals, lie about having eaten or conceal food rather than eat it,
although they may enjoy planning meals and cooking for others. They
may try to get rid of the food they have eaten by making themselves
sick (see also bulimia nervosa). They may also
undertake vigorous, lengthy exercise and consume laxatives in an
effort to lose weight.
Severe weight loss is the major sign of anorexia. In addition, a
girl's periods may stop if her weight drops well below normal.
Other symptoms, which may become more obvious as weight continues
to be lost, include sleeping problems, depressed feelings,
irritability, headaches, constipation, slowed pulse rate, lowered
blood pressure and greater sensitivity to cold. The young person
may become isolated from friends and/or over-concerned with
schoolwork or other issues or may develop obsessions or
compulsions.
Once weight has decreased beyond a certain point, it becomes very
difficult to reason with the person about the importance of eating.
However, long-term severe anorexia can damage health and, in some
cases, can be life-threatening.
The earlier the treatment, the more likely it is to be effective.
So, if you are worried about yourself or a friend or family member,
it is important to seek help from your GP as soon as possible.
Specialist care may also be needed.
antidepressants.
If you have been feeling very depressed for a long time or if you
have been very severely depressed every day for about two weeks or
more, your doctor may suggest prescribing you one of the
antidepressant drugs.
These are not prescribed for mild depression, which responds
better to other forms of support such as counselling. In
addition, although antidepressants are effective in relieving
medium-to-severe depression in the majority of cases, they do not
work for everyone.
There are three main types of antidepressants:
Antidepressant drugs - which are not addictive - are usually
prescribed for several months or longer. The aim is to enable you
to feel well enough to cope with life and tackle some of the
difficulties that may have contributed to your depression. You
should also be offered other forms of support such as counselling
as soon as you are able to benefit from them.
It may be two or three weeks before you notice any improvement.
Your physical symptoms will probably improve first - you will start
to sleep better and will regain your appetite. Next, you will begin
to feel more alert and active and find it easier to concentrate and
remember things. Finally, your mood should improve, although you
may have the odd black day from time to time.
You may experience some side-effects such as dry mouth, blurred
vision or constipation, but these will usually diminish as
treatment proceeds. However, if you find any side-effects very
troubling, tell your doctor who may then vary the dose or try a
different drug. You should avoid drinking alcohol with
antidepressants.
It is important not to stop taking antidepressants without
consulting your doctor as the depression may well recur. When you
are ready to stop, your doctor will gradually reduce the dose so
that you can avoid unpleasant withdrawal symptoms.
antipsychotic drugs.
Also known as the major tranquillisers or neuroleptics, these drugs
are used to treat distressing symptoms such as hearing voices or
disturbed thoughts, which can occur in conditions such as
schizophrenia and manic depression, when the person
is out of touch with reality. Antipsychotic drugs are also
sometimes used in the short term to alleviate severe anxiety
or episodes of mania.
These powerful drugs, generally prescribed by a psychiatrist, need
careful monitoring. They should be offered alongside other forms of
support to enable the person cope better with everyday life.
If you are prescribed an antipsychotic, it may take some days or
weeks before you notice any improvement in the way you feel. As you
start to recover, the dose will probably be reduced. You should
continue taking the drug for some time after you feel better and
then come off it gradually to reduce the risk of a relapse.
When first taking the drug, some people experience side-effects
such as drowsiness, dry mouth, dizziness and indigestion, but these
usually diminish after a time. There are, however, risks of more
serious adverse effects if high doses of the drugs are prescribed
continuously for a period of several years. You should discuss this
with your doctor.
anxiety.
Everyone feels anxious from time to time. However, if your anxiety
is severe or long lasting and begins to dominate your life, it is
sensible to seek help. Just why you should feel so anxious is not
always clear. It may be that you are particularly vulnerable to
anxiety, or your anxiety may be due to upsetting events or a
combination of stresses (see stress).
There are a number of symptoms of anxiety:
Physical symptoms.
Emotional symptoms.
You may also be excessively worried about not coping or afraid
that something dreadful is about to happen, or you may even have a
sense of unreality.
Anxiety may also result in panic attacks, phobias,
obsessions, compulsions or psychosomatic
illness. It also often occurs alongside other mental health
problems such as depression. If anxiety continues for any
length of time, it can be exhausting.
Anxiety is more difficult to deal with once it becomes entrenched,
so seek help early if you can. Your GP may offer you support or
refer you for other help such as counselling or cognitive
behaviour therapy. Relaxation exercises, regular
physical exercise, healthy meals and cutting down on
caffeine-containing drinks will all help you cope
better.
'I can't stop worrying about the future of the world and my family. I dread the day my mum or dad dies, and I keep crying when I think about it.'
approved social worker
(ASW).
If you are detained under the Mental Health Act l983 (or equivalent
legislation in Scotland), an approved social worker will be
involved. An ASW is a qualified social worker who has been
specially trained and approved by the local authority to handle
mental health problems. He or she will always look for alternatives
to compulsory detention. The equivalent of an ASW in
Scotland is a mental health officer (MHO).
art therapy.
In art therapy, you might first draw, paint or make something with
your hands. Whatever you have created often then serves as a
starting point for a discussion of your feelings with the art
therapist. See creative therapies.
assertiveness training.
If you lack self-esteem or expect too much from yourself or try too
hard to please, you might try assertiveness training. Being
assertive does not mean being aggressive or selfish. It means being
able to express your own needs and wishes in a calm and confident
way.
In assertiveness training, you will practise skills such as how to
say 'no' politely but firmly in difficult situations, how to ask
for things for yourself and how to give and receive criticism and
compliments. You will be encouraged to test your skills in actual
situations. Assertiveness training can help you realise that it
doesn't matter if you sometimes make mistakes or disappoint others.
It is more important to think about what you really want from
life.
attention deficit hyperactivity
disorder (ADHD).
A condition in which children have difficulty in concentrating and
controlling their behaviour and are overactive. Such children tend
to be restless and easily distracted and to behave impulsively.
They find it hard to learn at school and make friends, and as a
result, their self-esteem may be low and they may feel lonely or
disliked. Symptoms usually start when the children are very young
and always before the age of seven.
It is important to get help at an early stage. The GP should
normally refer the child for specialist help from either a child
and adolescent psychiatrist or a paediatrician. A combination
of approaches including behaviour therapy, family
therapy, counselling and special educational help may be
suggested.
In adults, the drug Ritalin stimulates the part of the brain that
regulates activity. Surprisingly, it can also have a calming effect
in children, and may be prescribed as part of a comprehensive ADHD
treatment programme. It should be prescribed by a specialist and
carefully monitored. Other drugs such as Dexedrine have similar
effects.
behaviour therapy.
This can be an effective practical treatment for problems such as
phobias, compulsions and obsessions. You and
your therapist will try and identify your problem and the things
that may trigger your distress. You will then look for an
alternative way of responding to these triggers that will enable
you to deal with the problem. This may involve working towards a
simple aim such as patting a dog if you are terrified of dogs or
travelling two stops on a bus if you are frightened of using public
transport. By gradual exposure to the thing that frightens you, you
become desensitised to the fear (see desensitisation,
exposure treatment).
benzodiazepines.
This group of drugs help control anxiety, and are sometimes
referred to as the 'minor tranquillisers'. The best-known brands
are Valium, Largactil, Ativan and Librium.
They reduce feelings of agitation and restlessness, relax muscles
and slow down mental activity. If you are highly anxious, your
doctor may prescribe one of them but usually for only a week or so.
You should also be offered other forms of support.
Benzodiazepines should be used with great caution as anyone taking
them for longer than a few weeks risks becoming dependent on them.
Side-effects include drowsiness, dizziness, forgetfulness and
unsteadiness, so you should not drive or operate dangerous
machinery while taking them.
Benzodiazepines are also used as illegal drugs, often to offset the
after-effects of stimulants. As well as the risk of dependency with
regular use, they can exaggerate the effects of alcohol, and mixing
the two can be dangerous.
bereavement.
If someone close to you has died, you will need time to come to
terms with your loss. There is no set way to grieve, but you may
experience a number of bewildering symptoms at different times over
the following months:
At other times, you may forget about the death and be able to
carry on with normal activities.
It is important to try and express your feelings rather than
bottling them up. Talk to friends or members of your family, or if
that is too difficult, try writing down what you feel. If you find
that your feelings are getting out of control or you are starting
to feel very anxious or depressed, ask your GP about what support
is available.
'I was in despair. I'd lost a close friend and felt I had come to the end of my life. So I phoned the Samaritans during the night - and they were there. They listened and didn't make me feel small. In fact, they saved my reason and my life.'
beta-blockers.
If you suffer from severe anxiety and have upsetting
physical symptoms such excessive sweating, shaking or palpitations,
your doctor may suggest prescribing a beta-blocker drug, especially
to help you deal with a particular event, such as having to speak
in public. The aim is to reduce your physical symptoms so that you
can cope better with your anxiety. However, beta-blockers will have
no effect on the psychological symptoms of anxiety or on symptoms
such as muscle tension caused by stress. Having certain conditions,
such as asthma, may prevent you from being able to take a
beta-blocker.
These drugs usually take effect after a couple of days. Some people
notice they have a dry mouth or feel rather drowsy while on them.
Your GP should also suggest other ways of helping you deal with
your anxiety.
bipolar affective disorder See manic
depression.
bulimia nervosa.
In this eating disorder, enormous quantities of food are consumed
in a very short time. This is known as 'binge eating'. Such
episodes may be planned ahead and are usually kept secret. Bulimics
often feel guilty or ashamed at their lack of control and then try
to counter the effects by self-induced vomiting or by consuming
laxatives, which can cause considerable damage to health. Vigorous
exercise and a period of strict dieting often follow a binge.
Bulimia can reduce concentration so studies or work may be
affected. Friendships and other relationships may suffer because of
the secrecy involved. Someone with bulimia may well feel very
depressed, and thoughts about suicide can sometimes
occur.
It is important to seek help as soon as possible if you are worried
about yourself or a friend or family member. Treatment involves
encouraging the person to establish regular eating patterns and to
maintain a steady weight without bingeing and vomiting. It may
include counselling, group therapy, cognitive behaviour
therapy or behaviour therapy. See also
anorexia nervosa.
bullying.
This may range from physical attacks through name-calling and
continual insensitive 'teasing' to deliberately excluding a person
from certain activities or groups. It can occur at school, at work,
in the family or in the neighbourhood. Bullying can deeply affect
both those who are being bullied and those who see others being
bullied. If you are the victim of a bully, you are likely to feel
humiliated, vulnerable and anxious.
It is important to seek help at an early stage and bring everything
out into the open, however difficult that might seem. You should
not have to cope with bullying on your own. You will need support
to raise your own confidence and self-esteem, which may have been
damaged by the bullying, and to find helpful ways of dealing with
the bullying should it reoccur.
Talk to your family, if appropriate, or to an understanding
professional. Many schools and even some workplaces now have
anti-bullying policies in place: check out what the procedure is
and take advantage of it. If you find this too difficult, you could
ring a helpline as a first step.
If you are a bully yourself, you also need support. You may be
resorting to this type of behaviour because you yourself have been
bullied or because you are confusing bullying with strong
leadership. It is important that you find other ways of handling
your relationships. Social skills training can sometimes be
helpful.
'I'm being bullied by a group of girls and I just want to die.'
caffeine.
This acts as a stimulant, speeding up the heart and breathing,
reducing fatigue and helping concentration. Tea and coffee contain
substantial amounts of caffeine and it is also present in cola
drinks, chocolate, cocoa and some over-the-counter remedies.
Although a few cups of tea or coffee a day will probably do little
harm to most people, caffeine can have unpleasant side-effects if
taken in larger quantities:
The problem is that many people do not recognise that caffeine
is the cause of their symptoms and so increase their intake to keep
going.
If your consumption of caffeine is high and you notice unpleasant
side-effects, it is a good idea to cut down. You could try
substituting decaffeinated tea or coffee, herb tea, fruit juice or
even water. If you have become dependent on caffeine, you may
experience withdrawal symptoms similar to those caused by taking
too much.
cannabis.
The drug cannabis - also known by a variety of names including
'blow' and 'dope' - comes from the plant Cannabis sativa and
is available as both marijuana and resin. Marijuana ('grass' or
'weed') consists of the dried leaves and flowers of the plant. It
can be smoked on its own in a pipe or in a cigarette ('joint' or
'spliff') but is often mixed with tobacco. Cannabis resin, or
hashish ('hash'), can be eaten but is often smoked with tobacco or
neat in a pipe.
Many people find that cannabis helps them to feel relaxed and happy
and that sights and sounds become more vivid. However, others
experience panic, anxiety, feelings of being persecuted or
depression, particularly after large doses. Regular heavy users may
run the risk of becoming dependent. If you feel you are smoking too
much cannabis and want help in giving up, seek support.
child abuse See sexual abuse.
child and adolescent
psychiatrist.
This is a fully qualified doctor who has undertaken further
specialist training in mental health and, in particular, in the
stresses and difficulties that can occur in childhood and
adolescence. Where appropriate, he or she will work closely with
you and your family, alongside other health professionals, to help
sort out problems. See also psychiatrist.
'It helps a lot when I can be with someone I trust. I need people to understand me, support me.'
child and family consultation service.
Also known as family counselling services and child guidance
clinics. These are places where health professionals can help
children, young people and their families to understand and deal
with their problems, which may range from difficulties in making
friends to feeling very depressed. You may be asked to attend for
just a few sessions or over a longer period.
In some areas, you can contact the service directly, but in others,
you need to be referred by a GP, social worker or teacher.
'I'm a bit of a loner. Everyone else seems to have loads of friends to hang out with, but I spend all my time alone reading or listening to music in my room. Sometimes I get really depressed ... but I can't bring myself to make friends.'
Children Act 1989.
The 1989 Children Act, which covers England and Wales, brings
together all the law relating to the responsibilities of parents
and the social services for the upbringing, care and protection of
children. It emphasises that the welfare of the child must be the
main concern whenever arrangements relating to the child are made.
It also stresses that the child's view should always be taken into
account. The Act mainly deals with children up to the age of
18.
In Scotland, the 1995 Children Act has similar general aims,
although there are differences in court procedures and over issues
of parental responsibility. In Northern Ireland, the Children
(Northern Ireland) Order 1995 is the equivalent legislation.
clinical
psychologist.
A clinical psychologist has a degree in psychology, which includes
the study of normal and unusual behaviour, followed by further
specialist qualifications in understanding and treating mental
health problems. Some clinical psychologists specialise in helping
children and adolescents.
cocaine.
Cocaine - also known as 'coke', 'charlie', 'snow' and 'C' - is a
powerful stimulant made from the leaves of the coca plant. It is
normally a white powder that can be injected or smoked with tobacco
but is usually snorted up the nose. 'Crack' is freebase cocaine
(treated with chemicals) that comes as small rocks or pellets and
is smoked.
Cocaine speeds up the heart and breathing. People who take it feel
more elated, alert and confident, but the effect usually wears off
in about an hour. The effects of crack are more intense and
short-lived, lasting only a matter of minutes.
Sometimes people feel anxious and panicky while under the influence
of cocaine. These feelings worsen with high or repeated doses.
Smoking a lot of crack over a short period may also lead to
anxiety and feelings of persecution, and people taking it
may become very over-excited and hyperactive. After the effects of
crack or cocaine wear off, the person may feel tired and hungry
and, possibly, agitated, anxious or depressed. Frequent long-term
use of cocaine or crack can lead to anxiety, difficulties in
sleeping and general ill health.
Cocaine, especially in its 'crack' form, is addictive and produces
unpleasant physical withdrawal symptoms. If you feel you have
become dependent on cocaine or crack and want to come off, seek
support.
cognitive behaviour therapy (CBT).
If you are distressed or have low self-esteem, you are likely to
view yourself and other people's attitudes towards you in a
negative way. This in turn may increase your unhappiness and lack
of confidence. A cognitive behaviour therapist can help you break
this cycle by encouraging you to recognise and challenge your
negative reactions and to begin to see life in a more positive and
realistic way.
For example, rather than telling yourself that there is no way that
you can cope with a certain situation, you can decide to tackle it
step by step. Or rather than telling yourself you are unpopular
because you have few friends, you might learn to say (and believe),
'I have friends who like me and I can make more if I wish.'
Your therapist may ask you to keep a diary to help you understand
your patterns of thinking and may use role play or relaxation
techniques to help you cope.
'My friends think I'm weird because I'm scared of so many things.'
compulsions.
Also known as rituals, these are seemingly purposeless types of
behaviour performed according to certain strict rules. Common
compulsions include excessive handwashing and needless checking and
touching and retouching objects in a certain order. Compulsions,
which often accompany obsessions, are an attempt to alleviate
anxiety and stress.
If you are affected by compulsions, you probably recognise that
they are irrational but feel that you are unable to manage without
them. Try to seek help at an early stage as compulsions can become
very time-consuming and seriously restrict your life. Behaviour
therapy can be very effective. If your family has been drawn
into your behaviour, they should also be involved in your treatment
so they can learn the best way to help.
compulsory detention.
A small number of people are taken to and kept in hospital against
their will under the terms of the Mental Health Act 1983 (which
covers England and Wales) or the Mental Health (Scotland) Act 1984,
so that their mental health problems can be assessed or treated.
This may be in the interests of their own health and safety or for
the protection of others.
Compulsory detention is also sometimes referred to as being
'sectioned' or being 'on a section' and the person who is detained
may be called a 'formal patient'.
No single individual can section someone. Generally, three
designated people - two doctors and a specially trained approved
social worker - must agree that it is necessary. It should
always be a last resort after everything else has been tried.
If you become a detained patient, you will not be free to leave
hospital when you wish. There are special rules about treatment and
whether or not you have the right to refuse it. You should be given
information about your rights (including your right to appeal
against detention) when you are admitted to hospital.
confidentiality.
You have a right to expect that any personal discussions you have
with medical professionals - for instance, doctors and
psychiatrists - remain confidential, although they may be disclosed
on a confidential basis to other professionals working in the same
team. If you have any doubts as to the situation, check with the
professional concerned.
Medical professionals should respect your right to confidentiality,
even though they may try to persuade you to be more open with, for
example, your family or friends if they feel this might help your
situation. They should also make clear that there are some
circumstances in which they may not be able to preserve
confidentiality. These might include situations involving sexual
abuse, a risk of suicide or a risk of harm to others.
consent to treatment.
Young people have the right to be consulted by medical
professionals (that is, doctors and psychiatrists) about their
treatment or about any decisions that concern them, and their views
should be listened to and respected. If you are aged 18 or over,
you can consent to or refuse treatment on your own behalf, and this
also applies in most cases if you are aged between 16 and 18.
If you are under 16, you can consent to treatment without your
parents having to know, as long as you understand what the
treatment is for and what the risks might be. However, most doctors
will want to discuss with you why you don't want your parents to
know. The law is a bit inconsistent in that, if you are under 16
and you refuse treatment, your parents or those responsible for you
can consent on your behalf. However, you should still be
consulted.
There are two circumstances when consent to treatment need not be
obtained, either from the young person or from those with parental
responsibility: in case of emergency when immediate action is
essential to save life or prevent serious injury; and when the
young person is detained under certain sections of the Mental
Health Act l983 or Mental Health (Scotland) Act 1984 (see
compulsory detention).
counselling.
In this, people have the chance to explore their feelings and
anxieties on a one-to-one basis and in confidence. Counsellors
should be trained to listen, without making judgements, and to
offer support while you work through your problems at your own
pace. They use a variety of approaches, but their main aim will be
to build up a relationship of trust with you so that you feel safe
to express your feelings. They will not provide you with solutions
but will try to guide you so that you find them for yourself.
Counselling and psychotherapy are quite similar. However, in
counselling you are likely to focus on problems you are
experiencing at the moment, whereas in psychotherapy you may look
more closely at the past.
Anyone can set themselves up as a counsellor, so it is important
that any you see have been recommended by someone you trust or by a
suitable organisation.
'After I felt depressed a few times, I knew I'd always come out of it ... It was horrible thinking it might come back, though. In the end, I went for counselling, which helped me feel more in control of my life.'
creative
therapies.
If you are distressed but find it difficult to talk about yourself
or your feelings, you may find one of the creative therapies
helpful. Also known as arts therapies, these include art
therapy, dance and movement therapy, drama therapy and music
therapy. They are a means of helping you explore your emotions
through, say, a picture or a story, at your own pace and in a way
that you may find easier to handle. You do not need any particular
skill or ability to participate in one of the creative therapies,
and you will probably find it an enriching and enjoyable
experience.
dance and movement therapy.
If you are distressed, you may well be concentrating on problems in
your head and ignoring your body's reactions. Dance and movement
therapy enables you to become more aware of your body and find ways
of expressing your feelings through gesture and movement.
See creative therapies.
delusions.
These are distorted ideas about the world, and people who have
delusions may be out of touch with reality. They may, for example,
believe that someone is deliberately putting thoughts into their
mind or extracting their thoughts with a machine. Other common
delusions include believing you are being pursued by secret agents,
or that someone is plotting to harm you in a particularly bizarre
way, or that you are someone else, such as a member of the royal
family. No amount of rational argument or reassurance will change
these beliefs. See schizophrenia and manic
depression.
depression.
It is quite normal to feel down or miserable from time to time.
However, if these kinds of feelings begin to dominate your life so
that you can no longer cope, or if they are more severe or
long-lasting than might have been expected, you may well be
'clinically' depressed. Depression often occurs alongside other
mental health problems such as anxiety.
There are a number of symptoms:
In very severe depression, there may be delusions or
hallucinations and recurrent thoughts of death or
suicide.
Anyone can become depressed, but some people are more vulnerable to
depression than others. The causes vary from person to person and
may include stresses and upsetting events that have occurred
recently or in the past.
Left untreated, depression can last for months or even years,
causing great distress to the person and to those close to them.
Early treatment can often prevent depression from worsening and can
alleviate the symptoms, so see your GP as soon as possible.
Not all treatments work equally well for everyone and your doctor
will need to find the one suitable for you. If
antidepressants are prescribed, other treatments or support
should also be offered, such as counselling, cognitive behaviour
therapy or supportive discussions on ways to cope.
'If you break your leg, you can talk about it, but if you are depressed, you're often treated as though you are mad.'
desensitisation.
In this behaviour therapy technique, you will be asked to
list the situations that make you most anxious. If you are
frightened of spiders, for example, these might range from seeing a
picture of a spider to holding a spider in your hand. Starting with
the least threatening, you will gradually overcome your anxiety in
each situation with the help of relaxation exercises and the
support of the therapist. You may prefer to work through the
situations in your imagination before gradually confronting them in
reality.
drama therapy.
In this, you might be asked to act out a story, improvise a scene,
interpret a poem or create a character. This kind of activity gives
you the opportunity to explore various sides of your personality
and test your reactions in imaginary settings. See
creative therapies.
eating disorders See anorexia nervosa, bulimia
nervosa.
ecstasy.
Also known as 'XTC', 'pills', 'jubes', 'smarties' and 'doves', this
is a mind-altering stimulant drug that is usually sold in capsule
or tablet form and taken by mouth. People usually take ecstasy to
feel more relaxed, energetic and exhilarated and able to experience
things with more intensity, especially music. However, some people
have adverse reactions such as feeling unsteady, sick, anxious or
persecuted.
Ecstasy speeds up the heart and breathing. It also raises body
temperature, and this, combined with dehydration and exhaustion
from dancing in a hot atmosphere, can be dangerous. Sipping water -
but no more than about a pint an hour - and taking frequent rests
can help to reduce the risks. Drinking alcohol will make
dehydration worse.
The drug usually takes 30-60 minutes to take effect and may last
several hours. Once it wears off, you will feel tired and possibly
anxious and depressed. This is even more likely with high and
repeated doses. Some long-term users report symptoms such as
general anxiety, panic attacks, depression, insomnia and
confusion; general health may also be affected.
Ecstasy is dangerous if you suffer from high blood pressure, heart
problems, diabetes, asthma or epilepsy. It also is dangerous to mix
ecstasy with other drugs, particularly other stimulants or
antidepressants. It is important to be aware that some
ecstasy tablets contain other drugs, which could be dangerous.
Testing a small amount first could help to reduce the risk.
If you feel you have become dependent on taking ecstasy and want to
stop, seek support.
ECT (electroconvulsive therapy).
In this, the person is given a short-acting anaesthetic and a
muscle relaxant. An electric current is then passed through the
brain causing a minor convulsion ('fit'), which appears as not much
more than a twitch. The person then rests for a couple of hours
and, afterwards, may experience some minor discomfort.
A course of ECT usually consists of six to eight sessions over a
two- to three-week period. Most people notice considerable
improvements after just two or three sessions. There may be some
memory loss, usually temporary, relating to the weeks during which
the treatment took place.
ECT is an uncommon form of treatment. It may be given to people
with very severe depression who fail to respond to other
forms of treatment or to people whose symptoms are so severe that
they are a danger to themselves. It is very rarely given to young
people.
education welfare officer (EWO).
An education welfare officer, also known as an education social
worker (ESW), can provide help if you are having problems that
affect your schooling such as missing school, falling behind in
your work or being unable to settle down at school. The EWO will
try and find the reasons for your difficulties and then look for
ways of enabling you to deal with them. These might include getting
support from your teachers or other sources of help. See
school phobia.
educational
psychologist.
In addition to having a degree in psychology, which includes the
study of normal and unusual behaviour, and further specialist
qualifications, educational psychologists are also trained and
experienced teachers. They may help you sort out problems that are
related to learning and to school, or they may advise your school
on ways to help you.
exposure
treatment.
This behaviour therapy technique, also known as 'flooding',
encourages you to confront completely whatever frightens you, with
the support of a therapist. At first, your anxiety will increase,
but if you can remain in the situation for half an hour or so, you
will find that it subsides naturally. Once you have overcome your
fear with the therapist present, you can practise with friends and
then on your own. If you are happier with a more gradual approach,
the therapist may set more limited weekly targets.
This technique might also be helpful if you have problems with
compulsions. The therapist will place you in circumstances
that normally give rise to your compulsive behaviour and ask you to
refrain from carrying it out for as long as possible. At first,
your anxiety will mount, but after a time, it will subside. This
will help you to realise that nothing dreadful occurs if the
compulsive behaviour is not carried out
family therapy.
Children and young people are usually affected by any problems
occurring within their families, and other family members can be
affected if a young person becomes distressed or starts behaving in
an unusual way. If you or other members of your family are upset
and finding it hard to cope, you may be offered family
therapy.
This involves family members working with specially trained
professionals to try and find the reasons for the problem and
discover ways in which everyone can help. Family therapy is usually
concerned with how people are getting on here and now, but it is
sometimes helpful to think about the past and how important events
have affected the family. Quite often you discover a new way of
looking at the situation or that small changes in behaviour by
different family members are all that are needed.
'You have to talk about problems or have a nervous breakdown.'
flooding See exposure
treatment.
gay or lesbian
orientation.
Although being gay or lesbian is, in itself, quite natural, many
young people feel very anxious and confused when they first
discover they are attracted to someone of the same sex. They may
worry about being different, and they may try to hide or suppress
their feelings for fear of disapproval or rejection by their family
or friends. Worries about their sexual orientation may begin to get
out of hand, sometimes resulting in depression and other
problems.
Sometimes attraction to someone of the same sex is a passing phase,
but many young people feel quite certain of their sexual
orientation. The more open you can be with family and friends, the
better, but if you find this difficult, you may find it helpful to
approach an appropriate organisation for support.
general practitioner (GP).
Your GP is there to look after your psychological as well as your
physical health. If you are feeling very anxious, stressed or
depressed, for example, or if you are worried about your own
behaviour or ability to cope, go to see your GP. The sooner your
problem can be identified, the more quickly appropriate support and
treatment can be offered.
Our minds and bodies interact very closely (see mind-body
interaction), and your GP will want to make sure that there is
no physical illness or condition that may be causing or
contributing to your problems before exploring other possible
reasons. Your doctor may offer you support or treatment him/herself
or may refer you to other sources of help.
Many young people share their GP with other family members, but you
can ask your doctor to keep things confidential unless your safety
is at stake (see confidentiality).
group therapy.
This is a way in which a number of people can explore their
problems and anxieties together with the help of professionals.
Group therapy can often be particularly helpful when individuals
are experiencing similar difficulties, or if they feel more relaxed
and able to communicate with people their own age rather than with
an individual therapist. You may find that it is easier to be
honest with young people than with adults and to accept their
suggestions and criticisms. You will also probably gain in
understanding and confidence through helping other people work
through their problems.
'My first choice would be an outsider who'd been through what I'd been through. You could click through that - you relate on that level. They can handle it, they know where to stop and what to ask.'
hallucinations.
These are perceptions that others do not share but which are very
real to the people experiencing them. They may see, hear, touch,
feel or smell things that are not apparent to others and for which
there is no external evidence. For example, they may hear voices
commenting on what they are thinking or urging them to take certain
actions. They may then reply to these voices either silently or out
loud.
Quite a lot of young people experience hallucinations, especially
when they have a high fever or are under the influence of drugs,
but this may be a sign that the person is out of touch with
reality. See schizophrenia.
heroin.
Also known as 'smack', 'skag', 'H', 'junk' and 'brown', this is an
opiate - one of the drugs derived from the opium poppy, which also
include opium, morphine and codeine, and synthetic drugs such as
pethidine and methadone. Many opiates, including heroin, are used
for medical purposes.
Heroin is also commonly used illegally. It can be snorted up the
nose, injected in a solution or heated on tin foil and smoked
('chasing the dragon'). Opiates slow down the heart and breathing
and, in higher doses, produce drowsiness. People take heroin to
stop worrying and to feel safe, warm and contented.
If you use heroin or other opiates illegally, you run the risk of
becoming dependent, particularly if you are using them because you
feel anxious or unable to cope. After a few weeks of frequent
doses, many people experience withdrawal symptoms if they stop
using abruptly ('going cold turkey'): vomiting, sweats, chills,
cramps, insomnia, hallucinations. This can encourage them to
continue using the drug.
Long-term use of heroin or other opiates can sap your motivation
and affect relationships, work, study and your general health.
Injecting heroin presents the greatest health risk. Unexpectedly
pure heroin may lead people to overdose. Taking heroin or other
opiates with alcohol or tranquillisers is dangerous and can lead to
breathing failure or coma. Sharing needles is one of the main
causes for the spread of AIDS in the Western world. And because it
is illegal and maintaining a 'habit' is expensive, using heroin
often leads to criminal behaviour and its consequences.
If you want to stop using heroin, seek appropriate support.
lesbian orientation See gay
or lesbian orientation.
Librium See benzodiazepines.
lithium.
This drug is sometimes prescribed for very severe depression
or to help control mild bouts of mania. It is also sometimes
prescribed as a maintenance treatment to help prevent episodes of
mania and depression or reduce their severity and frequency
(see manic depression).
If you are prescribed lithium, you need to be very careful as there
is only a very narrow margin between a dose that is high enough to
be effective and one that is dangerous.
LSD (lysergic acid diethylamide).
LSD, also known as 'acid', is a powerful hallucinogen - that is, a
drug that alters the way you perceive things. Its effects usually
occur 30-60 minutes after taking the drug and last 8-12 hours or
longer.
LSD's effects depend very much on your state of mind when taking
it. For example, you may feel a sense of heightened self-awareness
and colours may appear intensified and patterns distorted. Familiar
objects and people may seem new and fascinating, and some
individuals report feeling as though they have moved outside their
bodies.
However, LSD is unpredictable and you may experience unpleasant and
even frightening reactions - a bad 'trip'. You may feel dizzy,
confused, anxious, panicky or persecuted or as though you are dying
or losing your mind. Occasionally a bad trip may have
longer-lasting effects, such as recurring anxiety attacks, but
these usually fade with time. Even following a good experience with
LSD, you may feel anxious and depressed afterwards, and flashbacks
of the experience can occur several days or weeks later.
Long-term use of LSD may increase anxiety and depression or trigger
other mental health problems.
magic mushrooms.
These contain natural hallucinogens - substances that alter the way
you perceive things. The most commonly used type in the UK is the
liberty cap, but other mushrooms are also used. Magic mushrooms are
eaten or boiled and mixed with tea and drunk.
At low doses, magic mushrooms can give you a mild feeling of
elation. You may feel very relaxed and laugh a lot. At higher
doses, the effects can be very similar to those of LSD, but
they are not as long lasting. If you have a bad experience with
magic mushrooms, you may feel anxious or even terrified. In some
cases, you may still feel upset even when the effects of the drug
have worn off. You may also have stomach pains, feel sick or throw
up afterwards.
The biggest risk from magic mushrooms is poisoning yourself by
taking the wrong sort. Identifying mushrooms is tricky, and
consuming ones that appear to be magic mushrooms but are not could
prove fatal.
manic
depression.
Also called 'bipolar affective disorder'. In this condition, people
experience swings of mood, to mania (extreme elation and
over-activity) or severe depression or both. These periods
are usually interspersed with times of more or less normality.
Manic depression is very rarely diagnosed in young people below the
age of 14, but can occur at any time in life from then on. The
frequency, intensity and length of episodes varies between
individuals and often at different times of a person's life.
Many of the symptoms experienced in mania and mild mania
(hypomania) are almost the reverse of those experienced in
depression. They include greatly increased activity and energy, a
decreased need for sleep, excessive self-confidence and lack of
self-criticism. In the early stages, ideas flow rapidly, speech
accelerates and you may be highly creative and amusing.
In later stages, however, thoughts race, speech becomes incessant
and incoherent, you are less inhibited and your judgement is
affected. This may lead to highly confrontational behaviour,
hurtful comments, numerous sexual liaisons or disastrous spending
sprees. Those with severe mania may experience unintelligible
speech, delusions and hallucinations.
It is important to seek help from your doctor at an early stage as
prompt treatment can limit the severity or length of an attack. At
a later stage, you may no longer be in control of your own actions,
and others may be forced to seek help for you (see
compulsory detention).
Antipsychotic drugs may be prescribed for episodes of mania
and antidepressant drugs for severe depression.
Lithium may be prescribed for mild bouts of mania or as a
maintenance drug to help control the condition. You should also be
offered support to enable you to regain your confidence and
readjust to a normal life. Some form of therapy such as
counselling may be helpful at an appropriate time.
mental health officer (MHO) See approved social
worker (ASW).
mind-body interaction.
Our minds and bodies are very closely linked. Emotional and
psychological factors play a part in many physical illnesses, just
as physical illness may affect our emotional and psychological
well-being. For instance, someone who is emotionally stressed may
experience various aches and pains, and someone who is unwell may
become anxious or depressed. You should also be aware that
emotional problems such as depression can sometime follow
certain illnesses such as influenza or glandular fever or occur as
side-effects of certain drugs. See also psychosomatic
illness.
Monoamine oxidase inhibitors (MAOIs) See
antidepressants.
music therapy.
In this, you will use your voice or a simple instrument such as a
drum to explore sounds and express your feelings. The music
therapist will respond musically in the same mood, thereby showing
that he or she understands your emotions. Once trust has been built
up, you may feel more confident to look at some of your anxieties.
See creative therapies.
neuroses.
Mental health problems such as anxiety, phobias, obsessions
and some forms of depression may sometimes be referred to as
neuroses or neurotic disorders. Those affected by neuroses may be
very distressed, but they usually know that something is wrong and
are able to cope with most aspects of their lives in a rational
way. See psychoses.
'If I were to tell my mates how I really feel, they would think I was off my head. I known I'm not mad, just bloody unhappy.'
nicotine See tobacco.
nitrites (poppers).
Amyl and butyl nitrites are stimulants derived from nitrous oxide
('laughing gas'). Yellow in colour, they are highly flammable. When
used recreationally, they are inhaled.
Nitrites lower blood pressure and make the heart beat more quickly,
pumping blood to the brain. This often results in a rush of energy,
which heightens sensory experiences; afterwards, you may feel
light-headed for a few minutes. However, some people experience a
severe headache, flushes, dizziness or nausea, and there is a small
risk that you may black out. Repeated use can cause a rash around
the mouth and on the neck.
Nitrites will burn the skin if they come into contact with it and
they can be fatal if swallowed. They should never be used by
someone with low blood pressure, heart or breathing problems or
glaucoma. Using nitrites at the same time as other stimulants or
other drugs that lower blood pressure is also extremely
dangerous.
obsessions.
In the context of mental health, these are unwanted and intrusive
thoughts, ideas, images or impulses that keep recurring despite
efforts to resist them. There are many different types, including
worries about becoming contaminated or of harming yourself or
someone you care about. Obsessions about doing wrong or having done
wrong or having the odd bad thought become more common during
adolescence. They sometimes occur alone, but often they give rise
to compulsions that may or may not be connected with the
obsessions.
It is not clear what causes obsessions, but if you experience them,
you will probably find them quite distressing as they will seem to
be uncontrollable even though you realise that they are irrational.
Try and seek help at an early stage. Behaviour therapy can
be an effective treatment.
'I wonder if I'm going to be run over by the next car. Nobody's safe any more. You're not even safe at school.'
occupational therapist (OT).
You may come into contact with an occupational therapist if you are
admitted to hospital or attend an adolescent unit. The OT's aim is
to help you to become more confident and independent through
developing your skills and interests. This may include improving
your practical skills such as shopping, cooking, budgeting and
filling in forms, or improving your social skills in situations
such as a job interview or asking a friend for lunch. You may work
with an OT individually or in a group.
panic attacks.
These are periods of intense fear and discomfort that often seem to
come out of the blue and may last from several minutes to up to an
hour. If you have a panic attack, you may experience one or more
distressing symptoms:
Because panic attacks are usually unpredictable, you may also
become anxious about having one at an inconvenient time and may
restrict your activities accordingly. This can disrupt your life
and make you less confident.
If you have had several panic attacks, see your GP. He/she will
check that there is no physical cause for your symptoms and will
advise you how to cope. Relaxation exercises and
cognitive behaviour therapy can usually help.
parents with mental health
problems.
If you have a parent with a mental health problem or drug or
alcohol addiction, you are likely to feel isolated and under a lot
of stress. Your parent's behaviour may be very unpredictable
and you may be faced with a great deal of responsibility, both for
your parent and for the rest of the family. You may well find it
hard to concentrate on work or studies or lead a normal social
life.
You should not struggle on alone. There is confidential help
available. By taking advantage of it, you are not being disloyal to
your parent and you will benefit the whole family.
personality disorder.
This term is used to describe people who have difficulty in
learning from experience or in dealing appropriately with other
people or the demands made by society. Odd or disturbed ways of
behaving may become apparent in late childhood or adolescence and
may continue throughout life, often leading to depression
and anxiety.
There are a number of different types of personality disorders.
They include people who behave in a very eccentric way or who are
suspicious or mistrustful of others without reason or have
difficulty in forming social relationships. Those who demonstrate
persistent anti-social or aggressive behaviour, without
understanding its effect on other people may also have a
personality disorder. In addition, there are individuals who are
highly anxious and unable to function independently or who express
their anger in a passive-aggressive way by, for example,
persistently and deliberately failing to complete work.
Of course, even if you recognise that you behave in a way similar
to any of the above descriptions, this does not necessarily mean
that you have a personality disorder. However, if you are worried
that you may have one, talk to your GP. Some form of
counselling or behaviour therapy may be
helpful.
phobia.
This is an acute fear that is quite out of proportion to the actual
object or situation involved. Phobias range from fear of spiders to
fear of public places (agoraphobia) or of eating in public
(a type of social phobia). If you have a phobia, you will be
aware that your fear is quite irrational, but knowing this will not
help you to reason it away.
People with phobias experience extreme anxiety and sometimes
even panic attacks when faced with the object or situation
they fear. They may also become distressed simply by worrying about
the possibility of such an occurrence and how they would cope,
which further adds to their anxiety. Most people with phobias cope
by avoiding the object or situation of their fear, but this can
considerably restrict their lives and undermine their
self-confidence and may even make the phobia worse.
Sometimes phobias disappear of their own accord after several
months, but if yours persists for longer and affects your life, you
should seek help. Behaviour therapy is often a very
effective treatment.
'I know things like cotton wool and stairs can't really hurt me, but it doesn't stop them making me nervous.'
post-traumatic stress disorder (PTSD).
If you have experienced a very upsetting event, either as a victim
or eyewitness, you may feel distressed for a long time afterwards.
Such events might include a serious accident such as a train or car
crash, sexual abuse, a violent crime or a disaster such as
war or an earthquake. This distress - known as post-traumatic
stress disorder - may occur soon after the event or some time later
and can take a number of forms:
All these reactions are quite normal, given the circumstances,
but it is very important that you have help and support to deal
with your painful feelings. Emotional support from friends and
family and professional help at an early stage in the form of
individual counselling or cognitive behaviour therapy
may make it easier for you to cope.
Longer-term problems such as difficulties in making close
relationships may result if you try to suppress your feelings
rather than working through them with appropriate support. However,
it is never too late to seek help.
psychiatrist.
This is a qualified medical doctor who has undertaken further
specialist training in mental health. Some psychiatrists will have
additional specialist skills in certain areas such as eating
disorders or addiction, and some may specialise in certain
groups of people such as children and adolescents.
A 'consultant psychiatrist' is someone who holds a senior hospital
post and works closely with other doctors who are at various stages
of training in psychiatry. Even if you are referred to a
consultant, you may be seen by one of these other doctors, who will
then discuss your situation and treatment with the consultant
concerned.
Psychiatrists usually work closely with other health professionals
such as nurses and therapists as members of a team. See also
child and adolescent psychiatrist.
psychologist See clinical psychologist,
educational psychologist.
psychoses.
Mental health problems such as schizophrenia and manic
depression are sometimes referred to as psychoses or psychotic
disorders. Those affected by them are often out of touch with
reality and have little or no understanding of their own condition.
Their perceptions are likely to be distorted so that they are
unable to distinguish between what is happening in the outside
world and what is going on in their own internal world of confused
thoughts and feelings. See also neuroses.
psychosomatic illness.
The word 'psychosomatic' is
derived from psyche meaning 'mind' and soma meaning 'body'.
Psychosomatic illnesses are physical disorders that are largely
caused or aggravated by emotional upset or psychological
stress.
You might, for example, develop a skin rash in response to
anxiety or you might develop back pain because you are
depressed. The mind and body are very closely linked (see
mind-body interaction) and your body is responding to your
feelings in a physical way that is outside your control. Because of
this, you may sometimes need help in dealing with your emotional or
psychological difficulties before your physical symptoms can
improve.
Sometimes people use the term 'psychosomatic' to imply that others
are simply pretending to be ill. But psychosomatic disorders are
just as real as purely physical ones - they just have an added
psychological dimension to them.
psychotherapy.
Psychotherapy offers people the chance to explore their feelings
and anxieties on a one-to-one basis in confidence. The
psychotherapist should listen without making judgements and offer
support while you work through your problems at your own
pace.
Counselling and psychotherapy are quite similar, but whereas
counselling is more likely to focus on the present situation,
psychotherapy will look more closely at the past, in the belief
that the roots of many of problems lie in early childhood
experiences. The psychotherapist will try to build up a
relationship of trust with you so that you feel safe to explore
your past to gain a better understanding of your present
difficulties. Such an approach is sometimes referred to as
'psychodynamic'.
If you see a psychotherapist privately, make sure that the one you
chose has been recommended by someone you trust or by a suitable
organisation.
'It would be good if everyone could talk freely about how they feel, without being made to feel there is something wrong with them.'
relaxation exercises.
Being able to relax is vital for your physical and mental
well-being, particularly when you are under stress. It is a
way of renewing your energy so that you are able to cope better.
However, it is often when you are at your most anxious and tense
that you find it hardest to relax. Tension builds up and you become
even more stressed. If you find yourself in this situation,
relaxation exercises will usually help to relax your body, and in
the process, your mind will become calmer, too.
All relaxation exercises involve learning to breathe more fully
using the diaphragm and a method of muscular relaxation, such as
tensing and relaxing the main muscles in turn. Your GP or practice
nurse can probably suggest relaxation exercises for you. Once you
have learned them, you should practise regularly at home until you
find it easy to relax in stressful situations.
Ritalin See attention deficit hyperactivity
disorder (ADHD).
schizophrenia.
This is the most common form of severe mental illness, affecting
about 1 in 100 people before the age of 45. It usually first occurs
in adolescence, though it can begin at any time, and the onset can
be sudden and dramatic or build up over time. Some people have one
episode and fully recover, while others may have a number of
episodes and recover in between or need considerable support
throughout their lives.
In schizophrenia, the different parts of the mind such as thoughts,
sensations, memories and emotions no longer function harmoniously
together but become confused and disordered. As a result, you are
no longer able to trust your own reactions and may have difficulty
in distinguishing between fantasy and reality.
There is a wide range of symptoms in schizophrenia and you may
experience different ones at different times. They include symptoms
such as disturbances in thinking, delusions and
hallucinations (including 'hearing' voices), which often
respond well to treatment with antipsychotic drugs. Other
symptoms - such as lack of energy and motivation, difficulties in
concentrating and loss of interest in other people or activities -
respond better to a supportive routine and just the right amount of
stimulation.
If you are affected by schizophrenia, you are probably aware that
things are not right, but you are unlikely to know that you need
help. Friends or relatives will need to persuade you to see your GP
who may in turn refer you to a psychiatrist.
Drug treatment may be suggested if appropriate, but you should
always be offered other forms of support as well. This might
include regular supportive discussions with a health professional
to help you re-establish some sort of structure in your life,
social skills training to restore your confidence, or attendance at
a day centre, drop-in centre or training project. Professionals may
also work with your family to help them find ways of offering you
the right sort of support (see family
therapy).
school nurses.
These are qualified nurses who have extra training in working with
young people and work in some schools. A school nurse can offer
information, advice and support on a range of problems such as
relationships, bullying, exam worries and taking drugs. Young
people often find it helpful to talk to a school nurse in
confidence (see confidentiality).
school phobia.
Also known as 'school refusal', this is a reluctance or a refusal
to attend school usually caused by anxiety. It is not the
same as bunking off school because the person is bored or wants to
do something else.
School phobia occurs across all age groups and abilities, but it is
more common in early adolescence and usually develops gradually.
You may have physical symptoms of anxiety such as aches or
pains or feeling sick as the time to go to school approaches. If
you remain at home, these symptoms will disappear and they will not
occur at all at weekends and on holidays.
It is important to sort out as soon as possible just why you are
feeling anxious. The more school you miss, the harder it will be
for you to return. If your reluctance to go to school is due to
teasing, bullying or other school pressures, these should be
sorted out with the school. Your family or a professional such as
an education welfare officer can help you to do this. If it
is due to other anxieties or stresses, talk to your GP. He or she
may be able to help or may suggest that you have counselling,
family therapy or social skills training, for example, to help
you cope and support your return to school.
'I sit in my room and cry even though there is no reason to be unhappy. I worry about my GCSEs even though everybody tells me to slow down because I work too hard.'
sectioning See compulsory detention.
selective serotonin re-uptake inhibitors (SSRIs) See
antidepressants.
self-harm.
Also known as self-injury, this involves deliberately hurting
yourself. This might be through cutting, burning or bruising
yourself or by taking an overdose of tablets. It often starts
around the age of 14 or 15 and can continue for many years.
Self-harm is usually carried out in secret as many of the people
who do it feel very ashamed and guilty.
People who self-harm may get relief from unpleasant feelings for a
while but, at other times, are likely to feel anxious or depressed
and have low self-esteem. While the reasons why people self-harm
are not clear, it is known that some have suffered trauma or abuse
of some kind, including sexual abuse. Although some forms of
self-harm, such as cutting, do not involve thoughts of
suicide, people who self-harm repeatedly are more at risk of
suicide.
If you self-harm and want to stop, get support for yourself. Talk
to your GP or another health professional who will understand. If
that is too difficult, ring a telephone helpline.
'What helped was having someone to talk to who was reliable and didn't rush me. I haven't done anything to myself for ages now. Sometimes I feel like it, but I don't need to do it any more and the feeling goes.'
sexual abuse.
This can include different types of activities ranging from showing
pornographic material and inappropriate kissing, touching or
fondling to sexual intercourse. It happens to both boys and girls
and can be either heterosexual or homosexual.
It occurs when you are trapped in a sexual situation against your
will because you are too young, frightened and/or confused to
object. Sexual abusers are often known to those they abuse. For
instance, they may be relatives or family friends who are betraying
a position of trust. They are likely to insist on secrecy,
frightening you about what will happen if you tell.
People affected by sexual abuse react in different ways, but the
effects - in both the short and the long term - can be very serious
unless appropriate help and support is given. If you have been
abused, you may feel guilty, unclean, worthless, powerless and
ashamed even though it was not your fault. Sexual abuse is often a
major contributory factor in anxiety, depression,
eating disorders, running away, alcohol and drug
misuse, sexual and relationship problems, self-harm and
suicide.
If you are being or have been sexually abused, it is important to
tell someone who will be believe you, however hard that may seem.
This is necessary to stop the abuse, to prevent others from being
abused in the same way and to get support for yourself. Your
GP, a social worker or school nurse can refer
you for specialist help that may include counselling or
group therapy. If you find it difficult to talk to someone
face to face, take the first step by ringing a helpline to talk
things through.
smoking See tobacco.
social phobias.
These involve worries about performing ordinary activities in front
of other people. If you have a social phobia, you might be worried
about speaking in front of other people in case you suddenly dry
up, eating in public in case you choke, or writing in public in
case your hand shakes. Treatment usually involves some form of
behaviour therapy. See also phobias.
social worker.
The social services department of your local authority will have
social workers who have experience in working with young people and
families, as well as social workers with experience in mental
health problems. They can help by offering information on practical
matters, advising on ways of coping with pressures and stresses and
suggesting other sources of help. Who you see will depend on your
age and the way your local social services is organised. See
also approved social worker.
solvents.
These are products whose vapours act as depressants (downers) when
inhaled. They include various glues, cleaning fluids and paints,
gas lighter fuel, petrol and the gases in aerosols and fire
extinguishers.
The effects of inhaling solvents may partly depend on your mood,
your personality and the situation you are in. You may lose your
inhibitions and feel more outgoing and sociable. On the other hand,
if you already feel down, you may become more depressed. You may
also feel giddy, sick or drowsy. Afterwards, you may experience a
sort of hangover - for instance, headaches and poor concentration -
for about a day. Larger doses can make you feel out of control and
confused, and you may even pass out. Long-term use can cause health
problems and lead to serious depression.
You need to be aware that, if you pass out while using solvents,
you could die through inhaling your own vomit, and if you pass out
with a plastic bag over your head, you could die through
suffocation. Aerosols or butane gas sprayed directly into the mouth
can also cause breathing difficulties or suffocation.
stress.
Too much stress over a long period of time can lead to anxiety,
depression and other mental health problems. The amount of
stress each person can cope with varies considerably and may also
vary at different times in their lives. Finding the right balance
for you is important, as too little activity and stimulation can
sometimes be just as stressful as too much.
There are a number of situations that can give rise to stress:
It can sometimes be hard to deal with stress on your own. You
may need to sort out your priorities and what you want from life,
find ways of saying 'no' to inappropriate demands or improve your
low self-esteem. Talking things over with your GP or another health
professional may help you to find ways of coping. Depending on the
causes of your stress, counselling, cognitive behaviour
therapy or assertiveness training may be
helpful.
'I'm under lots of stress and my family don't understand. They don't know how hard it is for me to keep up my grades and cope with all the homework thrown at me.'
suicide.
Intentionally killing yourself is now the second most common cause
of death - after accidents - among young people aged 15-24. More
men than women commit suicide, though more women make suicide
attempts that are unsuccessful ('parasuicide'). About 90% of people
who attempt suicide take a drug overdose. Violent methods of taking
one's life are far more common among men.
Difficulties such as severe depression, alcohol or drug
misuse, eating disorders, manic depression and
schizophrenia may make suicide more likely. However, many
young people who are not affected by such problems may attempt it.
Overwhelmed by problems or strong emotions, they may lack the
experience to know that they will come through it in the end.
It is impossible to prevent all suicides, but everyone should be
aware of the warning signs. A person contemplating suicide may:
Suicide can be a very real risk if someone has had severe
depression, although people often kill themselves just when their
depression starts to improve. In some cases, there may be no
obvious warning signs.
The idea that people who talk about suicide never actually do it
was discredited a long time ago. If someone brings up the subject
of suicide, even as a casual remark, always be prepared to listen
and encourage them to talk. It may be upsetting for you, but it is
often a relief for the person to be able to say openly what they
feel. Never express disbelief about what they are saying or you may
push them into a 'dare' situation. Show them that you take their
feelings seriously and stay with them if they are distressed. You
don't have to find solutions to their problems, but you can
emphasise how important they are to you and others. If you feel it
is urgent, persuade them to see their GP immediately. If they
refuse to do this, you could ring the doctor or the Samaritans for
advice.
If someone has taken a drug overdose, however small, they should be
taken at once to the nearest hospital accident and emergency
department. Even if the attempt seems trivial or was carried out
very publicly, it should be treated as serious. Some drugs, such as
paracetamol, can cause serious permanent damage to health or can be
fatal, even in small amounts.
Anyone who makes an unsuccessful suicide attempt will need a great
deal of support afterwards. Some attempts are carried out in such a
way that rescue is possible and, indeed, likely. These should be
regarded as serious cries for help rather than as ways of seeking
attention. Appropriate help following a suicide attempt can
sometimes prevent it happening again. This may involve identifying
someone who the person can talk to if they feel suicidal again or
help with resolving family or relationship problems.
It is an overwhelming shock when someone close to you takes their
own life. You may find yourself experiencing the emotions
associated with any bereavement with the additional burden
of blaming yourself because you were unable to prevent it. Even if
the person wasn't successful in their suicide attempt, it can be
hard to deal with your feelings. Make sure you get support for
yourself - for instance, by talking to understanding friends or to
your GP.
'I didn't think there was any way out of my situation, so I took loads of tablets. I felt so bad, I just wanted to die ... and I nearly did. Now things are different, and I'm so glad to be alive.'
tobacco.
As well as many other substances, this contains nicotine, which is
responsible for the extremely high proportion of smokers who become
dependent on tobacco. It acts almost instantaneously, stimulating
the central nervous system and thus reducing fatigue, increasing
alertness and improving concentration. People often find it helps
to relax them and reduce stress. Its effects decline
rapidly.
Nicotine is particularly habit-forming because its effects are so
brief and because tolerance builds up so quickly. Sudden
withdrawal can cause headaches and insomnia as well as
anxiety and depression and a craving to smoke. The
more and the longer you smoke, the greater the risks to your health
from illnesses such as lung cancer, heart disease and bronchitis.
If you want to stop smoking, seek support.
tolerance.
People using drugs, including nicotine and alcohol,
for some time are said to develop a tolerance to them. This means
that they gradually have to take more to achieve the same
effect.
tranquillisers See antipsychotic drugs,
benzodiazepines.
tricyclic antidepressant drugs See
antidepressants.
Valium See
benzodiazepines.
violence at home.
Violence in the family may take the form of shouting or threats or
physical abuse such as one parent hitting the other or one of the
children.
Any form of violence gives rise to an atmosphere of fear. Sometimes
parents resort to violence as a way of expressing their own angry
feelings about a divorce or unemployment. Sometimes it may be due
to too much drink or a mental health problem (see parents
with mental health problems). In other cases, it may be because
they have never learned that violence is not an acceptable way of
dealing with situations.
The experience of violence can lead to low self-esteem and problems
such as depression, eating disorders or drug and
alcohol addiction. Some young people react with rebellious
behaviour such as truanting and lawbreaking, while others become
overachievers, almost as if they think they will make things better
by behaving perfectly. Moreover, although you have found the
violence very frightening, you may - as you get older - also see it
as a way of solving your own conflicts.
If you are in a family where violence occurs, you will need support
for yourself and sometimes even protection. Seeking help is not
being disloyal. It is a way of helping you to deal with problems or
prevent them from occurring. It can also be a means of helping the
whole family.
If the situation is very serious, you may decide to contact your GP
or social services. However, once these are involved, they may have
to take action under the law. You may first prefer to talk things
through with organisations such as the Samaritans, ChildLine or the
NSPCC Child Protection line. You could also approach your school
tutor to see if any confidential counselling is available at
school, or contact Youth Access to find your nearest youth
information, advice or counselling service.
voluntary hospital
admission.
The majority of young people who are admitted to mental hospitals
or to psychiatric units of general hospitals are voluntary patients
- that is, they have agreed to go into hospital of their own free
will. Although parents or others responsible will make the
arrangements for you if you are under 16, you should always be
consulted. Voluntary patients are also known as 'informal
patients'.
youth counselling, advice and information centres.
These are run by a variety of organisations for young people,
usually between the ages of 13 to 25. Help, which is always
confidential, may be free or charged on a sliding scale, depending
on your income. Some centres focus on specific issues such as drug
problems, while others deal with a wide range of problems and/or
offer counselling.
'I didn't think I could talk to anyone I knew. I thought it would just make things worse. I just felt completely alone. I wrote to a problem page and they encouraged me to phone a helpline. Once I did that, they helped me have more confidence to get help.'
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