Mental Health and Illness

Symptoms and Signs of Depression

When people are depressed, they often experience:

• Negative feelings about themselves;
• Sadness, irritable moods, lack of interest or concern;
• Loss or increase of appetite (significant changes in weight);
• Changes in sleep patterns;
• Feeling tired a lot of the time;
• Chronic but unexplained aches and pains;
• Loss of interest in life;
• An inability to make decisions;
• An inability to analyze and solve problem; or
• A tendency to blame themselves.

They may act out by:

• Increasing alcohol or other drug use;
• Changing their pattern of school attendance e.g. skipping school;
• Behaving badly;
• Showing major changes in school performance;
• Becoming involved with many sexual partners;
• Fighting with friends, family and teachers;
• Changing their level of activity e.g. restlessness to boredom;
• Rejecting past friends, family;
• Taking dangerous risks; or
• Running away from home.

Common Warning Signs of Suicide

Although individual motives for suicide vary, there are some common warning signs. These signs may indicate that someone is at risk or is having personal, family, or school problems.

Suicides seldom occur without warning.

If you're aware of common signs and changes in behaviour, you can recognize and better help a person in crisis. The following behaviours can serve as a warning sign. These warning signs are usually physical, emotional, and behavioural in nature.

Physical Signs

• Neglect of personal appearance or not taking care of oneself;
• Suddenly changing the way they dress, especially when the new style is completely out of character;
• Chronic or unexplained illness, aches and pains;
• Sudden weight gain or loss; and/or
• Sudden change in appetite.

Emotional Clues

• Sense of hopelessness or helplessness;
• Inability to enjoy or appreciate friendships;
• Extreme mood changes and sudden outbursts;
• Anxiousness, extreme tension and agitation;
• Feeling tired;
• Changes in personality: from outgoing to withdrawn, from polite to rude, from compliant to rebellious, from well-behaved to acting out;
• Loss of the ability to concentrate; daydreaming;
• Depression, sadness;
• Loss of rational thought;
• Feelings of guilt and failure;
• Self-destructive thoughts;
• Exaggerated fears of cancer, AIDS or physical impairment;
• Feelings of worthlessness or of being a burden; and/or
• Loss of enjoyment from activities enjoyed before.

Behavioural Signs

• Decreased school activity. Sudden drop in achievement and interest in school subjects or work;
• Loss of interest in hobbies, sports, work, etc;
• Unexplained and/or increased use of alcohol or other drugs;
• Withdrawal from family and friends, sometimes acting in a manner which forces others away;
• Spending a lot of time alone;
• Changes in eating and/or sleeping habits;
• Changes in friendship;
• Running away from home, skipping school;
• Increase in risk-taking behaviour such as careless driving, dangerous use of firearms;
• Becoming involved with many sexual partners;
• Giving away prized possessions;
• Preoccupation with thoughts of death; and/or
• Sudden changes in personality.

The following behavioural signs are especially significant, because these signs indicate that a decision to die by suicide may have been made.  A previous attempt is a particularly important sign.If a person has experienced a suicide attempt, it increases their risk for suicide.

• Making a will, writing poetry, or stories about suicide or death;
• Quietly putting affairs in order, "taking care of business";
• Threatening to die by suicide;
• Hoarding pills, hiding weapons, describing methods; and
• Previous suicide attempts.

A person may be more inclined to think of suicide or to take unnecessary risks when under the influence of drugs or alcohol. Loss, especially loss of a relationship, is one of the most common factors preceding the suicide of a young person. Other types of loss and lack of hope for the future also often underlie thoughts of suicide.

Suicide Intervention – You Can Help

Here are ways you can help if someone wants to talk to you about his or her feelings of depression or about suicide.

• Always treat such talk or behaviour seriously; don't believe that "it's just attention-seeking."
• Do not promise to keep such talk or behaviour a secret; it is one secret you should not keep. It's too risky.
• Do not give quick advice or say that "everything will be alright."
• Be an active listener. Do a lot of listening; little talking. Let the person know you are hearing what they are saying. Try paraphrasing to check whether you are accurately hearing what is being said.
• Remember that it is okay to ask the person if they have been thinking about suicide. It won't "put the ideas in their head."
• Help the person explore his or her own feelings. Do not add to possible guilt by saying things such as "think how your friends and family will feel."
• Don't "discount" the individual's feelings of crisis by saying things like "things aren't that bad," or "that's not true, you have lots of friends."
• Show and describe your concern and caring to the person.
• Try to determine whether or not the person has a plan or has attempted suicide.
• Do not debate whether or not suicide is right or wrong. To do so may add to guilt or feelings of worthlessness.
• Discussions of this nature do not always progress in a straight forward manner. It may be necessary to check on some point or other. If you miss something or it becomes obvious that you "should" have said something else, don't worry. Apologize and return to what was missed or say what you think needs saying.
• Remember: You can often be a help by just being there to talk to. Many crises are immediate and short term.Talk and listen.
• Encourage the person to go to a counsellor, minister or family member for additional help. If they won't and the risk remains, contact someone for them. You might consider:
  • contacting the person's family
  • accompanying the person to a walk-in clinic
  • phoning the family doctor
  • staying with him or her until help arrives
  • taking him or her to a mental health centre
  • call the SHA intake number in your area
  • call Kids Help Phone or Mobile Crisis with them present in the room
• If the risk seems high or immediate, do not leave the person alone or send them on their own to an agency or other resource person.
• Continue to be involved. Let the person know you care beyond the immediate crisis. Remember, the person may continue to need assistance - yours as well as that of a professional.

Suicide Intervention – Resources

You are not alone. There are individuals and agencies willing and able to assist you, or someone else, in dealing with depression or thoughts of suicide. These same individuals and agencies can provide information and support to assist you in working with others.

Each person's support network is unique; each community provides some kind of service. Generally, the following might provide initial and/or long-term support:

• Family physicians
• Family and community support services counsellors
• Local health clinics
• Employers
• Coaches
• Social workers
• Police
• Ministers, priests, rabbis and other religious leaders
• Medical personnel
• Psychologists
• Emergency response personnel
• Crisis/Suicide line
• Kids Help Phone

Find services and supports in your area.

The word trauma is used to describe many feelings and circumstances. People can be traumatized by divorce, workplace harassment, the death of someone close to us, being sexually assaulted, experiencing a fire, or natural disaster, as an example.

• "True" trauma occurs when the body reacts by turning on its "fight, flight or freeze" automatic pilot in response to situations involving intense fear, helplessness, or horror.
• "True" trauma is not the same as severe distress. It occurs when a person is exposed to real or perceived danger, directly (for self) or indirectly (for other) that results in an extreme set of physiological and psychological responses.

Traumatic events are characterized by:

• Threat to life and limb;
• Severe harm and/or injury;
• Being intentionally harmed or injured by someone;
• Exposure to grotesque, violent or sudden loss of a loved one;
• Witnessing or learning of violence to a loved one; and/or
• Causing death or severe injury to another.

Common Causes of Post-Traumatic Stress

There are certain factors that can increase vulnerability to post-traumatic stress:

• Witnessing domestic violence.
• Fear and fundamental lack of safety in children living with chronic parental addiction or other situations causing anxiety, fear and insecurity.
• Losing access to an absent parent or to a primary caregiver whoever that person may have been e.g. grandparent, aunt, etc.
• Being arrested or being kept in isolation in a custodial facility.
• Being the victim of peer violence, emotional, or physical.
• Witnessing or having knowledge of the suicide or suicide attempt of a family member or friend.

General Reactions to Trauma and Loss

Reactions to trauma are not solely determined by events. There are a number of other factors including the nature and magnitude of previous losses and trauma (especially childhood trauma) and coping strategies.

• Trauma experiences can affect how we function in all areas of our lives.
• There is no one "standard" pattern of reactions to the extreme stress of traumatic experiences. Some people respond immediately, others have delayed reactions over a period of weeks, months and even years.
• Some people experience adverse effects for a long period of time while others recover quite quickly. Serious life events such as deaths, suicide, murder, sexual assault, war, etc., are experiences that we do not just "get over." They may leave long-lasting scars.
• All loss involves some degree of trauma and all traumas involve a substantial amount of loss and grief.

Myths and Truths about Trauma

Myth: If it looks OK on the outside, it must be OK on the inside.

Truth: Showing no response or little response to trauma events is often a sign someone is coping through denial. Most reactions to trauma are normal in the short term, whether they are intense emotional reactions or avoidance and numbing reactions.

Myth: Trauma symptoms are a sign of dysfunction.

Truth: Trauma symptoms are functional and a sign of a person's system trying to re-establish its balance. They are signs of health not illness and reflect the need to recognize the reality and impact of the trauma and also to deny what is overwhelming and unbearable.

Myth: Loss, grief and trauma are the same thing.

Truth: Trauma is often in addition to the grief process, and may interfere with grieving and mourning if it is not addressed separately.

Myth: We should wait until victims seek help.

Truth: Victims of trauma are struggling to maintain or re-establish a sense of balance and want to appear as competent and in control as possible. Seeking out help may be difficult and victims will benefit from support and immediate trauma intervention.

Seeking Help

The roles of health professionals in responding to trauma include:

• Assessment;
• Intervention;
• Treatment; and
• Consultation to other service providers who have the primary responsibility for intervening and supporting clients experiencing post-trauma stress.

For help with post-traumatic stress, contact Mental Health Services in your community.

Find more detailed mental health information at HealthLine on the following topics:

• Depression
• Mental and Behavioural Health
• Mind-Body Wellness

About Eating Disorders
About Mood Disorders
About Positive Body Image
About Resiliency in Children