Mental Health Disorders

PSYCHOSIS

Broadly speaking, psychosis means a loss of contact with reality; it is a symptom of a number of mental illnesses rather than a medical condition in its own right. Psychosis is an umbrella term; it means that an individual has sensory experiences of things that do not exist and/or beliefs with no basis in reality. During a psychotic episode, an individual may experience hallucinations and/or delusions. They may see or hear things that do not exist.

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Listen and realize that your loved one may find it difficult to tell what is real from what is not. They may feel overwhelmed, confused, afraid, and distressed.

Be respectful, act calmly, show understanding, decrease distractions.

Learn the LEAP Approach.

DON'T

Don’t immediately assume that another breakdown is coming.

Don’t try to figure out what he or she is talking about or to whom they are talking to.

Don’t tell him or her to stop or force the hallucination to stop.

BORDERLINE PERSONALITY DISORDER

According to the DSM-IV, Borderline Personality Disorder (BPD) is a general pattern of instability of mood, interpersonal problems, and the image of themselves. It appears in the beginning of adulthood. 

It is present in a variety of contexts as indicated by at least 5 of the following :

Frantic efforts to avoid real or imagined abandonment.

A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

Identity disturbance: markedly and persistently unstable self-image or sense of self

Impulsivity that is potentially self-damaging

Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

Affective instability due to a marked reactivity of mood

Chronic feelings of emptiness

Inappropriate, intense anger or difficulty controlling anger

Transient, stress-related paranoid ideation or severe dissociative symptoms

DO

Respect yourself, set limits and protect your comfort zone.

Reach out for support and build a network of resources.

Take care of yourself, as self-care is the foundation of lasting change.

Lovingly hold your loved one accountable for their own behavior.

Remember that your loved one lacks the skills to manage their emotions.

DON'T

Don’t judge their feelings, because they are real for them.

Don’t get caught up in the chaos.

Don’t reinforce or normalize impulsive or dangerous behaviors.

Don’t blame yourself for their explosive behavior.

Don’t tell your loved one about your plans at the last minute, as they could end up feeling abandoned.

SUICIDAL THOUGHTS OR THREATS

Suicide is the act of intentionally taking one’s life. Studies have shown that over 90% of people who die from suicide have one or more psychiatric disorders at the time of their death. Comorbidity (having more than one illness at the same time) and how severe the disorders are can increase someone's risk for suicide. People who are thinking of committing suicide usually show warning signals that can alert family and friends to their distress and their plans. Here are some examples of these signals. It’s important to pay attention to them.

Direct messages

"I want to end it all." "I’m going to kill myself."

Indirect messages: "You’d be better off without me.” 

"I’m useless." "My life is a failure." "I’d be better off dead." "Life is no longer worth living."

Catching the warning signs early and seeing a doctor or other health care provider for a diagnosis and treatment plan could make it less likely that your friend or family member would commit suicide.

DO

Be yourself.

Let the person know you love them, you care about them, that they are not alone and that you're there for them.

Listen to them and let them express their anger and despair.

Be there for them without being judgmental. Be patient, calm, sympathetic and accepting.

Offer them hope. Reassure them and let them know that help is available. Let them know that their suicidal feelings will not last forever, but are temporary.

DON'T

Don’t deny the person’s feelings or argue with them.

Don’t react negatively or act shocked by the person.

Don’t lecture them on the value of life, or tell them that suicide is wrong or a mistake.

Don’t offer ways to fix their problems.

Don’t give them advice.

Don't make them feel like they have to justify their suicidal feelings.

Don’t promise to keep their secret.

Don’t blame yourself for your loved one’s lack of happiness, it is not your responsibility.

ANXIETY

People who suffer from anxiety, experience excessive fear and worrying most of the time. This affects a number of different aspects of their lives, including work, school, and relationships. The person has extreme difficulty controlling and managing their preoccupation, and often experience the following symptoms:

Agitation, feeling overexcited, or feeling at the end of your rope

Fatigability

Trouble concentrating or gaps in memory

Irritability

Muscle tension

Disturbed sleep

DO

Know the signs of an anxiety attack.

Ask ahead of time how you can help when/if an anxiety attack strikes.

Be there for them. Let the person know that they can talk to you about it openly, without any fear of judgment from you.

Be lenient with them and remember that they are doing the best they can.

Let them share their anxiety with you.

Make sure to work on your own stress and anxiety management.

DON'T

Don’t assume that they are anxious about something specific.

Don't say "Get over it". Remember, anxiety disorders are not just thought-related. They're chemical as well.

Don’t let their anxiety affect you as well.

Don’t expect massive, immediate changes or improvements.

DEPRESSION

Depression is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks. If your loved one has been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, they may be suffering from depression:

Persistent sad, anxious, or “empty” mood

Feelings of hopelessness, or pessimism

Irritability Feelings of guilt, worthlessness, or helplessness Loss of interest or pleasure in hobbies and activities Decreased energy or fatigue Moving or talking more slowly Feeling restless or having trouble sitting still Difficulty concentrating, remembering, or making decisions Difficulty sleeping, early-morning awakening, or oversleeping Appetite and/or weight changes Thoughts of death or suicide, or suicide attempts Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment

DO

Express your empathy with the person and offer them encouragement and support.

Know your role and have realistic expectations of yourself.

Realize this is something they can't just snap out of.

Give them space to heal. It’s common that a person who is depressed will isolate themselves.

Let your loved one know that you are there for them when they need a shoulder to cry on, even if they never take you up on your offer.

DON'T

Don’t say things like, “Be strong,” “Don’t cry,” “Focus on the positives!” “Be grateful for what you have,” or “Get over it.”

Don't be afraid to ask if they are suicidal. Don't give up on them without talking to them about it first.

Don’t minimize their feelings and what they're going through.

Don’t discredit what they’re feeling.

Don’t tell them you know exactly how they feel.

Don’t neglect yourself in the process.

EATING DISORDERS

There are three main types of eating disorders: Anorexia nervosa, bulimia nervosa, and binge eating. 

Someone suffering from anorexia nervosa refuses to keep their weight in a healthy weight range by restricting the intake of food or exercising more than usual. 

Bulimia nervosa is characterized by periods of binge eating and then purging. 

Binge-eating disorder involves periods of over-eating.

DO

Be mindful of your own attitudes about body image and eating habits.

Learn as much as you can about eating disorders so you can be a good source of support for your loved one.

Ask to be involved in the treatment plan of your loved one.

Hold your loved one accountable for their actions (i.e. eating or not eating a meal; going or not going to therapy).

Take care of yourself, set healthy boundaries for yourself and seek support if needed.

DON'T

Don’t react to discussions about body image.

Do not try to reason with the person about statements that seem unrealistic to you.

Don’t blame yourself. Families can be the best ally in treatment.

Don’t make changes in your life to accommodate the eating disorder.

Don’t ignore the problem hoping it will go away.

Don’t give up hope. Sustained and durable recovery from eating disorders is possible!

OBSESSIVE-COMPULSIVE DISORDER (OCD)

Obsessive-compulsive disorder (OCD) is made up of two parts: obsessions and compulsions. Obsessions are unwanted and repetitive thoughts, urges, or images that don’t go away and cause anxiety. Compulsions are actions that are performed to reduce the anxiety caused by the obsessions. 

DO

Set rules, limits, and boundaries, and stay consistent.

Learn as much as possible about OCD and make sure to educate yourself and your family about all aspects of the illness.

Remember to take care of yourself. Get support by joining a support group or talking to someone you trust.

Remember that you play an important role in your loved one's recovery.

Encourage your loved one to tackle fearful situations.

Recognize and acknowledge improvements, even small ones. That’s a powerful motivator.

DON'T

Don’t get involved in the person’s compulsive behaviors.

Don't reassure the person that everything is going to be okay.

Don’t trivialize the illness by saying things like, “I’m a little OCD too” or “I am being so OCD today.”

Don't make daily comparisons, but instead, focus on overall changes since the beginning of treatment.

SCHIZOPHRENIA

Schizophrenia is a disorder that is believed to be caused by biochemical imbalance in the brain. It affects a person’s perceptions. Individuals develop a marked change in how they think, feel and act. They can have some of the following symptoms for at least 6 months: hallucinations, delusion, disorganized speech, disorganized behavior, apathy and social withdrawal.

DO

Be patient and calm. It can be quite difficult to understand and interact with your loved one due to their apathy, disorganized thoughts and/or poor concentration.

Be understanding with your loved one and realize that the symptoms of the disease makes it difficult to have a conversation. Your loved one is not excluding you voluntarily.

Remember that proper sleep helps with recovery.

DON'T 

Don’t discuss strange ideas with your loved one, pretend to agree with them, or pretend to understand them if you can't.

Don’t pretend to agree with your loved one's strange ideas or way of speaking that you cannot understand.

Don’t try to keep up a conversation that you feel is too distressing, annoying, or confusing for you.

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RECOVERY HAS TWO MEANINGS

Clinical Recovery—focuses on getting rid of symptoms, restoring social functioning and “getting back to normal."

Personal Recovery –focuses on the process of building a meaningful life as defined by the person with the mental health issues. It involves re-establishing and recovering a sense of identity and purpose within and beyond the limits of the illness. The person develops a deeper understanding and acceptance of their limitations and overcomes their challenges.

DO 

Help the person find and maintain hope.

Allow the person to take responsibility for their own life in as many ways as possible, including making decisions.

Allow the person to take positive risks and build their own treatment plan.

DON'T

Don’t assume the person can't make their own decisions.

Don’t view the person as a diagnosis. They are people who face challenges and they are more than their illness.

Don’t impose your will on the loved one unless they are in a crisis. You are supposed to be a resource for the person.

References:

https://www.theodysseyonline.com/the-dos-and-donts-of-helping-someone-with-anxiety

https://www.calmclinic.com/anxiety/tips-for-friends-family

https://www.mindbodygreen.com/0-12962/the-dos-donts-of-helping-a-friend-whos-depressed.html

https://www.theodysseyonline.com/the-dos-and-donts-of-depression

Canadian Mental Health Association. (2018). Obsessive compulsive disorder. Retrieved from: https://cmha.ca/documents/obsessive-compulsive-disorder-ocd

Timms, P. (2015). Obsessive compulsive disorder. Retrieved from: https://www.rcpsych.ac.uk/healthadvice/problemsanddisorders/obsessivecompulsivedisorder.aspx

Van Noppen, B., and Torta, M. (2009). Living with someone who has OCD. Guidelines for family members. Retrieved from: https://iocdf.org/expert-opinions/expert-opinion-family-guidelines/

Canadian Mental Health Association. (2018). Eating disorders Retrieved from: https://cmha.ca/mental-health/understanding-mental-illness/eating-disorders

Mental Health America of Northern Kentucky and Southwest Ohio. (2013). Do’s & Don’ts for Confronting Individuals with Eating Disorders. Retrieved from: http://www.mhankyswoh.org/Uploads/files/pdfs/EatingDisorders-DoAndDont_20130812.pdf

National Eating disorder information. (2018). Help for Friends and Families. Retrieved from: http://nedic.ca/give-get-help/help-friends-family

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