2015 Personal Project Mental Disorder eBook by Carie

Help Mental Disorder A guide to help & understand mental disorders

By Carie Ng

2015 Grade 10 Personal Project

Table of Contents Introduction .........................................................................3

Anxiety ................................................................................6

Depression ........................................................................18

Alcohol/Substance Abuse & Dependence ........................31

Eating Disorder .................................................................47

ADHD (ADD) .....................................................................63

ÂŠ Carie Ng

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Introduction To have a good or meaningful life, it is not defined by the outcome or achievements, but the ongoing emotional journey. The point of life is not to be the greatest of the world, nor being the wealthiest, however it is to overcome emotional obstacles that everyone would come across. In order to pursue a life with compassion and meaning, it “requires becoming vulnerable to all dimensions of living --- sadness as well as joy, pain as well as comfort, fear as well as confidence” (Firestone, Firestone, and Cartlett, 16). In order to find this meaning life, it involves commitment to an ongoing search for personal goals and their own meaning of life, and often happiness is the byproduct. There is a difference between being self-aware and self-conscious. It is necessary to be aware of what’s going on in our lives, however not to be pulled into sleep because of negative thoughts, hatred, prejudices, or routines. “When children are emotionally deprived or psychologically damaged, they form powerful maladaptive defences that preclude the possibility for a richer, more fulfilling life”(Firestone, Firestone, and Cartlett, 35). Mental disorders affects people’s mood, thinking, and/or behavior. Sometimes people would have mental health concerns, where they are not sure if they have a mental disorder, but are experiencing symptoms. Mental concerns only becomes a mental disorder when the symptoms are ongoing caused by

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constant stress/worry and affects the ability to function. There are many causes of mental disorders, some of it could be from your genes and/or family history. Life experiences like excessive amount of stress/ worries, or history of abuse could also be some of the causes. Another typical cause of mental illnesses could be the use of illegal drugs or having a medical condition, such as cancer. There are many different types of mental disorders/illnesses. However, the 5 I’ll be focusing on would be anxiety, depression, alcohol/substance abuse and dependence, eating disorder (anorexia and bulimia), and ADHD. In this eBook, you would be able to find information about these mentioned mental disorders, such as the overview, causes, symptoms, effects, who it affects, treatments, and how we can help.

“Being too free, you fly away; being too connected, you’re weighted down. And trying to find that balance is a lifelong journey.” - FIRESTONE, FIRESTONE, AND CARTLETT (28)

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Sources Firestone, Robert, Lisa A. Firestone, and Joyce Cartlett. Creating a Life of Meaning and Compassion: The Wisdom of Psychotherapy. Washington: APA 2003. Print. "Mental Disorder." Medline Plus. U.S. National Library of Medicine, n.d. Web. 5 Oct. 2015. <https://www.nlm.nih.gov/medlineplus/mentaldisorders.html>. Mayo Clinic Staff. "Mental Illness." Mayo Clinic. Mayo Foundation for Medical Education and Research, 13 Oct. 2015. Web. 5 Oct. 2015. <http:// www.mayoclinic.org/diseases-conditions/mental-illness/basics/definition/ con-20033813?DSECTION=all&p=1>.

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Anxiety Overview ............................................................7 Causes ................................................................8 Symptoms ..........................................................9 Psychological signs: ....................................................................9 Physical signs: .............................................................................9 Other signs found for generalized anxiety disorder: .................10 Other signs found for panic disorders: ....................................11

Effects ..............................................................12 Who it Affects ...................................................13 Treatments .......................................................14 How to Help .....................................................15 Do’s and Don’ts .........................................................................15

Sources .............................................................17

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Overview Anxiety happens when too much stress or worry happens in your daily life. You can have anxiety without it being a serious disorder where you need medical attention. People would experience fear/worry towards something out of their comfort (for example a job interview), and this is a normal feeling. However, anxiety as a disorder tend to act as a warning sign to more conflicting disorders, such as depression. It becomes harder to live with all these constant worrying, it could be noticeable by others, but not always. There is a difference between anxiety disorder and panic disorder, and generalized anxiety. Anxiety is caused with a reason that you can pinpoint, while panic disorder or generalized anxiety just happens without a warning/reason. With panic disorder, the signs of it is noticeable. It happens when there is a sudden feeling of terror that happens without any warning (could also happen repeatedly). This causes people to develop serious anxiety between each episode of panic attacks, which they often worry about when and where the next one would occur. Whereas, generalized anxiety disorder is actually experienced more than normal anxiety. It happens due to consistent recurring and exaggerated worry/ tension, even though there is nothing that could cause it. This disorder causes people to always anticipate disasters, and worrying, such as health, money, family, or work. Often, the sources of worries are hard to pinpoint.â&#x20AC;Š

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Causes Anxiety can’t be pinpoint to what exactly causes it, because everyone would have different and/or mixed causes. Examples of what could cause anxiety are: • Difficult past events • Being bullied • Seeing a traumatic event • School/work could cause stress • Financial problems • Thinking of the future However with generalized anxiety disorder, you would feel worried all the time, and everything seems out of your control. Many times there isn’t a real reason to worry, but you just feel ‘on edge’ and very alert. So there is not an actual cause where you can pinpoint.

As well as panic disorder happens suddenly, mostly without any cause. It could happen repeatedly, which would cause you to non-stop worrying about the attacks.

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Symptoms Anxiety causes people to feel extremely uncomfortable, no control over anything, and helpless. There are psychological and physical signs. Psychological signs: • worry/uneasy a lot • confusion/poor memory • sleep disturbance (difficulty in sleep) • poor concentration • inability to relax/being extra alert • needing frequent reassurance from others • wanting to escape/ feeling trapped • feeling tearful Physical signs: • weak/muscle tension • palpitations (rapid/irregular heart beat) • breathing shorter/faster • sweating

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• sudden chills • shaking/trembling • feeling sick/nausea • loss of appetite/upset stomach (“butterflies” in stomach) • dizziness/ feeling like fainting • headaches • chest pains • dry mouth • hot flushes/blushing • frequently needing the bathroom Other signs found for generalized anxiety disorder: • withdrawing from social activities (with friends or family) • a sense of dread • feeling constantly “on edge” • irritable (feeling annoyed) • easily exhausted • mind goes blank/poor focus

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Other signs found for panic disorders: • choking sensation • numbness/tingling or burning sensation • ringing in ears • feeling of dread/fear of dying • shivering • feeling like losing control • feeling like you’re having a heart attack/ “going crazy” • worry/fear of other attacks and death • depersonalisation (detached from the situation, your body, your surrounding, making everything surreal) • sudden change in behavior (eg. avoiding exercise/unfamiliar situations)

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Effects Long term anxiety could lead to more serious mental disorders such as depression, hypertension (high blood pressure). You could feel anxious all the time which would affect your daily life like school/work. You would find yourself withdrawing from social interaction, which leads to you focusing on your stress and worry thoughts. Anxiety would make you want to avoid situations where you don’t want to be in, such as if you know you would get an excessive amount of stress from crowds, you might call in sick. Furthermore, it would increase the lack of self-esteem.

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Who it Affects Anyone could be affected by anxiety disorders. However, it shouldnâ&#x20AC;&#x2122;t be confused with the fact that everyone experience the feeling of anxiety from time to time. Only if the stress/worry are consistent, then you should seek for help and diagnosis if you have anxiety disorder.

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Treatments • Psychological/ talking therapies ‣ Cognitive behavioural therapy (understanding how your problem, thoughts, feelings, and behavior affect others) ‣ Applied relaxation (learn and practice how to relax) • Initial treatment (self-help course) ‣ Support groups (learning new coping and relaxation skills with people similar to you) • Medication (from doctors) • Complementary/alternative therapies (looking at physical, mental, and spiritual well-being)

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How to Help Talk to the people and make them talk. People who are suffering from these anxiety are having worries running through their head, the more they talk about it, it would help them figure out and solve and maybe pinpoint the reason of stress/worry. It would definitely decrease the anxiety they are suffering from.

Do’s and Don’ts Reassurance

Don’t tell them they are going to be fine or everything is okay. Tell them why they are going to be fine, or how everything is okay. They are already confused with the reason why they are suffering from worries and stress, they are not in the state of finding out why everything is going to be okay.

Encourage social and outdoors activities

The worst thing you want is for the person to feel alone. Being around friends who would listen and help the person suffering from anxiety is the best thing you can do. Studies shows that doing exercises help relieve stress, so gather around some friends and just jog around a park!

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Talking to them

If the person don’t want to talk about the cause of anxiety, it is possible that they don’t know the reason. It is okay to say ‘I don’t know’. Talk about their favorite singer, favorite tv show, or even simply what they did over the weekend. By distracting them, it would decrease the stressful thoughts in their head.

Not talking

Some people don’t want to talk at all and it’s okay if they are not comfortable with talking about their problems. Give them a cuddle, tell them you would be there to listen to them. This helps them a lot more than you think, because they now know that someone cares.

Focus on breathing

Ask them to take deep breaths with you. Inhale deeply and then exhale. This helps people to relax and calm down.

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Sources "Anxiety Disorders." Rethink Mental Illness. Rethink Mental Illness, n.d. Web. 9 Oct. 2015. <http://www.rethink.org/diagnosis-treatment/conditions/anxiety-disorders>.

"Generalised Anxiety Disorder in Adults." NHS Choices. Gov. UK, n.d. Web. 9 Oct. 2015. <http://www.nhs.uk/Conditions/Anxiety/Pages/Introduction.aspx>.

Grohol, John M. "Anxiety." Psych Central. Psych Central, n.d. Web. 9 Oct. 2015. <http:// psychcentral.com/disorders/anxiety/>.

Medina, Johanna. "Panic Disorder Symptoms." Psych Central. Psych Central, n.d. Web. 9 Oct. 2015. <http://psychcentral.com/disorders/panic-disorder-symptoms/>.

"Panic Disorder." NHS Choices. Gov. UK, n.d. Web. 9 Oct. 2015. <http://www.nhs.uk/ Conditions/Panic-disorder/Pages/Introduction.aspx>.

Psych Central Staff. "Generalized Anxiety Disorder Symptoms." Psych Central. Psych Central, n.d. Web. 9 Oct. 2015. <http://psychcentral.com/disorders/generalized-anxiety-disordersymptoms/>.

"Why Do I Feel Anxious and Panicky?" NHS Choices. Gov. UK, n.d. Web. 9 Oct. 2015. <http:// www.nhs.uk/Conditions/stress-anxiety-depression/Pages/understanding-panic.aspx>.

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Depression Overview ..........................................................19 Causes ..............................................................20 Symptoms ........................................................21 Psychological signs: ..................................................................21 Physical signs: ...........................................................................22 Social signs: ..............................................................................22

Effects ..............................................................23 Who it Affects ...................................................24 Treatments .......................................................25 Mild depression: .......................................................................25 Moderate depression: ...............................................................25 Severe depression: ....................................................................26

How to Help .....................................................28 Do’s and Don’ts .........................................................................28

Sources .............................................................30

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Overview It is normal to feel down once in awhile, because not everyday is the perfect day. However, it becomes an issue when you are constantly in a bad mood, and the feeling of loneliness, sadness, guilt, and worthlessness doesn’t go away. Depression is a mental disorder recognized worldwide, and it is very common (it affects about one out of ten people). There are many types of depressions, however these sections would only focus on clinical depression. Some people say that depression is a weakness, well they are wrong. Despite what people say, depression isn’t something you can just “snap out of it” or “pull yourself together”. Depression is a long lasting feeling that affects your daily life, because it changes our mood and views on different activities. This disorder isn’t forever, it is treatable with help but it is not always noticeable. Many times depression aren’t noticed until it’s too late. However, there are some signs that could suggest depression and help diagnosing it.

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Causes There is not always a single cause of depression, because many different reasons can trigger it. Some of the reason that causes depression could be: • stressful events ‣ divorce ‣ problems with loved ones ‣ job/money worries ‣ someone’s death • illness ‣ life- threatening disease (such as cancer, and coronary heart disease) ‣ severe head injuries (may cause mood swings, and emotional problems) • low self-esteem • overly self-critical • family history (genes) • loneliness • pregnancy (hormonal and physical changes, and responsibility of new life) • drugs and alcohol • your background (how you grew up) ‣ problems during childhood (such as abusive childhood)

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Symptoms There are different groups of signs that can lead to depression, such as psychological, physical, and social. The feelings you get when you have depression tend to stay with you for a long time, however remember that it is not forever.

Psychological signs: • continuous low mood/feeling sad ‣ feeling hopeless ‣ feeling guilty ‣ feeling worthless ‣ feeling helpless ‣ feeling lonely • low self-esteem / loss of confidence • feeling tearful/angry outbursts • feeling anxious/worried • loss of energy/become tired easily • loss of interest/no motivation in activities/hobbies you normally enjoy • troubles concentrating/ finds difficulties in making decisions • thoughts of self-harm/suicide or making attempts of them

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Physical signs: • change in weight ‣ stress eating/comfort eating (eating high fats/sugar to cope with depression) ‣ loss of appetite • moving/speaking slower than normal • constipation (troubles getting rid of waste in our body) • aches/pains for unknown reason ‣ headaches • trouble sleeping/ oversleeping • for women: change in menstrual cycle • giving away personal possessions/saying goodbye • talking about death/self-harm • small cuts/burns from self-harm • a sudden lifted mood (could be that they have decided to commit suicide, and feels pleased to have a final decision)

Social signs: • intolerable with others • avoiding interaction with people • not doing well in work/school • difficulties with family/friends

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Effects Depression would drastically change your daily life, such as your ability with school/work, or changing your sleeping and eating habits. It will change your view on life, and everyday would seem like a drag with a constantly dropping self-esteem and low motivation. Depression mainly affects the person who is suffering from it, however it would also affect all the loved ones around them. Many people don’t know how to help or think that depression is ‘just a phase’ or ‘a part of growing up’, which would cause the depressed person want to withdraw from social life because they would think that the family members or friends won’t believe them or can’t be trusted. Therefore, the relationship between the person with depression and the loved ones would create a gap that gets bigger and bigger as depression worsen.

“That's the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious, and it compounds daily, that it's impossible to ever see the end. The fog is like a cage without a key.” - ELIZABETH WURTZEL (AN AMERICAN WRITER)

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Who it Affects Anyone at any age can be affected, however it usually starts at the age of 15 to 30. Depression is one of the most common mental illness, and one out of ten people get diagnosed with it, however the number of people experiencing it may be higher. Women are diagnosed with it more than men, but that doesn’t imply that men can’t get depression, because they can.

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Treatments NOTE: Even though the treatments are in categories of how severe the depression is, all these methods are used for people despite their stage of depression. It all comes down to what method helps the person the most.

Mild depression: • ‘watchful waiting’ ‣ checking in with GP every two weeks and see if things have changed (mild depression can improve by itself) • exercise/exercise therapy ‣ 'exercise on prescription' by GP ; having a local/personal trainer ‣ exercising is proven to make people feel better about themselves and brightens up their mood • self-help groups (support groups) ‣ talking to people in similar situations about your feelings

Moderate depression: • talking therapy (talking to a therapist to help/guide through the problem)

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‣ cognitive behavioural therapy ‣ psychodynamic therapy ‣ problem-solving therapy ‣ interpersonal therapy ‣ general counselling • computerised cognitive behavioural therapy (learning cognitive behavioural therapy online with a regular session to help deal with the problem) • complementary/alternative therapy (aim to improve emotional well-being) ‣ aromatherapy ‣ massage ‣ mindfulness ‣ meditation ‣ yoga

Severe depression: • mental health teams (intensive special talk treatments and prescribed medication) ‣ the teams are often made up of:

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- psychologists - psychiatrists - specialist nurses - occupational therapists • medication - antidepressants (makes the chemicals that controls your mood more powerful) ‣ need to be prescribed by a GP - if you want to stop taking the pill, you must speak with your doctor beforehand. Suddenly stopping the medication would cause problems. ‣ there are about 30 different kinds of it, so it may take a while to find the one that suits you • combination therapy (taking different types of talk therapy) • Transcranial Magnetic Stimulation (using magnetic fields to try changing the way your brain work/your mood) • Electroconvulsive therapy (electrical currents passes through your brain) ‣ asleep during this treatment ‣ makes the chemical that's responsible for our mood in the brain work better/lighten our mood from depression

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How to Help When suffering from depression, people tend to feel very lonely and can’t seem to see the reason to continue living. That’s why it is up to us, the people who love and care for the person who is struggling through depression to voice up and help them.

Do’s and Don’ts Talk to them and show support

Remember that these people with depression aren’t in the mindset of ‘pulling themselves together’, so by talking to them it would help show that someone cares for them and could possibly help them open up.

Patience

Some people wouldn’t want to share what they are going through with you, and that’s ok! You shouldn’t ever push them to do things they are not comfortable with.

Reassurance

Make sure they know that you are there for them, and is willing to help in any way or form.

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Depression is not a weakness!

State and explain that you understand that depression is a medical condition, and not some flaw or weakness. This tend to reassure the person suffering from depression that someone is there for them.

Encourage pleasing activities/ stressfree environment

Just taking them out for a walk around the park or to a coffee shop would help taking the bad thoughts away. Distraction is a great way to get mind off things, but make sure that these activities are relaxing for the person with depression, the last thing you would ever want is to create even more stress or an unpleasant time for them.

Compliments/praising

Everyone loves hearing praises or compliments, and as people are feeling low about everything in life, a simple praise of something they do like scoring a good score in a test, or doing chores would help them feel loved. Compliments on something like â&#x20AC;&#x2DC;you look lovely todayâ&#x20AC;&#x2122; would help lighten up their dark thoughts roaming in their mind.

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Sources "Antidepressants." Rethink Mental Illness. Rethink Mental Illness, n.d. Web. 16 Oct. 2015. <http://www.rethink.org/diagnosis-treatment/medications/antidepressants>.

"Clinical Depression." NHS Choices. Gov. UK, n.d. Web. 16 Oct. 2015. <http://www.nhs.uk/ conditions/depression/Pages/Introduction.aspx>.

"Depression." Medline Plus. U.S. National Library of Medicine, n.d. Web. 16 Oct.2015. <https://www.nlm.nih.gov/medlineplus/depression.html>.

"Depression." Rethink Mental Illness. Rethink Mental Illness, n.d. Web. 16 Oct. 2015. <https:// www.rethink.org/diagnosis-treatment/conditions/depression>.

"Electroconvulsive Therapy (ECT)." Rethink Mental Illness. Rethink Mental Illness, n.d. Web. 16 Oct. 2015. <http://www.rethink.org/diagnosis-treatment/treatment-and-support/ electroconvulsive-therapy>. Mayo Clinic Staff. "Depression (Major Depressive Disorder)." Mayo Clinic. Mayo Foundation for Medical Education and Research, 6 Aug. 2015. Web. 16 Oct.2015. <http:// www.mayoclinic.org/diseases-conditions/depression/in-depth/depression/ART-20045943? p=1>. "Types of Depression." International Foundation for Research and Education on Depression (iFred). International Foundation for Research and Education on Depression (iFred), n.d. Web. 16 Oct. 2015. <http://www.ifred.org/types-of-depression>.â&#x20AC;Š

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Alcohol/Substance Abuse & Dependence Overview ..........................................................32 Causes ..............................................................33 Symptoms ........................................................34 Physical symptoms ...................................................................35

Effects ..............................................................37 Alcohol ......................................................................................37 Drugs .........................................................................................39

Who it Affects ...................................................40 Treatments .......................................................41 How to Help .....................................................42 Do’s and Don’ts .........................................................................42

Sources .............................................................46

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Overview There is a common belief that getting drunk or getting high would make you have a better time or have more fun. Some people drink with friends at a pub or at home, or they would use drugs to help them if they arenâ&#x20AC;&#x2122;t feeling well or need help sleeping. However alcohol and drugs is something that is easy to get and it is highly addictive, therefore making it easy for people to misuse them. The abuse of alcohol or drugs often leads to the dependence of it. Many drugs help recovering from illnesses, or it is used to help forgetting pain for a short while. Even so, using it for a long term period would have a negative effect. Substances such as meth, heroin, nicotine, marijuana, etc. are some of the common drugs that leads to impairment or distress if used for a long period of time (around a year). Abuse of alcohol and drugs means the misuse of them, such as drinking excessively, or consuming way too much of specific drugs. â&#x20AC;Š

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Causes • Problems with relationship (family, friends, boyfriend/girlfriend) ‣ Bad home environment ‣ genetic risks (can sometimes run in families) ‣ Lack of parental attachment/nurturing • Negative view on life/ yourself • Feeling of needing to have it/ needing more to feel the ‘full effect’ • Loss of motivation/ not doing well in work/school • Not wanting to socialize with people/ poor social coping skills • Association with people with easy access to drugs/alcohol ‣ influences of peers/ peer pressure

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Symptoms • Believes to have fun, there is the need to drink or use drugs/ needing more to feel the ‘full effect’ ‣ plans ahead (eg. hiding alcohol/drugs) • Sudden mood changes • Negative view on life/ yourself ‣ feeling hopeless/depressed ‣ sometimes suicidal • Selfish (not caring for others/ rude) ‣ avoiding friends/family • Loss of motivation/giving up activities that previously enjoyed • Being secretive • Inappropriately aggressive ‣ takes more risks (including sexual risks) • Not doing well in work/school • Having “blackouts” (Forgetting what they did) • Lying

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‣ Disappearance of money/valuables ‣ how much alcohol/drugs is consumed • Getting drunk/high on drugs regularly ‣ Regular hangovers • Pressuring others to do the same as them • Constantly talking about alcohol/drugs • Drinking and driving • Getting in trouble with law • Suspension from work/school due to alcohol/drugs

Physical symptoms • Hands shaking • Sweating • Nauseous/vomiting • Signs of psychosis • hallucinations • Seizures • Jaundice (yellow skin and eyes)

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• Increasing abdominal girth • Leg swelling • Cough that won't go away • Fever • Alcohol poisoning • seizures • vomiting • falling unconscious

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Effects Alcohol For a short term, if alcohol is consumed in small amounts, it would make people feel more confident and sociable. However, the more you drink it would cause you to feel tired, dizzy, confused, and unwell. The long term effect of alcohol depends on how much you drink and how regularly you drink. If drinking too much on a regular basis, it would cause serious physical and mental harm. It would also become more difficult to recover and reduce your quality of life. Sometimes, it could even cause people to develop mental illness, such as depression. The recommended alcohol consumption by the government is:

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Female

2-3 units a day

Male

3-4 units a day

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The measurements of drinking levels:

Increase-risk drinking Female

> 2-3 units a day

Male

> 3-4 units a day

High-risk drinking Female

> 6 units a day

Male

> 8 units a day

Binge drinking Heavily drinking in a short amount of time (within a hour or two).

Dependent drinking Having excessive desire to need to drink/ loosing control over drinking.

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Drugs There are many drugs, such as cannabis (also known as marijuana), amphetamine and methamphetamine (also known as meth), heroin, or Ecstasy, that if consumed too much for a long term it would cause you to feel depressed, anxious, paranoid, unable to sleep, and experience things that aren’t real (which is a sign for psychosis). Many of the drugs taken are known as ‘legal highs’ which are drugs that are available for people before the government has the chance to decide if they are dangerous or not. A very common drug is tobacco, which is commonly found in cigarettes. Many people uses it because it gives them pleasure, improve their performance and vigilance, relief for depression, and great weight control. However, smoking caused nearly half a million deaths every year, and tobacco contains a very addicting substance known as nicotine. But there are thousands of other chemicals found in tobacco that would cause damage to health. Any form of tobacco could increase the chances of heart disease, lung cancer, emphysema, peptic ulcer disease, and stroke. Other symptoms from smoking include anxiety, hunger (causing people to smoke more), unable to sleep, and depression.

“Drugs are a waste of time. They destroy your memory and your self-respect and everything that goes along with your self esteem.” - KURT COBAIN (LEAD SINGER OF NIRVANA)

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Who it Affects Alcohol or substance dependence would affect your mental health a lot. It changes the way you think and act. The craving you have for alcohol or drugs makes those substances highly addictive, which affects the amount you take. The more you take, the higher the risk of your health (physically and mentally) would be damaged. Alcohol or drugs dependency would also affect your relationship with loved ones. Dependency on alcohol or drugs would make you push away and avoid people that care for you, such as family members and friends. Sometimes your family or friends would feel hopeless and wouldn’t know what to do, just like how you are feeling. Best way is to talk with each other and resolve the dependency before it damages your health even further.

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Treatments If you recognize that you have alcohol/substance abuse or dependence, you should contact your local GP immediately. Your local GP would help you the most with your body to recover from the alcohol and/or drugs in your body that are affecting your health gravely. He/she would most likely give you some medication to help you withdraw from these craving for alcohol or drugs. They would also help with medical complication from the result of substance abuse/ dependence. There are also many charities and support groups that provides help and guides for people that have alcohol/drugs misuse problems. There are also therapy that could help people with alcohol/drugs dependency to figure out what caused it to happen, and what actions should be done next psychologically.

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How to Help When people are suffering from alcohol and/or substance abuse and dependence, it is important to stay in touch with them. They would try to push you away or avoid you, but you must make them understand that you would be there for them, and there is no need for them to harm their health.

Do’s and Don’ts Reassurance

The people with alcohol/drugs dependence need to know that you would be there for them, especially if they want to talk about it – Be it why they did what they did, or how they want to stop it.

Don’t force answers

Sometimes, especially the beginning of quitting the dependence of alcohol/ drugs, the victims might not want to talk about their problem. It is okay to not want to open up to everyone (they probably are slowly opening up to a support group or a therapist, which would be able to help them psychologically).

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Talk to them about the effect of

It is important to let them know what

alcohol/drugs misuse

people with alcohol/drugs dependence are getting themselves into. They might have heard and experience all the good feeling, and the ‘time of their life’ side of the effect, but they need to also be informed about the negative effects.

Be patient, but don’t shut them out!

You, as the family member or friend to the victim of alcohol and/or drugs dependency must understand that it would take time for them to get back to their old, normal selves. You should check in with them from time to time and get them talking about what they learned so far, or what actions are they planning on taking to get back on their feet.

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They must not withdraw from

Alcohol withdrawal syndrome occur

alcohol suddenly

when someone who has been heavily drinking and decides to suddenly stop. It would cause the person to experience: • Hands trembling • Sweating • Anxiety • Nausea • Vomiting • Headache • Insomnia It is best to take the people with alcohol dependence to a local GP that could give the appropriate medication to deal with the body recovering from huge amounts of alcohol.

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Encourage therapy/support groups

Therapy and support groups would be able to help people to figure out the reason to why they started this dependency on alcohol and/or drugs. It would be easier to have someone professional to talk to them to help them figure out a more efficient way to resolve the issue.

Also, therapy and support groups provide education on alcohol and drugs that the person with the dependency may not have known before. It would broaden their understanding of why it has a bad effect on their health.

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Sources "Alcohol Misuse." NHS Choices. Gov. UK, n.d. Web. 30 Oct. 2015.<http://www.nhs.uk/ Conditions/Alcohol-misuse/Pages/Introduction.aspx>.

"Alcohol Withdrawal." WebMD. WebMD, n.d. Web. 30 Oct. 2015. <http://www.webmd.com/ mental-health/addiction/alcohol-withdrawal-symptoms-treatments?page=1#1>.

"Drugs, Alcohol and Mental Health." Rethink Mental Illness. Rethink Mental Illness, n.d. Web. 30 Oct. 2015. <https://www.rethink.org/diagnosis-treatment/conditions/drugs-alcohol-andmental-health>.

Psych Central Staff. "Alcohol & Substance Abuse Symptoms." Psych Central. Psych Central, n.d. Web. 30 Oct. 2015. <http://psychcentral.com/disorders/alcohol-substance-abusesymptoms/>.

Psych Central Staff. "Alcohol & Substance Dependence Symptoms." Psych Central. Psych Central, n.d. Web. 30 Oct. 2015. <http://psychcentral.com/disorders/alcohol-substancedependence-symptoms/>.

"Substance Abuse." WebMD. WebMD, n.d. Web. 30 Oct. 2015. <http://www.webmd.com/ mental-health/addiction/substance-abuse>.

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Eating Disorder Overview ..........................................................48 Causes ..............................................................50 Symptoms ........................................................51 Anorexia ....................................................................................51 Bulimia ......................................................................................52

Effects ..............................................................53 Physical Effects of Anorexia ......................................................53 Physical Effects of Bulimia .........................................................54

Who it Affects ...................................................55 Treatments .......................................................56 How to Help .....................................................58 Do’s and Don’ts .........................................................................58

Sources .............................................................62

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Overview Eating disorder occur when there is a sudden change in the way you eat; either you are eating too less or over-eating. Anyone of any age, sex, cultural or racial background can develop an eating disorder. It is not only because of having the desire to have the perfect body shape, yes, it is part of it, but mainly it is the emotional control and distress. This is not a lifestyle, it is a mental disorder. It is most common during adolescence or early adulthood, and it is commonly found in females, however males are generally under-diagnosed with it. Anorexia and bulimia are two different types of eating disorder, however they go hand-inhand. The symptoms, causes, effect, and even treatment is fairly similar.

Anorexia is a type of eating disorder where you want to keep your weight as low as possible. It would cause you to become very anxious and troubled when eating or the thought of eating. It also causes you to have a very twisted way of viewing how you look. If you are suffering from anorexia, you would feel and think you are overweight even if you have become dangerously thin. About 1 in 250 teenage girls and young women, and about 1 in 2000 teenage boys and young men have been diagnosed with anorexia.

ÂŠ Carie Ng

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Bulimia is another type of common eating disorder. It could affect anyone of any age, but it is more commonly found in women than men, however men do experience it as well. Sometimes bulimia could occur after experiences of anorexia. Bulimia is mostly cause by how someone feels about themselves. Often, they would try to keep their weight as low as possible or they would binge eat and then try to make up for it (known as purge). In order to ‘make up for it’, people would vomit and/or take laxatives (pills that boosts reduction of undigested food). Sometimes people would starve themselves or exercise way too much to work off the calories. Many people feel disgusted or ashamed when they binge eat due to not liking how they look, but then feel better once they purge. Bulimia is harder to notice because many times people with the issue of bulimia actually have average body weight, but it’s the way they get the average body weight that suggests signs of bulimia.

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Causes • Needing to have the perfect body/ you are better/prefect depending on weight/body shape ‣ obsession over weight loss ‣ fear for being overweight ‣ eating too much • Low self-esteem • Lack of stability in relationships (Anorexia could occur even in a supportive relationship) ‣ family ‣ friends ‣ significant other • Anxiety about growing up/ body changes • Past traumatic experience ‣ sexual abuse ‣ physical abuse ‣ emotional abuse • Being neglected ‣ at home ‣ school/work • Social media

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Symptoms Anorexia What You Think/Feel

What you do

• Seems like you can’t stop thinking about anything but food

• Reducing food intake/stop eating

• Wanting to disappear (signs of depression)

‣ Using pills to reduce appetite

• Perfection/ having the need to be perfect body

‣ Using pills to speed up digestion/ using laxatives

• Lonely/ignored

‣ Making yourself vomit

• Feel like eating is the same as losing control ‣ avoiding eating • Anxious (especially eating/ordering and/or buying food) • Feeling like you’re fat/weight loss is not enough • many times people would see you as underweight • Frighten of gaining weight • Tired/uninterested in common activities • Feeling you have achieved something when denying food/over-exercising

• Counting the calories intake obsessively ‣ avoiding food that you think is dangerous • Hide food/throwing it away secretly • Obsessed with losing weight • Over-exercising • Compete to eat less than others • Make rules for food ‣ good and bad foods based on calories

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Bulimia What You Think/Feel

What you do

• Ashamed/ guilty

• Tries to gain back control of your life

• Hate your body shape/ thinking you are fat • Scared of being found out by family, friends, or significant other • Depressed • Anxious

‣ over-exercising ‣ binge eating (eating a lot in one go) - eating food that you know is bad for you ‣ purging

• Lonely/ neglected

- forcing yourself to vomit

• Mood changes quickly/suddenly

- using pills to speed up digestion (using laxatives)

• Feeling stuck/ feeling out of control • Blaming failures in life (social/ professional) on your weight

‣ starving yourself • Eating in secret ‣ fear of eating around others • Regret eating ‣ making you want to make up for it • Craving certain types of food

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Effects Physical Effects of Anorexia • Loss of weight drastically • Physically underdeveloped (if anorexia happened before puberty) • Feeling weak/dizzy ‣ feeling like you would faint • Dehydrated • Feeling cold ‣ wearing a lot of clothes to cover weight loss and keep warmth • Hard to concentrate • Hair thinning/fall out • Fine/fuzzy hair on arms and face (lanugo) • Losing interest/not being able to enjoy activities previously enjoy (mostly activities that involves a lot of movement) ‣ Feeling out of breath after light activities • Could develop bone density problems such as osteoporosis ‣ bones becoming very fragile • Muscle/joint pain • For women: periods would become irregular/stop

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Physical Effects of Bulimia • Feeling numb ‣ Feelings are blocked out by binge eating or purging • Staying in the same weight OR going from overweight to underweight very often • Dehydrated • Harming your teeth and having a sore throat ‣ vomiting forces food out of your body, but as well as stomach acid, which harms your teeth and makes you have a sore throat (when done regularly) • Overusing laxatives: ‣ develop irritable bowel syndrome ‣ stretched colon ‣ constipation ‣ heart disease • Unable to sleep • Losing interest/not being able to enjoy activities previously enjoy (mostly activities that involves a lot of movement) ‣ Feeling out of breath after light activates • Muscle/joint pain • For women: periods would become irregular/stop

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Who it Affects Eating disorders affects anyone of any sex and age. It is harmful to their health, both physically and mentally. Anorexia and bulimia would change your eating habits, which makes you not able to have all the nutrients that you need daily and energy. Mentally, it continues to lower your self-esteem and you become very focus on having the perfect body. You end up hiding or fear of people close to you, which would affect your social life dramatically. People such as your family or friends don’t understand your mindset of having this mental disorder. They realize you won’t eat or just throw out their food, which portrays you as someone obsessed with body shape and a food waster. It is hard to see the difference between an eating disorder where it is all about bad thoughts about your own body shape occurs on a daily basis rather than just wanting to have a thin body. Therefore is would slowly make the people that were once close to you slowly push you away.

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Treatments • Local GP ‣ could open up some medication for you - anorexia: - antidepressants which alters mood, sleep, and emotions - Olanzapine treat anxiety about food and weight - bulimia: - SSRIs/ antidepressant (which alters mood, sleep, and emotions) ‣ could help you with finding special services - counselling/ psychotherapy - group counselling/ support groups • Dietician ‣ gives advice about having the right nutrients ‣ how to reach a healthy weight • Talk therapy ‣ Cognitive behavioural therapy - Understanding the way your thoughts and feelings affect you (behavior and actions)

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- Helps you make changes to the way you feel about yourself - Understanding emotions behind why you are restricting food or binge eating - Helps you change this pattern/diet ‣ Interpersonal therapy - looks at connections between relationships - looks at how you feel ‣ Dialectical behaviour therapy - Helps you become more aware of your emotions - Helps you learn to accept yourself ‣ Focal psychodynamic therapy * This type of theory is based on the theory that the mental disorder started due to an unresolved conflict in the past. - Encourages the victims to think about how childhood/past experience have affected them - Aims for finding a more successful way to cope with - stressful situation/the past - negative thoughts and emotions

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How to Help The most important thing to know is that people with eating disorders can’t just stop, because this is a serious mental disorder and people are having these thoughts on their body shape daily. As people that care and love them, we need to support them and help them through harsh time, especially when we get the shot of preventing them from relapsing into eating disorder again. We are known as the care team for people who are suffering from eating disorders.

Do’s and Don’ts Don’t give up on them

You may not understand why they do this, or how come they just can’t stop it, but know that this is a serious mental disorder. You don’t have to understand why they binge eat or refuse to eat, but you will need to let them know that you would be there for them. Just to listen to them and let them rant to you, because it would help them get it out of their heads and reduce the need to stop eating or binge eat.

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Include them in activities

If you are planning anything such as going to the movies, or going for a walk, ask them to come. Even if they might decide to not go, just including them in activities reassures them that you havenâ&#x20AC;&#x2122;t forgotten or avoiding them.

Be patient

Recovering from eating disorder is really tough, so donâ&#x20AC;&#x2122;t expect this to be something they can recover quickly like a common cold. Reassure them that you will be there for them if they want to talk, however do not force them to tell you everything.

ÂŠ Carie Ng

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Boost their self-esteem

The best way to boost someoneâ&#x20AC;&#x2122;s selfesteem is to tell them how you view her/him, or why you have become friends with them. Many times friendship doesnâ&#x20AC;&#x2122;t come from their appearance, and since eating disorder is mentally driven by the thought of needing to feel you have the right body shape. Therefore talking about how you became friends with him/her is a great way to boost their selfesteem. Also bring up good or embarrassing memories will boost up happiness, and you and the person who is suffering from this disorder might just have a fit of laughter.

ÂŠ Carie Ng

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Encourage seeing professionals

Of course you would still be there for them, however you wouldn’t know all the answers to how to help them back on their feet or how to help them cope with all the thoughts they get. Seeking for a professional who as been trained to help people with eating disorder is the best option. You could still go with the person who has eating disorder, but don’t let him/her only tell you about her problem as there will be times where you won’t know how to help, and it definitely won’t be helping them.

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Sources "Anorexia Nervosa." NHS Choices. Gov. UK, n.d. Web. 6 Nov. 2015. <http:// www.nhs.uk/conditions/Anorexia-nervosa/Pages/Introduction.aspx>.

"Bulimia." NHS Choices. Gov. UK, n.d. Web. 6 Nov. 2015. <http://www.nhs.uk/ Conditions/Bulimia/Pages/Introduction.aspx>.

"Eating Disorders." Rethink Mental Illness. Rethink Mental Illness, n.d. Web. 6 Nov. 2015. <http://www.rethink.org/diagnosis-treatment/conditions/eatingdisorders>.

"Supporting Someone with an Eating Disorder." NHS Choices. Gov. UK, n.d. Web. 6 Nov. 2015. <http://www.nhs.uk/Livewell/teengirls/Pages/ treatmentforeatingdisorders.aspx>.

"Types of Eating Problems." Mind. Mind, n.d. Web. 6 Nov. 2015. <http:// www.mind.org.uk/information-support/your-stories/eating-disorders-are-not-alifestyle-choice/#.Vj-IfxDhD-Y>.

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ADHD (ADD) Overview ..............................................................64 Causes .................................................................65 Symptoms ............................................................66 Inattentive Symptoms ...............................................................66 Hyperactivity and Impulsivity Symptoms ..................................66

Effects ..................................................................68 Who it Affects ......................................................69 Treatments ...........................................................70 Medication - psychostimulants (also known as stimulants) .......70 Therapy .....................................................................................72 Other possible ways include .....................................................72

How to Help.........................................................73 Do’s and Don’ts .........................................................................73

Sources ................................................................77

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Overview Attention deficit hyperactivity disorder (ADHD) was formerly called Attention deficit disorder (ADD). This is a disorder where you are constantly having trouble concentrating, constantly having daydreams, acting without thinking things through, or finding it hard to sit still. Sometimes, you would also be hyperactive or have trouble being patient. These behaviors are uncontrollable, and interferes with people who have ADHD’s ability to form lasting friendships, behaving at home/communities, or succeed at school/ profession. ADHD can affect anyone of any age, but it begins in childhood, that can continue through adolescence and adulthood. Some additional problems that are caused by ADHD are sleeping disorders and anxiety, but luckily it can be treated with doctors and specialists’ help.

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Causes The signs of ADHD is spotted during the beginning of childhood, but it could continue into adulthood. It is much more diagnosed in boys than girls.The cause of ADHD is unknown, however it is suggested that it is a combination of genetics and environmental factors. In most cases, ADHD runs in families. Research has shown that there are some differences in the brains of people with ADHD and the ones that doesn’t. Some brain imaging scan studies shown that certain areas of the brain are smaller in people with ADHD. Another research has shown that it takes about 2-3 years longer for people with ADHD to mature. Others studies have suggested that people with ADHD might have imbalance levels of chemicals in the brain (neurotransmitters), or these chemicals might not work properly. There are other factors that may be possible causes of ADHD: • being born prematurely (born before the 37th week of pregnancy) • having low birthweight • brain damage (in the womb or first few years of life) • Drinking alcohol/smoking/misusing drugs during pregnancy • Exposed to high levels of toxic at a young age • Extreme neglect/abuse • Food additives (artificial coloring) ‣ may cause hyperactivity

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Symptoms Inattentive Symptoms • Easily distracted/ short attention span • Fail to give close attention to details • Careless mistakes in schoolwork/work or other activities • Difficulty sustaining attention for tasks/activities ‣ Constantly changing/fail to complete a task/activities • Doesn’t seem to listen when spoken to • Doesn’t follow through instructions • Poor organization skills • Avoids dislike/doesn’t want to engage in tasks that require mental effort (eg. schoolwork/homework) • Loses things easily (eg. school assignments/utencils) • Forgetful of daily activities (even if it is done regularly) Hyperactivity and Impulsivity Symptoms • Excessive physical movement ‣ fidget with hands/feet ‣ unable to sit still/ squirms in seat

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• Difficulty playing/engaging in quiet activities • Often runs about/climb when it is inappropriate ‣ in adolescents/adulthood: limited to subjective feelings of restlessness • Talks excessively/ interrupting • Unable to concentrate on tasks/activities • Unable to wait for their turn • Act without thinking/ no sense of danger

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Effects ADHD affects people with distractibility, disorganization, and poor concentration. If in school, school becomes a huge struggle; grades could fall, forgotten assignments, lost of textbooks/notebooks, and simply getting bored of daily classwork. Hyperactivity also affects the way people act such as having poor impulse control, which makes people take too many risks or breaking rules. People would also become inattentive, where they would get distracted very easily even if they are spoken to. However, they could also become very attentive, where they wouldn’t wait for their turn before speaking, or just keep talking non-stop (this could also cause them to rush through assignments). People with ADHD have a hard time sitting still and doing a quiet task that requires a lot of focus. Many times, their mind would be off somewhere and completely forgetting about the task at hand.

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Who it Affects The people who is experiencing ADHD is affected by this the most, due to the fact that it affects their concentration. They become unable to focus at the task at hand, and they can’t help it. It is a mental disorder that they can’t recover/ be cured from, but they could learn to control it even if it just by a bit. ADHD also affects their social life, because they might seem very distracted when someone is speaking and it would become irritating for others. However, people with ADHD could also become very hyperactive or would become very attentive where they end up talking excessively, which people may find annoying or see them as self-centered people. These judgements due to ADHD may lead to close friends or family to exclude you on certain activities, which would damage the socializing aspect of these victims of ADHD.

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Treatments There are two main ways to help dealing with ADHD; medication and therapy Medication - psychostimulants (also known as stimulants) • Methylphenidate • Increase activity in brain (parts that control attention and behavior) ‣ side effects: - small increase in blood pressure/heart rate - loss of appetite (weight loss/ poor weight gain) - trouble sleeping - headaches - stomach aches - mood swings • Dexamfetamine/ Lisdexamfetamine • Stimulates area of brain that controls attention and behavior ‣ side effects: - loss of appetite (weight loss/ poor weight gain) - mood swings

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- agitation/aggression - dizziness - headaches - diarrhoea - nausea/vomiting • Atomoxetine • Increases amount of chemical in brain called noradrenaline. This chemical passes messages between brain cells to increase the amount that aids concentration and help controlling impulses. ‣ side effects: - small increase in blood pressure/heart rate - nausea/vomiting - stomach aches - trouble sleeping - dizziness - headaches - irritability - suicidal thoughts - liver damage

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Therapy • Psychoeducation ‣ Encourages discussion of ADHD and how it affects you ‣ Helps people to make sense of being diagnosed with ADHD ‣ Helps people cope and live with ADHD • Behaviour therapy ‣ Supports carers for people with ADHD ‣ Discusses behaviour managements ‣ Have a system of rewarding ‣ encouraging people to control their ADHD • Cognitive behavioural therapy ‣ Talk therapy that could be only with a therapist or in a support group ‣ Aim to change the way you think and behave

Other possible ways include • Having a consistent daily schedule • Find something that helps you relax (eg. listening to music) • Limit distractions (Keep your phone away!) • Having a healthy, balanced diet • Having enough rest

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How to Help It is quite difficult to trying to find ways to help people with ADHD, but just imagine how much harder it is for them. We must remember that these people doesn’t have control over the way they are behaving, and the best way to help is to support them and suggest ways to help controlling themselves.

Do’s and Don’ts

Build up their self-esteem

Giving positive comments when they are able to focus for a good amount of time would help boost up their confidence. As well as, by doing so it would encourage them to try to focus again.

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Keep social situations short

You should continue to include them in social activities such as hanging out together, however keep in mind that they have a short attention span. Therefore, keep the hang out short or do many different activities that doesn’t take too much time. Most importantly, do something that you know the person would enjoy (especially something that won’t take too much mental effort).

Give short, clear points/instructions

ADHD people may not be able to follow through everything that’s being said to them, so making sure the comments or instructions given to them are straight to the point, so then they can understand it easier.

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Remind them of tasks/to focus

People with ADHD tend to become forgetful, it would be very helpful to remind them of tasks that they need to do, or just reminding them to focus from time to time.

Nicely remind them to take a break

When you feel like they are talking too much, just kindly ask them to breath and stop for a bit. Many of the times, people with ADHD doesnâ&#x20AC;&#x2122;t realize that they are talking nonstop, therefore just some gentle reminders would help them slowly to understand that concept.

ÂŠ Carie Ng

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Help them organize

Ask them to create a plan for the day, or a plan to organize their time spent on homework/work, but make sure to include breaks. Due to the fact that people with ADHD have poor concentration, working of a short amount of time would be the best for them. For example, making them work for 20-30 minutes without any distractions, then ask them to reward themselves (eg, taking a 10 minute break, get some snacks, etc.) They may have difficulties following their schedule, so make sure you check in on them once in awhile.

ÂŠ Carie Ng

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Sources "ADD & ADHD Health Center." WebMD. WebMD, n.d. Web. 6 Nov. 2015. <http://www.webmd.com/add-adhd/default.htm>. "Attention Deficit Hyperactivity Disorder." Medline Plus. U.S. National Library of Medicine, n.d. Web. 6 Nov. 2015. <https://www.nlm.nih.gov/medlineplus/ency/ article/001551.htm>. "Attention Deficit Hyperactivity Disorder." The National Institute of Mental Health. U.S. Department of Health and Human Services, n.d. Web. 6 Nov. 2015. <http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivitydisorder-easy-to-read/index.shtml>. "Attention Deficit Hyperactivity Disorder (ADHD)." NHS Choices. Gov. UK, n.d. Web. 6 Nov. 2015. <http://www.nhs.uk/conditions/Attention-deficithyperactivity-disorder/Pages/Introduction.aspx>. Grohol, John M. "Attention Deficit Disorder." Psych Central. Psych Central, n.d. Web. 6 Nov. 2015. <http://psychcentral.com/disorders/adhd/>. Psych Central Staff. "Attention Deficit Hyperactivity Disorder (ADHD) Symptoms." Psych Central. Psych Central, n.d. Web. 6 Nov. 2015.<http:// psychcentral.com/disorders/attention-deficit-hyperactivity-disorder-adhdsymptoms/>.

ÂŠ Carie Ng

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