Worried about…?
You may find some of the answers to these anxiety FAQs useful:
Anxiety is a biological reaction to threat or danger. It helps protect us. When anxiety becomes overwhelming and stops you from being able to get on with day to day activities and the threat is perceived as more dangerous than it is, then it is an anxiety disorder.
There are many signs of anxiety all consistent with our body’s response to fear. Physically some of these signs include heart racing, feeling faint, breathing changes, dry mouth, tenseness in muscles and stomach or bladder control changes.
There are many thought-based changes, some of which include difficulty paying attention and concentrating and fear-based, negative thoughts. Socially, people may stop doing the things they used to enjoy because they don’t feel comfortable about them anymore and they may start to avoid daily activities.
Social anxiety is a fear of being seen negatively by others often leading to not wanting to be in social groups. Social anxiety disorder is when an extreme fear of being judged, together with very low self-esteem means that people cannot join in social situations, avoid doing usually unfearful activities (e.g. eating, drinking) in front of people and experience acute panic symptoms when in social situations.
Often the term panic attack and anxiety attack are used interchangeably. However, they are not the same.
An anxiety attack is the experience of a built-up period of severe fear. This will involve experiencing a variety of fear symptoms such as racing heart, tightening of the chest, lightheadedness and hot and cold flushes. Thoughts may race and generally be fear-based.
A panic attack will have all of the symptoms above but will come on suddenly, be intense, often with difficulty breathing, chest pain, hyperventilation, a fear of going out of control and extreme agitation and panic. A person experiencing a panic attack may well believe they are going to die. Whilst most often people will experience a single panic attack or a few infrequently, a very small proportion of people might experience panic disorder when they experience more regular panic attack symptoms. Panic attacks respond very well to psychological treatment.
Obsessive Compulsive Disorder or OCD is a serious mental illness. The word is often misused with people referring to neatness and tidiness as having OCD. People who have a diagnosis of OCD experience unwanted, repetitive and unpleasant thoughts or images that are so distasteful or frightening that they then have to carry out a range of repetitive behaviours to somehow try and deal with these thoughts.
There are many causes of anxiety disorders including genetic factors, brain biochemistry, stress, health-related factors and the impact of certain experiences.
This is not to be confused with normal anxiety which is in itself is a positive emotion that alerts our body to danger in the face of something that can cause us harm, helping us to protect ourselves.
There are a number of questionnaires that screen for an anxiety or mood disorder. Whilst these should usually be diagnosed by a professional, ‘Moodzone’ on the NHS website has a quiz provided by GPs.
Yes, some people can experience more than one anxiety disorder, for example, someone who has a phobia may also experience panic attacks.
Anxiety disorders are very common. Around 1 in 8 children and young people have experienced an anxiety disorder
Stress is triggered by an existing ‘stressor’ or threat – for example, you may feel stressed before an exam.
Anxiety is stress that lasts longer and goes on after the cause of the stress has gone or keeps happening when the threat is no longer there or is not significant – for example, high levels of fear/anxiety a month after the exams.
In the short term, both stress and anxiety are beneficial since they prepare your body and thinking to achieve the best performance. However, if experienced severely over a period of time it can have a negative effect, leading to decreased performance, strained relationships, the triggering of poor physical health and potentially, low mood and/or depression.
There are many self-care techniques that are essential to managing anxiety. These include making sure you have sufficient sleep, have a regular and well-balanced diet, that you exercise/have some form of physical activity every day, take time to have breaks/rest, manage unhelpful coping strategies such as alcohol or drug misuse or other behavioural addictions such as excessive internet use, gaming and learn to identify the way in which anxiety affects your body.
Mild-moderate symptoms of anxiety will respond well to self-care. For moderate-severe symptoms, the most common treatment is called Cognitive Behavioural Therapy or CBT. However, there are a variety of other psychological treatments as well as medication that can help.
- Learn some breathing strategies and put them into practice as anxiety symptoms start
- Learn some quick release of tension strategies to stop the build-up of anxiety symptoms in your body. They are usually all quite discrete and can be done at school
- Note anxious thoughts and work on making change
- Walk to school or get some exercise or activity before you start – it will help you relax
- Arrange an easy way to take a break if anxiety gets too high at school (for example, a ‘take a break’ card system)
- Share how you feel
- Why not try the free Clear Fear app which has a range of strategies?
There are many different types of relaxation techniques and how you are as a person will also influence what works (for example, music might relax some people and make others tense!).
You might like to have a list of things you can do you find relaxing such as reading, having a shower, going for a walk, drawing etc. In addition, there are breathing techniques, muscle relaxing techniques, the use of visual imagery, body awareness methods, mindfulness and meditation techniques, martial arts techniques that all help.
Sometimes, the best relaxer is laughter so finding some things that make you laugh can help.
Why not try the Clear Fear app to learn some of these?
The ultimate goal is to help someone face their fear. This can be done by creating a safe environment which includes being reliable and helping deal with change, encouraging facing fears one step at a time, encouraging less reliance on reassurance provided by others and learning to self-reassure, learning how to help support someone who is having a panic attack, being positive – anxiety does respond very well to treatment.
Why not try the Clear Fear app which uses Cognitive Behavioural Therapy (CBT) principles?
For further information, you can head to stem4’s dedicated Anxiety* section on our website.
You may find some of the answers to these depression FAQs useful:
Depression, in the context of everyday conversation, is a term used to describe low mood. This is not a disorder. However, in the context of mental ill health, depression or clinical depression or a depressive disorder is a mental illness characterised by a number of different identifying factors.
Clinical depression is the same as a depressive disorder. It is a mental illness that is characterised by a variety of physical and psychological factors.
Young people who are clinically depressed will often shows signs of irritability, might be excessively tearful or say they are numb, say and believe very negative and critical things about themselves and lack interest in things they used to enjoy.
There are many symptoms of clinical depression which require diagnosis by a clinician or specialist. These include symptoms such as persistently changed low mood, negativity and a lack of engagement socially. These symptoms are often there most of the time.
Clinical depression can affect the way you see yourself and a result stop you from doing the things you enjoy. It can affect the way you work and your productivity. Clinical depression has the most effect on social connections often making the person who experiences depression withdraw from others.
There are some screening questionnaires for depression but since it is a serious mental illness, it should be diagnosed by a qualified mental health professional.
Self-diagnosis should be used with caution and should be seen as a signpost to accessing relevant professional help. Use a valid source of information such as the questionnaire on the Moodzone section on the NHS website rather than other unverified online information sites.
There are a number of self-care strategies that are helpful in managing mild-moderate depression. These include daily exercise (minimum half an hour a day), eating a regular and balanced diet, engaging in regular activities you enjoy and meeting up with friends.
Whilst it is often difficult to motivate yourself to do these activities whilst depressed, taking small but consistent steps to make a daily change can help enormously.
In addition, it’s important to be honest to yourself about any increase in negative ‘coping’ behaviours such as drinking too much, misuse of substances, self-harm or too much gaming/screen time to try and escape from difficult feelings and take steps to make positive change by substituting these with positive helpful behaviours.
There are also many treatments that work. Psychological treatments include three main therapies – Cognitive Behavioural Therapy (CBT), Interpersonal Therapy (IPT) and Behavioural Activation (BA). Medication can also sometimes help and will need assessment by an adolescent psychiatrist.
Talk to them and encourage them to tell a responsible adult who can get them help. If they find this difficult offer to talk to someone on their behalf or go with them as support when they tell someone. Keep being their friend rather than their carer and look after yourself.
Children can also develop a depressive disorder. Depression, as in low mood is very common in children and this can be part of everyday growing up. Depressive disorders in children have to be diagnosed by a health professional.
Depression is a common condition in teenage years affecting approximately just under a quarter of the population. According to latest NHS Digital figures, ‘emotional disorders’ are highest in females aged between 17-19 years (NHS Digital, 2017) but please note that these statistics are only through the use of screening questionnaires rather than clinical assessment and diagnosis.
Whilst similar numbers of girls and boys get depression until the age of 17, between the aged of 17-19 girls are four times more likely than boys to present with depression. In adulthood, women are twice as likely.
For milder problems, there are also some effective self-help programmes. Your GP should be your first port of call.
For further information, you can head to stem4’s dedicated Depression* section on our website.
Uncomfortable Feelings? Some of the content of these pages is sensitive and may trigger emotions in students or adults. You are invited to close your eyes or take a moment and connect with a responsible adult. We recommend you have a look at the signpost section of your stem4 conference homepage for options of further help and support.
You may find some of the answers to these self-harm FAQs useful:
Self-harm is when someone hurts themselves intentionally, usually to deal with a difficult emotion.
The main type of self-harm referred to is self-caused physical harm. However, self-harm can also refer to any intentional harm behaviour such as drinking to cause damage, eating to cause pain or frequently being in damaging relationships.
People self-harm for a number of reasons. Some of the reasons include as a way to release emotions, to express emotional pain, because they feel numb, as a habitual behaviour or because they dislike themselves.
There are many effective ways to stop self-harming. The first is to make a decision to stop. Make harming yourself less easy by putting away triggers, changing your routine and tell someone you trust that you are going to make a stop.
Download the Calm Harm app that helps manage the urge to self-harm. The app provides a timer to delay giving into the urge whilst providing a range of activities and self-reflections to help. It also provides a breathing exercise to help calm.
There are helplines you can call or make sure you phone a friend. Remind yourself of the consequences of your actions such as scars. Read about or get some help to challenge negative thoughts. Work on building self-esteem. Alcohol and drugs can increase self-harm – you may need to first stop the use of these to effectively stop self-harm. Get help for underlying reasons for self-harm such as anxiety or depression.
Listening to someone who is self-harming can provide huge support. Arrange some private time and focus on what they tell you, making sure to be non-judgemental. Be empathetic (which means understanding things from their point of view) and let them know you are there for them.
Don’t take control, let them lead the conversation and make their own choices. Encourage and support them to seek help if you are worried about their safety. Talk in confidence to someone who can help. Ultimately, friends who are self-harming have a big emotional effect on you, so make sure you talk to someone about how it may be affecting you. Remain their friend but don’t be their therapist.
Keeping avenues of communication open is the first step. This means not getting angry and asking too many questions. It is not helpful to insist the child or young person describe how they self-harm or to show you. Focus on the whole person rather than on the behaviour. This means asking about things that might be bothering them, what they might be worried about, their mood, etc.
Don’t take away their sharp implements before they have alternative ways to deal with the reasons that trigger self-harm. Also, avoid trying to physically prevent them from self-harming since this will only drive the behaviour underground. This doesn’t mean you have to accept the self-harm, it means trying to work with them a solution to making a change.
Keep the same boundaries you always have. It is always worth getting an assessment from a professional on risk and to check on physical safety caused by harm, for example, that the cuts are not infected.
If a child or young person comes to you with an injury stay calm. They will usually be scared and over-reacting in this instance doesn’t help. Treat the wound or seek medical attention. Comfort them but restrain from asking too many questions to start with.
You may see frequent injuries, not easily attributable to an accidental cause, or be told by someone close to the person such as a friend or the person themselves. Sometimes people will cover up inappropriately, for example wearing sleeves or long trousers even when it is really hot, or they may refuse to wear a swimsuit when it wasn’t a problem before.
Improving knowledge and awareness for children and young people through mental health education, building skills to deal with life’s challenges, providing strategies to reduce stress, providing easily accessible resources such as the Calm Harm app to help manage the urge, providing more mental health support in schools, colleges and universities, being able to access help easily via GPs can all help prevent self-harm.
The first step is to see your GP. They can refer you to mental health services. Helpful organisations include Childline, Samaritans, Mind, The National Self Harm Network, and YoungMinds Parent helpline. stem4 has a guide to Talking to your teenager about self-harm and a leaflet on Asking for help.
The Calm Harm app says ‘the urge to self-harm is like a wave’. It’s strongest when you start wanting to do it and will build to a peak. If you find alternative things to do or you can delay giving in in order to ‘surf the wave’ this will help you to combat the urge.
For milder problems, there are also some effective self-help programmes. Your GP should be your first port of call.
Using a variety of alternatives to self-harm will help you get through intense urges. The coping strategies help to manage the behaviour but it’s important to get to the root of why you want to do it by seeking professional help. The Calm Harm app provides a range of tasks, which fall into four different categories: ‘Distract’ to help you ‘surf the wave’ to self-harm, ‘Comfort’ which helps comfort rather than harm, ‘Express’ which helps get the feelings out in a different way and ‘Release’ which provides safe alternatives to self-harm.
Toolkits generally provide information on identification, practical steps to manage immediate symptoms and resources. Self-harm resources include informative websites, leaflets and fact sheets, helplines, web communities, services, books, and carer support.
Websites:
stem4.org.uk, harmless.org.uk, rethink.org
These organisations also produce leaflets and fact sheets.
Helplines:
111, 999, supportline.org.uk, Samaritans, selfharm.co.uk, 7cups.com
GPs can refer to local mental health professionals.
Books:
Self-harm: The Path to Recovery, Middleton & Garvie; Who’s Hurting Who? Spandler.
Calm Harm app available free on App Store and Google Play.
There are a range of treatments to help recover from self-harm. Since each individual and their reasons for self-harm will vary, having a thorough assessment from a specialist will help decide on the correct treatment. The range of available treatment includes medication and psychological treatments with specific reference to Dialectic Behaviour Therapy (DBT), Mentalisation Based Therapy (MBT) and targeted Cognitive Behaviour Therapy (CBT).
The exact number of people who self-harm is unknown since it is a secret behaviour. However, according to 2015 figures approximately 10% of young people self-harm. The NHS confirms that the number of young people self-harming has risen dramatically in the past 10 years.
It is unclear of the precise reasons but a rise in stress and serious psychological conditions has been seen as a likely cause. In addition, there is a larger spread of information via digital means, which possibly makes the methods used to manage stress known.
Schools are providing education to children and young people about practical ways to manage their stress and distress as well as train parents and teachers to spot early signs. Primary care professionals such as GPs and school nurses are linking more with schools to provide medical support, intervention and referrals.
The Calm Harm app is free, private and helps users manage the urge to self-harm. It is listed on the NHS Apps Library. This is a good place to look for mental health apps as apps on here have been through a rigorous accreditation process. Please note that the Calm Harm app is an aid to treatment, but doesn’t replace it.
For further information, you can head to stem4’s dedicated Self-harm* section on our website.
You may find some of the answers to these eating disorders FAQs useful:
Eating disorders are serious mental illnesses that are characterised by disordered eating which often includes inadequate or excessive food intake. Eating disorders often reflect a range of emotional difficulties including low self-esteem, issues of control, a disordered perspective about weight and shape, difficulty in managing mood and interpersonal difficulties.
There are three main types of eating disorders – anorexia nervosa, bulimia nervosa and binge eating disorder. However, there are also other variables.
Anorexia nervosa is when food is restricted so severely that the person’s body weight and as a result, their health is of concern. It is a very serious illness that requires specialist assessment and intervention. Bulimia nervosa is when people find it difficult to manage their emotions and so binge-eat to cope. They then carry out a range of behaviours to try and get rid of the food they have consumed. In binge eating disorder, people binge eat regularly causing distress.
1.6 million people in the UK are affected by an eating disorder.
11% of the 1.6 million are male.
14-25 year-olds are most affected by an eating disorder.
Research suggests that the earlier treatment is sought, the better the sufferer’s chance of recovery.
There are many. Some include:
- Extreme weight loss
- Severely restricted eating
- In females, periods stopping
- A variety of medical problems such as low iron, changes to liver enzymes
- Tiredness, lethargy, fatigue
- Fainting, lightheaded
- Skin changes – dry, spots
- Hair falling, breaking
- Muscle wastage
- Feeling very cold all the time
- Difficulty sleeping
Everyone is different and so the signs and symptoms, as well as the reasons for an eating disorder, will vary. In general:
Physical:
Sudden and rapid weight loss
Frequent weight changes
Fainting/dizziness
Tiredness
Thoughts:
Constant thoughts about weight and shape
Low self-esteem
Distorted body image
Behaviours:
Constant repeated dieting with or without binge eating
A range of behaviours aimed to get rid of the food
Intense focus on body shape and weight
A range of repeating checking behaviours
Emotions:
A range of emotions including:
Low mood
Anxiety
Irritability
Extreme bouts of anger
Increased stress
Mood swings
Social:
Finding social eating difficult
Lonely
There are many causes, often no one cause but a mix. Most common are issues of low self-esteem, social pressure, family breakdown, emotional issues, a perfectionist personality, or experiences that have made the person feel out of control.
School programmes on how to build positive self-worth, body confidence, reducing the impact of social pressure – to be more accepting of body size, avoiding dieting, parent education, discouraging perfectionism, helping healthcare professionals to identify problems early, establishing services that offer early intervention, helping teachers to identify and signposting to services.
Anorexia has an enormous negative physical impact. This includes thinning of bones, abnormal blood counts which affects body functioning, brittle nails, an effect on the regular working of the heart, low blood pressure, stomach problems. In addition, it affects concentration and learning. It also affects friendships and relationships.
Encourage the person with anorexia to speak out and ask for help – the earlier the better. The first person to see is your GP who can carry out a physical assessment to make sure you are safe and refer you to suitable services.
If you are worried about a friend or family member, don’t criticise or lecture. Express your concerns and offer to go with them to ask for help. Expect the person to deny the problem, remain calm and gently reiterate your view when appropriate.
There are many types of support. These include outpatient services, which offer a combination of dietetic, activity and psychological help, day hospital treatment to supervise eating and in patient care. There are also community eating disorder teams who can offer advice on a range of different types of eating disorders.
For milder problems, there are also some effective self-help programmes. Your GP should be your first port of call. Check the stem4 website and Beat the UK’s eating disorder charity website.
Treatment will vary depending on the person, the type of eating disorder and how long the disorder has been there for. It will also depend on your physical state. Generally, for anorexia, there is a mix of nutritional and psychological treatments. For bulimia and binge eating disorder there are specific forms of cognitive behaviour therapy and occasionally medication.
It seems that eating disorders are more common today and may be due to a number of reasons. The first is the promotion of a body shape that is thin. In addition, people exercise less and eat higher calorific food. More is known about eating disorders and this might prompt more people to ask for help or to be diagnosed with an eating disorder.
For further information, you can head to stem4’s dedicated Eating disorders* section on our website.
You may find some of the answers to these resilience FAQs useful:
Resilience is the ability to adapt to stressful situations without any lasting impact.
Resilience helps us to adapt and through this protect ourselves against experiences that could be overwhelming, ultimately protecting us from becoming vulnerable to mental ill-health.
Yes. Some people seem to be born with high tolerance to distress but usually all elements can be learned.
Resilience helps deal with difficult situations in life. Families, schools and society can also provide opportunities to promote resilience by having clear rules, providing safety and care, encouraging individuality and growth for example.
Grit is the passion and perseverance to reach a goal. Resilience is the ability to deal with and adapt to stress and failure.
‘Stiff upper lip’ is about ‘bottling’ up or not expressing upset. This technique doesn’t generally provide you with the ability to deal with difficulties. Resilience includes being upset since this is a healing emotion that is needed to deal with certain difficulties.
For further information, you can head to stem4’s dedicated Resilience* section on our website.