It is Mental Health Awareness week and this year is about tackling loneliness and the risk it has upon our own health and mental wellbeing. Dealing with loneliness can be difficult. Thankfully, there are things we can all do and prevent some of the negative feelings and mental health problems that can come with it. We invited Alicia Drummond, child and adolescent psychotherapist and founder of The Wellbeing Hub, to guest write this week’s blog about mental health and what this actually means and looks like.
The mental health continuum
Our mental health is not static, it is a continuum that we all move along, day by day, throughout our lives. For example, people with Schizophrenia aren’t mentally ill all the time, they have psychotic episodes, but episodes in between might be mentally healthy.
Communicating the idea that our mental health is not static is deeply important for young people. It gives them hope when they are feeling low and helps them appreciate the need for self care when they are feeling ok. Furthermore, if suicide is a way to stop feeling utterly hopeless and helpless, then hope is essential for prevention.
Recovery to wellness is a process
So let’s start talking about how our mental health is just as likely to change day by day as our physical health. I don’t agree with labelling people as anxious or depressed, it runs the risk of making the person ‘the illness’. It is more helpful to think of a mental illness as an injury: I have depression, rather than I am depressed. The majority will recover from the injury and may never suffer again; others will sustain an injury that can lead to long-term problems; or symptoms that are harder to manage. However, it is vital that we never take away anyone’s hope of a full recovery.
Feeling mentally healthy allows us to feel confident in ourselves, for example:
- we value and accept ourselves and judge ourselves against realistic and reasonable standards
- we can feel and express a range of emotions.
- we can feel engaged with the world around us & can build and maintain positive relationships with other people.
- we feel we can contribute to the community we live in.
- we can live and work productively.
- we can cope with the stresses of daily life.
- we can enjoy time alone.
So, if this is mental health, what is mental illness?
There is a manual used in the world of psychiatry to diagnose mental illness, and it lists approximately 297 mental health disorders. These can be divided into 2 categories: Psychotic disorders and Neurotic disorders.
Neurotic conditions are related to “normal” emotions e.g. we all feel depressed from time to time, but clinical depression is a neurotic disorder. In this case, the normal emotion has become a serious illness and is overtaking our emotions. Other examples of neurotic illness are anxiety, phobia, OCD & panic disorder.
Psychotic disorders are very different. People experiencing psychosis will display symptoms that do not relate to normal experiences: hearing voices, having strange thoughts or beliefs. Occasionally, they might believe that mermaids are sending them email messages or every electrical socket is in fact a secret camera recording them. Schizophrenia and Bi-polar disorder are amongst the psychotic illnesses.
The key is to recognise the difference between the two. A person suffering a psychotic episode needs psychiatric intervention and usually medication. In contrast, the neurotic disorders, if caught early, may be helped by therapy. Remember that neurotic disorders are not any less serious because they can be more effectively treated.
- Clinical depression can lead to self harm and suicide
- Anxiety can lead to OCD & panic disorder
- Phobias like agoraphobia can lead to social isolation and depression.
Mental ill health can be just as debilitating as any physical illness and often the two are closely linked. I have worked with young people who suffer from migraines and stomach pains that have no medical explanation because they are caused by stress.
So what causes mental illness?
There are three main areas and our mental health is influenced by how these different factors dynamically interact with one another.
- The first is our individual attributes: our genetic makeup; our biological makeup; our resilience, personality, identity and coping strategies; and our use of, and response to, on-line media.
- The second area is our Social and Economic Circumstances: do we feel loved and accepted by our family?; are we able to make and maintain friendships?; are we living in economic deprivation or with abuse, addiction, racism, trauma, bullying, loneliness or illness? Are we a young carer feeling unsupported or do we feel under pressure to perform or be perfect?
- The third area to take into consideration is our environment: where we operate has a huge impact on how we feel. It means we must be mindful of the culture being created in homes, schools, clubs, offices and places of worship. Are we creating environments that allow young people to feel valued and respected? Do they have opportunities and a degree of influence over their future?
These factors are all intertwined and impact upon each other. We need to consider them all when thinking about mental health. This is an important message if you are a parent or carer of someone with a mental illness. It is so easy to blame ourselves when a child or young person that we love is suffering. Yes, we may have played our part, but mental illness is way too complicated to be able to attach it to any one factor. Thankfully, not everyone who experiences a traumatic event gets PTSD (Post Traumatic Stress Disorder) as the outcome depends on other factors at play; such as our resilience, personality and environment.
Adolescence, in and of itself, is stressful
Children are transitioning from being dependent to becoming independent adults; which is tough. Adapting the bonds they have with their parents, whilst trying to find their adult identity. Their brains are wired to need social acceptance and connection whilst being super sensitive to judgement, criticism or rejection. Many are under way too much pressure to perform. Sadly, some are so busy trying desperately to be perfect that they burn out hard and fast. On top of this, there are the decisions that all teenagers must make, some of which, such as drug taking or their use of screens, may have a disastrous impact on their mental health.
Result, there is a lot going on. Many of the symptoms that might help us diagnose a mental health problem in adults are actual normal teenage behaviours. You might recognise: fast changing emotions; withdrawing to their rooms; being secretive; and losing their interest in some childhood pleasures. Our vigilance in spotting a mental health disorder has to be about putting together a few changes in behaviour, particularly in feeling and thinking. If your child is becoming mentally unwell you would expect to see changes across the categories, it is important to remember that a single sign does not necessarily indicate there is a problem.
Signs of behavioural change, feelings or thinking:
We don’t medicalise a normal reaction to a life event. Consequently, if someone dies, it is normal to feel disbelief, sadness, anger and sometimes a host of other emotions such as relief or guilt. It will take time to come to terms with the loss but this is not a mental illness.
If the grief does not abate over time then maybe some professional help is necessary, however in the first instance they need your empathy, your reassurance; practical support and love. Being their parent or carer, who is consistent and present. Be vigilant and act if their symptoms worsen. Whatever your thoughts about mental illness may be, this is not the time to let your personal prejudices and fears get in the way of their recovery.
Concerned about someone who is suffering?
Questions to ask if you are concerned that someone you know is suffering a mental illness but not sure: consider how different they are to their usual self, how many changes have you noticed in their thoughts, feelings and behaviour? How often are symptoms evident, how long have these symptoms been present and how severe are they?
If you have observed a number of symptoms for three weeks or longer, intervention is advised unless they express suicidal thoughts or are exhibiting psychotic symptoms in which case immediate help is required.
Supporting someone with a mental illness
If someone you know is diagnosed with a mental illness what can you do to support them, apart from finding appropriate expert help?
There are key ways we can all help someone. Therefore, when someone is in a mental crisis they need as much care and attention as someone who has undergone major surgery. As they start to recover, we can gently encourage them to do the things that will help speed up recovery. Just as we must do our physio after physical injury, we must learn to use healthy coping strategies to build our resilience after a mental injury.
Help them discover what makes them feel better: talking, learning to ask for help, learning to face problems and avoid procrastination, learning to be kinder to themselves and to give up on perfection; using relaxation techniques, taking regular exercise, getting outdoors every day, eating well, doing hobbies that spark joy and socialising.
These things not only aid recovery after injury, they are also preventative for the next time. The more we add into our daily lives, our emotional resilience strengthens. It is vital that we teach young people to explore and use their coping strategies. It is not only to build their emotional resilience, but also a defence when stress builds; it stops them turning to unhealthy coping strategies. Moreover, substance abuse, self-harm, emotional eating, compulsive spending, sleeping excessively, procrastinating, zoning out for hours on screens and withdrawing from friends and family may offer temporary relief, but they all exacerbate problems over the long term.
My final thought is this. Acknowledging that your child is mentally unwell is tough and is likely to bring up a whole host of difficult feelings and thoughts for you. It is normal to feel guilt, shame, anger, disbelief, sadness, worry, loneliness and scared. We all want to do the best for our children and the best thing you can do right now is get support. Remember, the sooner a problem is addressed the less likely it is to remain or recur.
I hope you have found this helpful, being mentally unwell can be terrifying not only for the sufferer but also for all those who love and care for them. Use the resources that are available and say yes to anyone who offers to support you, because you too are worth it.
The Wellbeing Hub from Teen Tips delivers a wealth of online resources and advice to help parents positively support their children’s mental health and wellbeing. The Wellbeing Hub is also available for Schools, with live and interactive portals for all parents, pupils and staff in the school community. Teen Tips takes a proactive approach and aims to support children through adolescence, and prevent mental health difficulties from arising. Sign up for their newsletter for updates here.
If you or someone you know needs help, here are some resources and contacts in the UK:
- Talk to your GP or urgent medical help – use the NHS 111 online service, or call 111 if you’re unable to get help online.
- NHS information: https://www.nhs.uk/mental-health/nhs-voluntary-charity-services/charity-and-voluntary-services/get-help-from-mental-health-helplines/
- Mind: https://www.mind.org.uk/
- Helpline: 0300 123 3393 (Open 9am-6pm, Mon-Fri)
- Campaign Against Living Miserably (CALM) https://www.thecalmzone.net/
- Helpline: 0800 58 58 58 (Open 5pm-Midnight, 365 days a year)
- Samaritans – listening service https://www.samaritans.org/
- Talk line: 116 123 (Open 24 hours a day, 365 days a year)
- Shout Crisis Text Line – for support in a crisis https://giveusashout.org/
- Text “Shout” to 85258 (Open 24 hours a day, 365 days a year)