Supporting Someone with a Mental Illness


Know someone with a mental illness?

A closer look at how you can support them


Tips for supporting a friend with a mental illness

Someone who is experiencing mental health difficulties is usually able to live a successful and satisfying life, particularly if they are receiving help to manage the illness. However, it’s not uncommon for a stigma to be attached to someone who is having a hard time.

A person with a mental illness might feel embarrassed or like an outcast because of these harmful stigmas. Often people with mental health difficulties worry that others will tease them or treat them differently. Here are some tips for making your friend feel more comfortable:

Avoid being judgmental. Be aware of the stigma associated with mental health difficulties, but keep an open mind. This might help create a safe environment for your friend, which can allow them to relax and enjoy life.

Talk about what your friend finds helpful. Make sure that the conversations you have about your friend’s illness are easy and open. Try asking about what helps your friend get through the tough times. By talking openly, you’re letting your friend know that you love and support them.

Respect your friend’s limits. There might be times when your friend says that they aren’t able to hang out because of the illness. It’s important that you respect this and don’t put extra pressure on your friend. Often, people who are taking medication can’t drink alcohol or take drugs because it could trigger a harmful reaction. This might make certain social situations hard for your friend. If you know your friend has limitations (for whatever reason), try to be mindful of what activities you invite them to.

Encourage your friend to stick with medication. It’s likely that someone with a long-term mental illness will be on regular medication. Their medication may have side effects that your friend might not like, but medication is often an important part of managing the illness, and your friend might need your support to keep taking it.

If your friend stops using or changes the amount of medication they are taking without permission from a psychiatrist or medical doctor, encourage your friend to make an appointment quickly. Similarly, if your friend is experiencing side effects that weren’t expected and are negatively impacting them, they should contact their psychiatrist or physician immediately.

Ensure that you have contact numbers. Having the contact numbers of people like your friend’s psychiatrist or doctor could be important if you need to help your friend through a crisis, or if your friend is saying or doing things that worry you about their safety.

Getting help for your friend

For those who have a mental health issue, there might be periods of time when things aren’t manageable. Harder times can be triggered if your friend is stressed, or if they have recently experienced a traumatic event, or changed medication. These can trigger the characteristics of the mental illness, which is what most professionals call an “episode.”

If you’re concerned that your friend isn’t behaving normally, it’s important to encourage them to talk to someone trustworthy, like a doctor, psychologist or psychiatrist. If you think that your friend is likely to hurt themselves or someone else, find help immediately—even if your friend doesn’t want you to. This may even mean accompanying your friend to the nearest emergency room or going with your friend to see a counselor.

If your friend is experiencing a crisis, have them call a crisis line: Lines for Life's Suicide Lifeline (1-800-273-8255) or their Youthline (1-877-968-8491). Both are anonymous, free, with staff available 24/7/365. They also offer texting and online chat options if speaking on the phone is too uncomfortable or your friend is otherwise unable to do so. It may also be helpful to talk to the person on the helpline if your friend feels talking to them is too much.

Looking after yourself

Sometimes when you help a friend, you might forget to look after yourself. It’s important to take care of your own needs while you’re helping out your friend. Make sure that you don’t give up things that you enjoy, and if you’re feeling tired or overwhelmed, take some time out and relax. You’re not your friend’s therapist, you’re just their friend. It’s okay to have boundaries with yourself.


Information for this article was provided by:

  • Mental Health America, “Giving Support to Someone Close to You”

Acknowledgements: This article was originally developed by youth and staff for

Is My Therapist Right for Me?


New Therapist?

Let’s take a closer look at what to expect and how to know if they’re the best fit for you


Reaching out to someone for help can be a big step, but it’s important that you get the best help possible. Every counselor, therapist, or mental health professional has a different approach to helping their clients. It’s important to do your research about the provider before you meet with them, as well as get to know them in your first session to know if they’re the right fit.

What should I expect?

It may seem intimidating going to talk to someone for the first time. If you would like more information on what to expect, check out our Visiting a Mental Health Professional for the First Time article. That being said, there are steps you can take to make sure that you’re getting the best help for you. Here are a few examples:

Know your medical history. When you see any health or mental health professional—like a doctor, nurse, psychiatrist or psychologist—they will ask you some questions about your health and medical background, such as:

  • Are you’re taking any medications or herbal treatments?

  • Do you smoke, drink or use illegal drugs?

  • Do you have any allergies or reactions to medication?

By knowing the answers to these questions, you can help your provider give you the best treatment.

Be honest. Sometimes health and mental health professionals need to know things about you that you might find embarrassing or uncomfortable. It’s important to try to be as honest as possible with the provider you’re seeing. If you’re unsure about why your provider is asking you certain questions, it’s O.K. to ask him or her why the information is necessary. If you’re worried about your rights or whether your provider will keep your information confidential, make sure to talk to them about it. For more information, check out our Confidentiality article.

Ask questions. Don’t be afraid to ask questions about your health or treatment. If you don’t understand what your provider says, ask them to explain it again or in a different way. Health and mental health professionals should help you find the best solution to your concerns.

Seek support. Talking to family and friends about any treatment decisions you might need to make can help you make the right choice for you. Sometimes you might need to talk to your doctor or mental health care provider again, or get a second opinion from another provider.

Take notice of any side effects. If you’re taking medication, make sure to ask your doctor about any possible side effects. If you do experience undesirable side effects, tell your doctor.

Express your concerns. If you’re unhappy with the provider you’re seeing, it might be a good idea to let him or her know about your concerns. It’s important that you’re comfortable with your provider, and if talking with the person isn’t comfortable, you might want to also consider changing providers.

It’s also important that you let your provider know about beliefs and cultural practices that may be relevant to your care so that he or she can be more sensitive to your needs. You might also find it easier to see a provider who has similar cultural or religious beliefs, or is the same gender as you.

Maybe they’re not the best fit

Sometimes the mental health professional you start to see, might not feel like the right fit. Not all counselors, psychiatrists or psychologists are the same. If you don’t like the first, or even the second or third person you see, it’s important to find someone else.

However, like any relationship you have with friends, family or the people you work with, your relationship with your counselor, psychiatrist or psychologist is best when you trust them. Gaining this trust can take time. For more information, check out the Relationship Issues article.

Deciding if your provider is right for you

Some of the questions you can ask yourself to help you decide are:

  • Do I like talking to the person?

  • Do I feel meeting with this person helps?

  • Do I feel respected?

  • Do I feel listened to?

  • Is this someone I could grow to trust?

If you answered “no” to any of these questions, you might want to consider changing providers.

It is also important to realize that when you work with a mental health professional, the work itself might be difficult. Talking about tough issues can make you feel sad, angry, frustrated or uncomfortable. It’s not uncommon to direct these feelings towards your counselor, psychiatrist or psychologist. Be careful that you don’t confuse the hard work and the feelings it might bring up, with thoughts that the helper might not be a good fit. It’s OK to discuss this with your provider; it could mean that you need a change of pace or someone else that can intuit the best approach for your specific goals. Talking it through might help you decide whether it’s best to see someone else.


Acknowledgements: This article was partially developed by youth and staff for




A closer look at what schizophrenia is, what causes it, the symptoms, and what treatment options are available

What is schizophrenia?

Schizophrenia is a mental illness that affects about 1% of the adult population. Schizophrenia affects both men and women with equal frequency. It often appears in men in their late teens or early twenties, and with women in their twenties or early thirties. Schizophrenia is often related to dissociative identity disorder (DID), also known as multiple personality disorder, in which someone alternates between different personalities. Schizophrenia is not related to DID, but more so relates to the “split” between emotional expression and current experiences.

Symptoms of schizophrenia

Schizophrenia often interferes with a person’s ability to think clearly, to distinguish reality from fantasy, to manage emotions, make decisions, and to relate to others. The symptoms of schizophrenia often include positive symptoms, behaviors that are present that should be absent, and negative symptoms, behaviors that are absent that should be present. Examples include:

Positive Symptoms

  • Delusions: Beliefs that may be possible but are not true (such as believing that people are plotting against you or tracking your behavior, or that you are the Messiah)

  • Hallucinations: When someone hears, sees, feels, or smells things that are not actually present (such as hearing voices that no one else can hear)

  • Disorganized speech (rambling or incoherent): Not being able to organize thoughts and communicating them in a way which other people can’t understand

  • Difficulty prioritizing tasks

Negative Symptoms

  • Emotional flatness or lack of expression: When a person’s face, voice, and gestures seem flat

  • Lack of interest in life: Difficulty starting and following through on activities and having trouble doing simple things

  • Lack of pleasure: Not enjoying things they used to enjoy, including relationships and activities

Other things besides schizophrenia may also cause similar symptoms, such as drug usage or a medical condition affecting the brain (head, injury, tumor, etc). Therefore, if you or someone you know is concerned about the symptoms described above, it is best to consult about the symptoms with a medical doctor for a complete checkup.

What causes schizophrenia?

The exact cause of schizophrenia is not known. Like other medical illnesses such as cancer or diabetes, schizophrenia seems to be caused by a combination of genetics, environmental factors, and psycho-social factors. Examples include:

  • Genetics or family history: People who have first-degree relatives, such as parents, brothers, or sisters, have a higher risk of inheriting schizophrenia. However, genes only increase the chances of developing this illness; it does not depend on any single gene.

  • Biochemical factors: Research has indicated that the deficient activity of the neurotransmitters dopamine and glutamate, possibly play a role in developing schizophrenia.

  • Environment: Your prenatal environment, like if your mother had the flu when she was pregnant or not receiving sufficient nutrition as a child, can put you at high risk of developing schizophrenia. Also, situations like being exposed to stress or trauma can increase risks.

  • Drug use: Some research suggest that drug misuse is related to the development of schizophrenia. It’s likely that substance misuse can bring on or worsen the symptoms and get in the way of the treatment of a person with schizophrenia.

Getting help

Schizophrenia is treatable and people with schizophrenia can lead happy, fulfilling, productive lives. The most effective form of treatment is a combination of medications, professional counseling, and peer-to-peer and family support. If you have or think you have schizophrenia, seeking help is important.

It should begin with a visit to a medical doctor, and sharing when you started experiencing symptoms. A general practitioner or psychiatrist may prescribe medication. Therapy or counseling with a psychiatrist, psychologist, social worker, or counselor can also help manage your symptoms and help you manage day to day tasks. Some who have schizophrenia may have periods of acute symptoms that require intensive treatment, such as hospitalization (if necessary).

The National Alliance on Mental Illness has a weekly recovery support group for people living with mental illness in which people learn from each others’ experiences, share coping strategies, and offer each other encouragement and understanding. They also have resources for family and friends of a person who has schizophrenia. Check out the NAMI Connection to find a support group near you.

Information for this article was provided by:


Acknowledgements: This article was originally developed by youth and staff for

What to Expect When Calling a Helpline


Calling a helpline

A closer look into what to expect when calling a helpline

Why should I call a helpline?

Talking in real-time to a trained counselor or volunteer provides you with immediate support and allows counselors to easily connect you with additional places to get help. If you’re feeling nervous about calling, that’s okay. It can be scary to pick up the phone, especially if you don’t know what to expect.

If you’re facing a serious issue or worried for your safety, we encourage you to contact crisis helplines, such as:

  • Lines for Life: Suicide LifeLine - For those going through crisis and those concerned for them

    • Call 1-800-273-8255 (24/7/365)

    • Text 273TALK to 839863 (8am-11pm PST daily)

  • Lines for Life: Alcohol and Drug Helpline - For individuals and family members seeking crisis intervention, treatment referral, and chemical-dependency information

    • Call 1-800-923-4357 (24/7/365)

    • Text RecoveryNow to 839863 (8am-11pm PST daily)

  • Lines for Life: Military Helpline - Support for service members, veterans and their families

    • Call 1-888-457-4838 (24/7/365)

    • Text MIL1 to 839863 (8am-11pm PST daily)

  • Lines for Life: Youthline - Support for youth in crisis or when needing help

    • Call 1-877-968-8491

    • Text teen2teen to 839863

    • Email at

    • Chat online here

    • Teens are available to chat with you from 4pm-10pm PST daily, all other times are with adults

  • Your Life Your Voice - Trained counselors to talk to 24/7, ran by Boystown (for everyone)

    • Call 1-800-448-300

  • National Runaway Safeline - If you’ve run away from home

    • Call 1-800-RUNAWAY

  • The Trevor Project - If you’re struggling with LGBTQ challenges

    • Call 1-866-488-7386

  • RAINN -  If you’re struggling with sexual violence, like rape, abuse and incest

    • Call 1-800-656-HOPE

Common questions you might have

Who answers your call? When you call a helpline, a trained counselor will answer your calls. Many have a background in mental health or social work, but all volunteers receive training in crisis counseling and suicide intervention.

When should you call? You do not have to be in a serious crisis to call a helpline. Some people call simply to obtain information and referrals for local community services. Others call because they have something that’s on their mind that they want to talk over with someone outside of the current situation. Of course, if you are in a serious emotional crisis, they’re there for that too.

How can they help? Above all, the counselor who answers your call is there to listen.  Whether you’re feeling hopeless, angry or confused, counselors can help you process your feelings and assess your situation before working out what comes next.

Different helplines focus on different topics, but all will be able to provide support, information and referrals. Whatever your issue, your call will be answered by someone who will be supportive and non-judgmental, and who will try to understand exactly what you’re saying and how you’re feeling.

They want to help you stay safe, think through your situation or problem, explore your options, and to help you figure out what you want to do, if anything.

What types of questions will you be asked? A lot of help lines are designed to be anonymous and confidential. This means that while you may be asked to give your first name, you will not need to provide any additional identifying information like last names or addresses, etc. Many find that this anonymity helps them to feel more comfortable when answering personal questions about their situation.

Some sample questions you may be asked include:

  • Are you in a safe place to talk?

  • How can I help you today?

  • How old are you?

    • This helps counselors understand your eligibility for different types of services.

    • If you are a minor (legal definition varies from state to state) and have specific questions related to your age and the issue you’re experiencing the counselor can address those questions.  

  • Tell me a little about what happened that led you to call?

  • When you are upset, to whom do you usually go to for support?

  • Is there anyone else that you feel you can talk to about this situation?

  • How are you surviving, and do you need a safe place to go?

    • For those callers who express a need for safe shelter, counselors, like those at National Runaway Safeline, will need to know your city and state to begin locating an available safe shelter for you.

Why do they ask so many questions?

It‘s important for them to get a clear understanding of your situation and see it from your perspective. Remember, they don’t know you or anything about your life. They don’t ask questions to be nosy—they ask questions to find the source of your trouble and develop an action plan that makes you feel comfortable.

Regardless of age or location, these services are in place to provide support and assure your safety. Honesty about your situation will help counselors determine the best resources for you whether you’re dealing with LGBTQIA+ issues, child abuse, mental health struggles, etc.

Are there alternatives to calling?

Yes. We know some people may be more comfortable reaching out over the Internet, and many services also offer chat, email, online forum or text options.

You can also reach out to someone in person. Speaking to a trusted adult, teacher, school counselor, doctor, or another mental health professional is also a great option.

No matter how you reach out, the most important thing is getting help. You’re not alone!

Acknowledgements: This article was partially developed by youth and staff for

Sexual Violence


Sexual Violence

A closer look at what sexual violence is, how it can affect someone, and important laws you should know

Sexual violence is a crime and can refer to any type of sexual activity where consent is not obtained or freely given. The person responsible for the violence is often someone known to the victim, and can be, but is not limited to, a friend, family member, coworker, or neighbor. Sexual violence is never the fault of the victim.

Different types of sexual violence

There are a lot of different ways that people can become victims to sexual violence, and it can happen to anyone, regardless of age or gender. These acts might include those that:

Do not include physical contact:

  • Sexual harassment

  • Threats

  • Intimidation

  • Peeping

  • Taking nude photos or videos

Do include touching:

  • Unwanted touching

  • Sexual assault

  • Rape

”Sexual assault” in everyday language is a general term that includes rape and other offenses like assault/battery and sexual groping. The definitions and labels for sexual offenses can differ slightly from state to state. In some states, sex without consent is called “rape,” while in others, it is called ”sexual assault,” ”sexual intercourse without consent,” or “sexual penetration without consent.”

Though the term “assault” may bring physical attack to mind, it isn’t just about hitting. Sexual violence can also include using force or fear to make you do things that you don’t want to do.

Why are people sexually violent toward others?

Sexual violence is not about offenders getting pleasure from sex or any other form of harassment, but rather about them asserting power and control over someone else. Some offenders have been abused themselves, but this is not always the case, and there’s no evidence that a victim or survivor of sexual assault will become a perpetrator. To learn more about the theories behind sexual aggression, check out the U.S. Department of Justice’s National Criminal Justice Reference Service.

How experiencing sexual violence might affect you

Everyone reacts to the types of sexual violence differently. Individuals can experience a variety of immediate, short-term and long-term effects on their physical and emotional well being. These can include:

Shock and denial. Someone who has been a victim of sexual violence might not accept that it has really occurred. “Has this really happened to me?” and “Why me?” might be common questions that someone asks themselves.

Fear. After any form of sexual violence occurs, a person might be afraid of the offender, other people, or of being alone. A person might also be afraid to deal with the medical, legal or social consequences of the crime, and of being rejected by loved ones because of the sexual violence.

Silence. A sexual violence survivor might be unable to talk about the experience or describe what it means and feels like. There are also social pressures that might keep you from speaking, too.

Anxiety. A survivor might always be on edge. He or she might be unable to relax or feel safe.

Depression. Survivors might be at a greater risk of depression after the incident.

Guilt and blame. A survivor might continually question the events leading up to the violent event, and find fault with themselves or others for the assault. Questions they might ask themselves include, “Why did I go there?”, “Why did I let it happen?” and “Why did I not fight back?”

Low self-esteem. A survivor might feel ashamed or dirty after the assault.

Isolation. A survivor might want to be alone, and have a tendency to close him or herself off from friends and family members. A survivor might also have a hard time getting emotionally close to others after experiencing sexual violence.

Nightmares and flashbacks. Images and memories of the violence might continue in a survivor’s daily life and sleep.

Mood swings. Survivors might quickly change moods from anger and rage to tears and despair.

Loss of confidence. Survivors might become apathetic or self-conscious when working, studying or socializing with friends.

Loss of trust. After an assault, a victim might have a hard time trusting people who weren’t even connected with the incident, including friends and family members.

Lack of intimacy. Survivors might be afraid of, or uncomfortable in, sexual relationships after an assault.

To stay safe, play it safe

Most sexual violence occurs within a relationship (intimate partners, family members, or acquaintances). On average, 74% of sexual assaults are perpetrated by a non-stranger, and 30% are by an intimate partner, according to the Centers for Disease Control and Prevention. Sexual violence can also happen outside of relationships. Check out the CDC’s fact sheet on sexual violence or the Rape, Abuse, and Incest National Network website for statistical or crisis helpline information.

Here are some tips or things you can do to keep safe:

  • Plan to go out and hang out in a group

  • Go out with people you feel safe with and who you know have your best interests at heart. Good friends make sure that their friends are safe and make safe choices.

  • Have transportation plans to make sure you can get to where you’re going and back safely. Carry money for a taxi-cab just in case.

  • Let someone—like your parents, siblings or roommates—know where you’re going and when you’ll be home. If your plans change, let these people know.

  • Alcohol and sex can be a dangerous mix. Remember: if you aren’t in control of yourself, you won’t be able to control your situation.

  • Avoid being alone and isolated with someone you don’t know well. If you start to feel uncomfortable, go with your feelings, and get to a safe place as fast as you can.

  • Take a self-defense class at your local high school, college or recreation center. It might also be a good idea to have pepper spray, wasp spray, a whistle, or a self-defense keychain handy.

Agreeing to one type of activity such as kissing doesn’t mean that it’s a ”green light” for other sexual contact. Remember: it’s OK to change your mind and say no at any stage. Also keep in mind that you shouldn’t stop being careful just because you know the person you’re with. You might not know the person as well as you think.

Sexual violence and the law

In the United States, laws relating to sex and sexual violence can differ between states. Crimes such as statutory rape, sexual assault, and sexual abuse can just mean people having sex under a certain age (the age of consent), and do not necessarily include force. The age of consent varies between the states, ranging from 14 to 18, with most states setting it at 16. This means that having sex with someone under that age, even if it is consensual, is a crime. Some states base the penalty for these violations on the age of the offender, with older offenders receiving harsher punishments. For example, in certain states, a minor might receive as little as six months or one year in prison, and an older offender might receive life imprisonment. Most penalties range from 10 to 30 years, depending on age and state, according to the Connecticut General Assembly Report.

The federal government has certain laws to ensure that all victims of violence have their rights. Since 2003, every state has some sort of crime compensation program and victims’ rights legislation. The Crime Victims’ Rights Act, a component of the Justice for All Act of 2004, specifies the roles of various criminal justice officials in supplying the information the victim is to receive, as well as in implementing victims’ rights. A second act, the Violence Against Women Act of 1998, enhances the investigation and prosecution of violent crimes against women and increases the jail time of the accused perpetrator before the trial. These laws, along with other state and federal laws are continuously updated and reauthorized.

Sexual violence is a crime. If you or someone you know has been sexually assaulted or was a victim of another type of sexual violence —either recently or in the distant past—you have the right to report it to the police. If you decide to report an assault, an officer will take your statement. If the assault was recent, he or she might also ask you to have a medical examination, during which a health care professional will make sure you’re physically OK and possibly take evidence. Check out the Rape, Abuse and Incest National Network for more about what happens during an examination and who might conduct it.

Where to get help

Finding the courage to talk about sexual violence is important.

If you need help, you can call the Rape, Abuse and Incest National Network (RAINN) at 1-800-656-4673 or the National Center for Victims of Crime hotline at 1-800-FYI-CALL. You can also call The Boys Town National Hotline at 1-800-448-3000 to find help in your area. You could also check out our Crisis Helplines directory to find additional resource.. Remember: do not hesitate to call your doctor, nurse, or local health professional if you feel comfortable doing so.

Each state has a sexual assault coalition that can provide with state-specific information and resources.  You can access each state’s coalition through the Office of Violence Against Women at the U.S. Department of Justice.

For emergency situations that require immediate and urgent assistance, call 911.

Information for this article was provided by:

Acknowledgements: This article was originally developed by youth and staff for

Psychiatric Hospitals and Wards


Psychiatric Hospitals

A closer look at what to expect

What happens in psychiatric hospitals and wards?

Psychiatric hospitals and wards specialize in treating people who are experiencing a variety of different mental illnesses, including depression, schizophrenia, anxiety and eating disorders.

Psychiatric hospitals and wards can be part of a larger hospital or located in a smaller building like a clinic.

Many people find spending time in a psychiatric hospital a very helpful way to:

  • Rest and reflect

  • Find out what is happening emotionally and why

  • Stabilize medications they might be taking

  • Get intensive treatment from doctors and other health professionals with specialist training, like nurses, occupational therapists, social workers and psychologists

Voluntary and involuntary admission

A voluntary admission is when a person enters a psychiatric hospital at his or her own request or at the suggestion of a doctor, parent, or guardian. This can be at a time when that person feels he or she needs some extra support. Voluntary admission can be organized by the person who is being admitted or by a doctor, parent, or guardian.

There are times when a person becomes so ill that they are at risk of hurting themselves or others and hospitalization becomes necessary even though the individual does not wish to enter a hospital. This is called an involuntary admission. This occurs when someone else has recognized that the person is imminently a danger to him or herself or others. In most states, police officers and designated mental health professionals can require a brief commitment of an individual for psychiatric evaluation. If the individual is evaluated and needs further hospitalization, a court order must be obtained.

Where are psychiatric hospitals located?

You might find it difficult to research psychiatric wards and hospitals over the Internet, but your medical doctor or psychiatrist should be able to recommend one that will suit you best.

Some are privately run, while others are within larger hospitals. Some might also have a limited number of places available, while others may only admit people at certain times of the year.

Things you might consider when choosing a psychiatric hospital is the cost, program (including any restrictions in activity and other policies), size and length of stay.

How much will it cost to stay at a psychiatric hospital?

The cost of a stay in a psychiatric hospital or ward varies widely. Some run on donations or require a very small fee, while others are privately run and expensive. You or your parents might be able to claim back some of costs through private health insurance or through federally funded health insurance programs.

How much time do people spend in psychiatric hospitals?

The length of stay depends on a variety of factors. These can include what you are being treated for, the type of treatment you need and what your doctor decides will help you best. Most stays are short-term.

It’s common that programs will run for a set period of time, and most people stay for the duration of that period. Involuntary patients may have the length of time set by a judge. After that set amount of time expires, a doctor will usually decide if further treatment is needed. Sometimes, the judges and doctors will not agree and a lawyer might need to get involved.

What happens in the psychiatric hospital?

Upon arrival at the hospital, a patient will have a consultation with a doctor.  The doctor will give an assessment of the situation a patient is in, and tell him or her a bit more about how everything works. If you’re a patient, this is a good time for to ask any questions you might have about your treatment or what you should expect. Depending on state law, you might get a second opinion from another doctor early on in your stay.

During your stay, the activities you take part in will vary depending on what your goals are. They might include:

  • Group work. This is a group discussion with other patients that is facilitated by a social worker, nurse, doctor, psychiatrist, psychologist or counselor.

  • Individual therapy. This is one-on-one counseling with a social worker, psychologist, psychiatrist or counselor.

  • Personal time. You’ll probably find that you have a lot of time to yourself during your stay. How you fill this time is up to you, but it might include interacting with other patients, doing work or studying if you feel able, or just chilling out and reflecting. Depending on the hospital and your needs, you might have your own room, or you might have to share with others. You might also be allowed to bring your own books, phone and music.

  • Visitors. Many hospitals have set visiting times so you can see family and friends. You might also be allowed to go home during weekends.


Unless it is an emergency situation, you can work with your psychiatrist on deciding whether medication should be part of your treatment.  Medication might include antidepressants, sedatives, antipsychotics and occasionally electric shock treatment for very severe mental illnesses. Just because a person is on more or less medication than you doesn’t mean that you are any better or worse than they are.

What to do if you’re unhappy with treatment

If you’re unhappy or unsatisfied with any part of your treatment, it’s important that you talk about it with your doctor or psychiatrist. They may not realize you’re unhappy unless you say something. You might then discuss ways to adjust your treatment so you’re getting the best possible outcome. If you continue to be unhappy with your treatment, you have the right to ask for a second opinion.

Dealing with fears about going home

You might look forward to going home, or you might feel scared or nervous at the thought of leaving the hospital. You might be scared that things will go back to the way they were, that you’ll be alone, or that you won’t be able to cope with the added pressures of home, like chores, work and school. The first few days at home can be tough. If you’re having a rough time, it’s important to make use of the supportive people you have around you. Try to identify people that you can talk to or call when you are having a hard time, like friends, family or a counselor. You might want to set this up before you leave the hospital.

It might also help to arrange activities before you leave the hospital so you have something to look forward to and to make you feel less alone. It’s a good idea to investigate and list these activities before leaving the hospital so that supports are in place before returning home, making the transition a little easier and less overwhelming. Hospital staff or a community mental health team member can assist you in doing this.

You or your doctor might also arrange for you to attend an Intensive Outpatient Program (IOP) as a way to transition from hospital to home. IOPs meet three to five days per week, for three to eight hours at a time. Like a hospital, you do a variety of work, including group and individual meetings, art therapy or recreational activities. Unlike a hospital, you go home at the end of the day. An IOP might also be an option if you aren't able to find a hospital that can help you, or if you want a treatment option that is in-between outpatient therapy and inpatient hospital stay.  


Acknowledgements: This article was originally developed by youth and staff for

Post-Traumatic Stress Disorder (PTSD)



A closer look at post-traumatic stress disorder, how it’s caused, and what treatment options are available

What is Post-Traumatic Stress Disorder?

Frightening, overwhelming or traumatic experiences can have a strong impact on your mind and emotions, especially if these experiences are life-threatening.

Post-Traumatic Stress Disorder, or PTSD, is classified as a trauma and stressor-related disorder and is one of many psychological reactions you can have to a traumatic event. These traumatic events might include:

  • An accident

  • Sexual assault

  • Violence

  • A natural disaster, like a flood, fire or tornado

  • War

  • Torture

Experiencing a stressful or upsetting event—like a break up, for example—is not the same as a traumatic event like those listed above.

How a traumatic experience might affect you

It’s not uncommon to experience strong emotional reactions like fear, horror and helplessness during a traumatic experience. Other emotions like sadness, guilt and anger are often felt in the days that follow. Many people will recover after a few weeks following a traumatic experience with the help of family and friends.

These sort of reactions are normal and don’t necessarily mean that you have PTSD. But if you are experiencing any of these feelings, it’s important that you look after yourself.

For a small group of people, the distress following a traumatic event doesn’t go away and interferes with important areas of their normal everyday functioning. In these cases, it’s no longer considered a normal response to trauma, and a mental health professional should evaluate for a possible diagnosis of PTSD.

What are the effects of PTSD?

PTSD can be distressing and have negative consequences for your health and wellbeing. It can affect anybody from any culture—men and women, young people, and children. People with PTSD might:

  • Not be able to get the incident out of their minds

  • Have trouble sleeping

  • Feel irritable with themselves and the world in general

  • Have trouble concentrating

  • Abuse alcohol or drugs to block out memories

  • Become unusually busy to avoid dealing with emotions

  • Struggle with school or work

  • Have trouble connecting with others

  • Feel depressed, panicky or anxious

PTSD symptoms cover four main areas:

1. Reexperiencing

Intrusive memories, flashbacks, nightmares or daydreams ”intrude” into the life of someone with PTSD. These memories can be extremely vivid and sometimes make people feel as if the traumatic event is happening all over again.

2. Avoidance

A natural response for people with PTSD is to avoid people or situations that remind them of the traumatic event. For instance, if the event was a car accident, a person might not be able to drive or be a passenger in a car. People with PTSD can become so numb that they “shut down” in these situations, withdraw from life and have trouble connecting with others.

3. Negative alterations in thoughts and feelings

This can include things like:

  • Being unable to recall important aspects of the traumatic event

  • Frequently feeling negative about oneself, others, or the world

  • An inability to experience positive emotions

  • Diminished interest or participation in significant life activities

4. Heightened arousal

People who experience “heightened arousal” feel jumpy and on edge. Some are constantly on the lookout for signs of danger, as if another traumatic experience could happen.

Getting help for PTSD

Nobody can snap out of PTSD. Getting better takes professional help, time and effort. PTSD is treatable and usually requires treatment from a mental health professional.

The sooner a person is treated for PTSD, the better. Early treatment will help the PTSD from becoming ingrained and persistent for a long time. If left untreated, PTSD can become a chronic disabling mental health disorder.

It is very common to have PTSD at the same time as another mental health problem. Depression, alcohol or substance abuse problems, panic disorder, and other anxiety disorders often occur along with PTSD. The best treatment results occur when both PTSD and the other problems are treated together rather than one after the other.

Where to get help

Your local medical doctor can be a good place to start if you’re experiencing PTSD symptoms. A doctor can also help manage some of these symptoms.

If you experience PTSD, it’s likely that a doctor will recommend you see a mental health professional. These include psychologists, psychiatrists and counselors. If you’d rather talk to someone immediately, try Lines for Life’s YouthLine at 1-877-968-8491 or Suicide LifeLine at 1-800-273-8255. These helplines are free and staffed by trained volunteers who are available 24/7 to talk to you. They also have texting and online chat options available. If you’d like more resources, check out our crisis helpline directory.

Types of treatment

Dealing with memories

Talking about the traumatic event helps people confront what has happened to them. You can talk to your doctor, but a psychiatrist, psychologist or counselor will be able to help more specifically with PTSD. These providers use a variety of techniques to help you deal with the incident at your own pace.

Check out the different kinds of mental health professionals and the Cognitive Behavioral Therapy article for more information on the types of counseling used for PTSD. Our article on Counseling and Therapy may also be helpful.

Stress management

Your doctor or mental health professional can help you ease the distress that comes with troublesome memories. Relaxation techniques, mindfulness, controlled breathing and other methods are an important part of managing PTSD symptoms.


Even though you might not feel like it, taking care of yourself physically can help you deal with the emotional aspects of PTSD. Remember to exercise, eat well and go easy on drugs and alcohol. You might also want to try and get your body into a routine—like eating and sleeping on a regular schedule—to help you get some structure and security back into your life.


Medication can be a useful part of PTSD treatment. Your medical doctor or mental health professional should be able to tell you about what’s available. Currently, the most common drugs used are antidepressants. Some people might need to continue using medication to control their symptoms for a few years.

For more information on the treatment of PTSD, check out the website for the National Center for Posttraumatic Stress Disorder.

Helping someone with PTSD

If you have a friend or a family member who has PTSD, you might want to check out this help guide.


Information for this article was provided by:

Acknowledgements: This article was originally developed by youth and staff for

Visiting a Mental Health Professional for the First Time


Preparing for your visit

A closer look at what you might be feeling and what to expect seeing a mental health professional for the first time

Why might you want to see a mental health professional?

Asking for help can sometimes feel scary. It probably feels like a big step. It’s really important to take that step and to get help if things are not going well. A mental health professional can help you work through whatever is troubling you and will work with you to find solutions to your problems. Talking with a mental health professional might leave you feeling less alone and like a load has been taken off your shoulders.

There are lots of reasons why you might go and see a mental health professional. For example, you might feel like life is overwhelming and like you aren’t taking care of yourself. Or, you might feel like it would be helpful to talk with someone about a major event in your life that is impacting your day to day activities in a negative way and just won’t go away. It might even be that you are concerned about a friend or family member and want to talk with someone about this who has more expertise than friends or family.

How you might be feeling or questions you might have

Before your first visit to a mental health professional, you might be experiencing a lot of emotions and have a lot of questions. You might feel:

  • Worried or scared

  • Embarrassed

  • Unsure

Here are some questions you might be asking yourself:

  • What will happen at the session?

  • How will I tell the mental health professional what’s wrong?

  • What if the problem isn’t important enough and I’m just wasting the person’s time?

  • What if the person thinks I’m really strange?

  • What if my problem is embarrassing?

  • Will the mental health professional tell my parents?

  • Should I just deal with this by myself?

Experiencing any of these feelings and asking yourself these questions is not at all uncommon. It is important to realize that mental health professionals are used to dealing with all sorts of issues, and that no problem is too big or small. Every problem is important. If your issue is affecting your day to day routine and is troubling you, this is reason enough to talk to a helping professional.

Setting up a visit

It can help to lessen some of your concerns by arming yourself with information about what your session might be like. If you do decide that you want to talk to someone, there are a lot of different services available. Check out the Counseling and Therapy article for more information about what type of provider might be right for you.

What might happen at the first session?

Talking to a mental health professional can feel pretty scary. Sometimes it is really hard to say the things you are feeling because you might be worried that the mental health professional might judge you. In the first session, it is likely that the mental health professional will want to get some general information about you. They might ask questions about:

  • How you have been feeling lately

  • What’s been happening in your life

  • Your past

  • How things are with your family and at school

  • Your physical health

You might also have to fill out a questionnaire or survey that will help the mental health professional understand what the problem might be.

The reason a mental health professional will ask you all these questions is so they can better understand what is going on in your life. It is important to be honest and try to say as much as you can so that the mental health professional can get a better understanding of your situation and how you feel.

Sometimes people feel concerned because their counselor or therapist doesn’t give them a diagnosis right away, but this is not at all unusual. A mental health professional will not give you a quick diagnosis because they’ll want to have a really good understanding of your emotional state and what can make you happier and healthier.

After your first session, your mental health professional will probably talk to you about what you would like to do from there. They might suggest that you come back and visit regularly, but this decision is ultimately up to you.

After speaking with a counselor

After speaking with a counselor you might have mixed reactions. You might feel calmer and understand your concerns more clearly, but it’s also not uncommon to feel confused, stressed, or sad after you have spoken to your counselor. This could be because the session has brought up some scary emotions. It might take a number of visits with your counselor to deal with this stuff. If this is the case, it’s a good idea to talk to your counselor about your reactions and the best way to manage them.

Tips to getting the most out of your sessions

Here are some general things you might want to keep in mind if you decide to see a mental health professional. You can apply these tips to your first visit and every visit after that.

Write ideas down beforehand. You might want write down some issues you want to talk about in case you forget them.

Ask lots of questions. It’s OK to ask lots of questions, especially if you don’t understand why the counselor or therapist is asking you to talk about, or do certain things. It’s pretty standard to “interview” your counselor during the first session, asking them what they specialize in, what type of therapy do they do, etc. It’s important you find the best counselor for you.

Go in to your sessions with a positive attitude. Keeping an open mind and positive attitude will help you get the most possible out of your counseling session. You might as well give it a shot!

Don’t be thrown off by note taking. Your counselor or therapist will probably take notes while you are talking. Don’t be put off by this. Often a mental health professional will write down things like names of people and events so they can talk about it with you later. He or she might also write down specific things you have said that are important. If you feel uncomfortable with your mental health professional writing things, you can ask to see the notes or talk to your counselor about it.

Understand your confidentiality rights. Client confidentiality is an ethical code that mental health professionals should adhere to. This means that your mental health professional should not disclose information about your sessions without your consent. One universal exception to this is if the mental health professional is genuinely concerned that you are at risk of harm or harming someone else. There are other state specific exceptions about what a mental health professional can and cannot keep confidential, and the age at which a client’s parent or legal guardian is no longer entitled by law to information. It’s best to ask your mental health professional about his or her confidentiality policy and state law and regulations before your sessions start. In most cases this is something that your mental health professional will bring up as part of an initial meeting. Check out the Confidentiality article for more info.

Be honest with your mental health professional. Your mental health professional will try to help you feel better, but you need work with mental health professional and open up about how you are feeling and the things that are causing you stress and pain. It’s OK if you are having trouble finding the right words. This isn’t unusual. Sometimes a counselor or therapist will use writing or drawing, or other art such as making a collage or painting a picture to help you tell your story.

Don’t be afraid to change mental health professionals. Sometimes you won’t “click” with the first person you see (or the second, or maybe even the third). If that’s the case and you’ve given the relationship some time, it might be a good idea to try seeing another person. Just because it didn’t work with one, doesn’t mean it won’t work with another. Keep trying.

Don’t be afraid of your counselor. Remember that your mental health professional wants to help you. You can disagree with the person and question things if you don’t feel comfortable.


Acknowledgements: This article was originally developed by youth and staff for



Your right to privacy

A closer look at confidentiality and your rights

What is confidentiality?

Confidentiality means information you share with another person, either written or verbal, will be kept between you and that person. It’s common to confide in friends because you trust them. Keeping certain things confidential is kind of an “unspoken rule” in a friendship, but it can also be important that others—like health and mental health professionals—keep your information private as well.

Confidentiality in a Professional Setting

For doctors, nurses, counselors and all other health and mental health professionals, confidentiality is part of a professional code of ethics. Health professionals agree to abide by a set of ethical principles that include keeping your information confidential. Doctors and nurses cannot disclose your medical information unless you give them permission to do so. However, if you threaten bodily harm to yourself or another person, then your physician must reveal this information to the proper authorities. If you’re unsure about what a health professional might report, you should talk to the person about your concerns. You might also want to find out who will receive the information—in some cases, it could be your family, the police, or state and local officials. In some rare situations, it could involve speaking in court. Private communication between you and your physician is also protected by law.

Like physicians, mental health professionals also abide by a code of ethics that means they will not disclose information unless you give them permission to do so. They also have the duty to disclose information if they feel you or someone else is in imminent danger. Your communication with mental health professionals may also be protected by law, however this varies state by state, and by type of mental health professional. For example, one state may grant by law “privileged communication” between a client and psychiatrists or psychologists, but “privileged communication” may not exist for clients and school counselors.

For both medical and mental health professionals, this becomes further complicated by a patient or client’s age. States have different laws and regulations regarding the age at which an adolescent has the legal right to consent to medical care or mental health care without being required to notify their parents or obtain authorization for care. For minors, in some states, the right to privacy legally belongs to parents or guardians, meaning that the adolescent has the same right to have information kept confidential, yet this information by law cannot be kept from parents or guardians.

And, in most states, physicians and mental health professionals are required by law to report suspected cases of child abuse (abuse of those under the age of 18) and in four states, domestic violence. This is called “mandatory reporting”. This will include physical abuse, sexual abuse, emotional abuse, and neglect. Other circumstances where states may require mandatory reporting include sexually transmitted diseases, communicable diseases, HIV/AIDS, or other conditions deemed to be risks to the health and safety of the public at large.

Talking about confidentiality with a mental health professional

Generally when you first see a mental health professional, the issue of confidentiality is discussed as part of a first appointment. For those under 18, the mental health professional typically has parents or guardians sign a form that describes the limits of confidentiality and the professional’s expectations for keeping session content private. This means it’s only between the mental health professional and you, and what the circumstances will be when the professional will feel obligated to share information with parents. This is a good time for you to raise any concerns that you may have. You can do this in the privacy of your session with the mental health professional.

How important is confidentiality?

The answer is simple: it’s really important, especially because confidentiality is a big part of trusting a medical or mental health provider. You might be worried about whether this professional will keep what you tell them confidential. This type of worry is normal. Going to see someone might be a new experience for you, and it may take time to understand and trust the person.

It’s also possible that you or someone you know might have had a negative experience with a health or mental health professional. This might affect your ability to trust. If this is the case, try to remember that not all health or mental health professionals are the same. Trust usually evolves over time and as you become more comfortable in the relationship, you will begin to be able to share more about the things that are causing you stress and pain.

It is important for you to find someone you can trust. Sometimes this can happen through word of mouth from friends who have had good experiences or through recommendations from other professionals. If you do not feel at ease with your counselor, don’t get discouraged. It’s OK. Mental health professionals have different personalities, approaches and styles. The most important thing is that you don’t give up, but instead look for a person who you will feel comfortable with.

For more information on the privacy of your health records, click here.


Acknowledgements: This article was originally developed by youth and staff for

School Counselors


School Counselors

A brief look at how school counselors might help you

Counselors who work in schools

There are two kinds of counselors who work in schools: school counselors who traditionally have been referred to as school guidance counselors and school-based mental health clinicians. Not all schools have both types, although most have school counselors. Both are mental health professionals who can help you manage the issues that stress you out. Both will work with you to find a solution to the problems you’re facing, which could include difficulties at school, problems with friends or teachers, and homework and exam stress, as well as issues you might be having at home.

School guidance counselors spend time making sure all of the students assigned to them satisfy the academic requirements needed for graduation. They also assist students with other academic concerns such as course selection, study habits, and time management, as well as planning for college and other post-high school career opportunities. Because these activities may take up a majority of a counselor’s time, students often don’t think of their counselor as someone who can help with more personal problems.

School-based mental health clinicians may be trained either as counselors, psychologists, or social workers, or in some cases as family therapists. Generally they are employed by a community-based or private agency that contracts with the school system to provide services to students in offices located within the school grounds. School-based mental health clinicians focus primarily on helping students with personal problems and helping those students with chronic or more severe mental health problems.

Both school counselors and school-based mental health clinicians also consult with teachers and family members and in some cases will involve family members in counseling sessions.

Making an appointment

Each school has a different policy on how to visit your school counselor or your school’s mental health clinician. In most cases, you’ll need to make an appointment. To find out how your school operates, ask a teacher or friend that you trust, check out the school website or ask the front office.

Paying for services

Generally if you see a counselor at your school you will not have to pay. This is always the case with school counselors who are employees of the school system. School-based clinicians are generally paid under a contract with the school system; however in some instances the clinician will bill your insurance company if you are covered by insurance. Different school systems have different arrangements with school-based clinicians so it is best to ask about payment when you make your first appointment.

Ask about your privacy

It’s a good idea to talk to the counselor you see about keeping your information private. This is generally something that your counselor will bring up in your first session, but if they don’t it’s OK for you to ask. In most situations, unless you ask the counselor to share information, your counselor will keep what you tell him or her confidential. If you would tell your counselor something that suggests you are in serious danger to yourself or another person the counselor would be ethically bound to share that information so that you or the other person could be safe. Counselors are also required by law to report instances of abuse.

Other people you can talk to

If you’d rather talk to someone immediately, try Lines for Life’s YouthLine at 1-877-968-8491. This hotline is free and staffed by trained volunteers who are available 24/7 to talk to you. They also have texting and online chat options available. You can also try Youth helpline Your Life Your Voice at 1-800 448-3000, run by Boys Town for everyone. If you’d like more resources, check out our crisis helpline directory.


Everyone has problems. It might feel scary to step out and talk to someone. Just sharing your problem with someone who will listen can bring some relief.


Information for this article was provided by:

Acknowledgements: This article was originally developed by youth and staff for

Experiencing Grief


Experiencing Grief

A closer look at mourning the death of a loved one

Experiencing grief

Losing someone

If you’ve lost a loved one, you’re probably experiencing a lot of different emotions. Each feeling you experience is another step in your grieving process. The grieving process is like a journey—it takes you from the starting point of your bereavement to another stage in your life.

Stages of grief

Everyone grieves differently; some people become very quiet and thoughtful, others cry a lot. No one way is better than the other. Some experts believe that most people go through similar stages of grief depending on how far into the grieving process they are. These stages include:

  • Denial: You might not believe that your loved one has really died or perhaps the news hasn’t really sunk in yet.

  • Anger: You might be angry at yourself, your family members, a higher power, or even the person who died.

  • Bargaining: You might try to negotiate with yourself or if you are religious, the figure you pray to in order to get your loved one—or even some piece of mind—back.

  • Depression: This might be an emotional low point for you, when you don’t care about anything or anyone. You might go through feelings of emptiness, loneliness, or might even stop caring about anything or anyone. Our Depression article will have more information if you feel you may be depressed.

  • Acceptance: At this point, you may begin to make peace with the fact that your loved one has died.

Everyone grieves at this or her own pace because there isn’t a fixed amount of time that you have to go through these stages.

After the memorial service

The time after a funeral (or other type of memorial service) can be hard. Attending the service might help you feel connected to the person you’ve lost or a sense of closure with their death. But after the service, you might also start to feel empty, lonely and sad. You might have to start thinking about returning to your everyday routine including school or work.

It’s likely that you’re still grieving, which can make it hard to get back into a balanced routine. Sometimes it can be difficult to do day-to-day stuff. Other times, you might want to throw yourself back into work or school as a helpful distraction.

Everybody is different, and you’re the only one who can judge what you’re able to handle. It’s a good idea to get back into your routine at a pace that suits you. Keep in mind that it’s normal to have some days that are tougher than others. Over time, it’s likely that you’ll get back into the swing of things.

When friends and family are moving on

Your friends and family may have started to get back to their normal routines, or maybe they never really got out of them in the first place. Because you’re all in different emotional states, it might be that your friends and family aren’t able to support you in the way that you need or that they are experiencing their grieving differently. It might be hard for your friends and family who weren’t connected to the person who died to know what to do and how to help you. It’s a good idea to keep your friends and family in the loop with how you’re feeling. Let them know what you need and how they can help. The odds are that they’re waiting for you to ask for support and will support you in the way that you need.

Making it through the grieving process

Managing grief is hard but here are some suggestions that may help you to get through the process:

Accept your feelings. There’s no right or wrong way to feel after losing someone you care about. Accepting the feelings you have and acknowledging that you’re going through a stressful experience can help you manage your reactions. Sometimes you might feel overwhelmed with your thoughts and feelings, which might make you think you’re going crazy. Don’t fret because this isn’t the case at all. It’s just another stage you go through when grieving.

It’s important for you to manage how you’re feeling. It might be helpful to set aside some time in the day to deal with your thoughts. During this time, you might want to write in a journal, draw, punch a pillow or exercise to let off some steam. Check out the Express Yourself or Developing Coping Strategies for more ideas.

Allow yourself to cry. It’s OK to cry. If you feel uncomfortable crying in front of other people, you might want to make a plan to leave and cry in a private place. This could be in a quiet room, in your parked car, at the park, at school, or in a campus counselor’s office.

Talk to your teacher or boss. If you’re going back to school and/or work, it might be a good idea to talk with your teacher or boss about what you want others to know about your loss. This will make them aware so they can help support you in the best way possible. Discussing your workload with your teacher or boss might also help you ease back in. It’s OK to ask for some consideration on homework or your work responsibilities.

Also, keep in mind that difficulties with concentration and memory are common during the grieving process, and they might affect your performance. If this happens, it may help to discuss it with your teacher or boss.

Smile. Many times we focus on the sadness of losing a loved one, but it may be helpful to talk about the memories and good times you’ve had with the person. It’s OK to enjoy those memories and laugh about the fun times you shared. This isn’t a sign that you miss the person any less.

Saying goodbye. Part of the grieving process is letting go of the person who died. It’s important to say goodbye in your own way in your own time. There’s no right or wrong way. Some ways that can help you say goodbye to the person is by:

  • Writing a letter

  • Going to the funeral

  • Having a memorial service by yourself in your own way

  • Honoring your memory of the person who passed

It’s important to say goodbye in your own way and in your own time. There’s no right or wrong way to doing this.

Avoid bottling up emotions. Keeping things to yourself might build up tension inside you. Finding a way to express how you are feeling might help you to feel better. You might want to talk to someone, write your thoughts down, draw, or punch some pillows.

There’s no timeline or deadline. Don’t worry about how long grieving should last, or any judgments that you should be “over it” by now. Everyone experiences grief in their own way and on their own timeline. And you may feel better for a while and then experience a fresh wave of grief—especially if something happens that reminds you of the person, or as a significant holiday or anniversary approaches.

Talk to someone. It might be helpful to talk to someone you trust about how you’re feeling. This could be a family member, friend, mental health professional, minister or other spiritual leader. If you’re in need of crisis services, check out our crisis helpline and resource directory.

Information for this article was provided by:

  • Some of the information is adapted from the book After Suicide, Help For The Bereaved by Sheila Clark. Published in 1995 by Hill of Content Publishing Company Pty Ltd, Melbourne 3000.

  • The Elisabeth Kubler-Ross Foundation

  • The American Society of Clinical Oncology website, “Coping with Change After the Death of Someone You Love”

Acknowledgements: This article was originally developed by youth and staff for

Grief: Holidays & Special Occasions


Handling grief on special occasions

A closer look at processing grief over the holidays and on special occasions

Holidays and special occasions like birthdays and anniversaries may be a time when you get together with family and friends. Often, if you’ve lost someone you love, you might be reminded that this person isn’t around. This can be a hard and each person will cope with this differently.

Here are some ideas that may help you better manage these special occasions:

Plan for the day. Treat the anniversary or special occasion in the same way as you do other important days. Plan ahead. Talk with your family and friends about the best way to remember your loved one.

Allow yourself to be sad. These occasions might have been a time you spent with someone you’ve lost. It’s normal to feel sad that this person is no longer with you. It may help to take some time out for yourself to remember the person you love. You might want to:

  • Find a quiet spot to remember all the good things about the person

  • Do something that you used to do with that person

  • Write a letter to the person

  • Revisit a favorite spot that you shared

  • Share some of the memories with people who were also close to the person

It is O.K. to enjoy yourself. It might be hard to celebrate when you’re missing someone you love. It’s not uncommon to have a whole lot of different feelings, like sadness, guilt or excitement. Getting together with family and close friends can be a chance to remember the good times with the person who’s died, and it’s O.K. to relax and have a laugh. Having fun is not necessarily a sign that you miss that person any less.

Look after yourself. This might be a tough time for you, so remember to take care of yourself. Avoid making major decisions until after holidays are over. If possible, treat yourself to something you enjoy doing. Here are some ideas to help you relax:

  • Go to the beach

  • Go for a walk

  • Play a sport

  • Listen to music

  • Go shopping

  • Get a massage

  • Hang out with friends

Check out the Relaxation article for more ideas.

Talk to someone. It might be helpful to talk to someone you trust—like a family member, friend or teacher. If you’re finding it hard to cope with day-to-day stuff, it might help to talk to someone like a counselor or other mental health professional. You can also get information on local mental health professionals from your medical doctor.

If you’d rather talk to someone immediately, try Lines for Life’s YouthLine at 1-877-968-8491. This hotline is free and staffed by trained volunteers who are available 24/7 to talk to you. They also have texting and online chat options available. If you’d like more resources, check out our crisis helpline directory.

Avoid bottling stuff up. Getting stuff off your chest is important. Tension can build up if you keep your feelings to yourself, and finding a way to get it out can help you feel better. You may want to talk to someone, write your thoughts down, draw, cry or punch some pillows. Check out the Express Yourself article for more ideas about how to get stuff off your chest. The Developing Coping Strategies may also be worthwhile to check out.

Information for this article was provided by:

  • Some of the information is adapted from the book After Suicide, Help For The Bereaved by Sheila Clark. Published in 1995 by Hill of Content Publishing Company Pty Ltd, Melbourne 3000.

Acknowledgements: This article was originally developed by youth and staff for

Communicating About Grief


Navigating grief and conversation

A closer look at how to connect with others after the loss of a loved one

Telling family about your loss

After someone dies it can be hard for everyone to adjust. Family members might argue with each other more often, and sometimes being with your family can be uncomfortable for you. However, it can also be a time when you can grieve together.

Try to be understanding of your family’s reactions. Doing things together like having dinner, playing a sport, or hanging out and talking about some of the things you’re feeling might help you all to better understand how each other grieves.

Don’t be afraid to talk about the person who has died. You might not want to mention that person for fear of upsetting others, but don’t forget that your family members and friends are probably already upset, even though they might not be showing it. The silence created by not talking about the person who has died might make your family members feel like that person was not significant, or that this person didn’t exist at all.

Telling friends

Friends of the person who has died might have deep feelings of grief as well. Like you, they may also want to have something of their friend’s. Try and be sensitive to their requests.

Including these people into your grieving might help you get through your own loss. Friends may also be a great source of support and good people to talk to about some of the major decisions you need to make.

Coping with other people’s reactions

Chances are your friends won’t know what to do or say to make you feel better. This can be difficult for both you and the people who are trying to support you. It may help to let them know how you’re feeling and that it might take time for you to get back into your normal routine. If there are things that your friends and relatives could do to help you out, it may be a good idea to let them know.

People may ask you a whole lot of questions that you may not want, or are not ready, to answer. It’s O.K. to tell people that you aren’t ready to talk, and that you’ll let them know when you are ready.

Get Support

While it’s important to get support from your friends and family, you might find that you need to speak with someone who’s removed from the situation, like a mental health professional or minister or other spiritual leader.

If your grief has become overwhelming and you’d like to talk to someone, you can always call a crisis helpline. They will listen to you and offer support. Never feel afraid to reach out.

Information for this article was provided by:

  • Some of the information is adapted from the book After Suicide, Help For The Bereaved by Sheila Clark. Published in 1995 by Hill of Content Publishing Company Pty Ltd, Melbourne 3000.

Acknowledgements: This article was originally developed by youth and staff for



Feeling lonely

A closer look at loneliness and how to develop connections with others

I feel lonely

It’s not unusual to feel lonely every now and then. However, if you’re feeling this way for an extended period of time, it can lead you to feel socially isolated. You might feel isolated from people your age, or society as a whole, for a number of reasons. You might be new to a school, city, or town. You might be geographically isolated in a rural area that is far from other people that are your age. You might be ethnically, racially, culturally or religiously different from the people around you, or you might just feel like you don’t have similar values or experiences as the people in your day-to-day life. You may also feel socially awkward, like you’re not sure what to say or do or quite how to fit in with a group you would like to connect with.

Feeling connected to a group of people is important for your health and well-being. People are naturally social beings, and those who have a strong support group are more likely to be happy and physically healthy. Social isolation can also be connected to depression and social anxiety.

How do I feel less lonely?

Depending on your circumstances, it might be hard to connect with people. For example, if you live in an isolated location, far from a large metropolitan area, your social resources might be limited. At the same time, though, big cities can feel just as lonely.

Here are a few ideas to help you connect with others, no matter where you are:

  • Join online forums and groups. Many people today find like-minded friends to connect with through the internet. The internet can bring you into touch with people all over the world, and gives you a chance through chat rooms to practice conversational skills. There are numerous online groups, pages, blogs, apps, servers, and other social media platforms that can offer connection and solidarity through mutual interest. Just remember to practice internet safety. The internet is widely anonymous and people can pretend to be whoever they want. Never give out your information or address to a stranger online.

  • Talk to a family member, teacher or youth leader. Even though you feel lonely, remember that you don’t have to go at it alone. The first step in ending your loneliness is simply talking to someone from your family, a teacher, a school or campus counselor, or your spiritual mentor/leader. Tell them how you’re feeling. Chances are they’ll be happy to help you and can give you some ideas for how to meet people and feel more connected.

  • Start small. You don’t need to find a best friend or go out with people every night of the week. Start small by finding something in common with your peers—it could be something as simple as a T.V. show, your favorite band or even the homework you had last night.

  • Challenge your negative thinking. You might feel like no one will ever understand you. But chances are that you are your own worst critic. Try to look at each situation objectively to avoid being too hard on yourself. For more tips on how to do this, check out the Challenging Negative Self-Talk article.

  • Get outside. Sometimes, even if you’re not talking or interacting with anyone, just being around other people can make you feel good. Try going to a park, a coffee shop or a library to do some people watching!

  • Join a club or a team. The best way to meet people that have the same interests as you is to join a club or a team. You can join groups through your school, local community center or faith center. Some groups you could join might be a dance group, tabletop tournaments, starting a band, joining 4H, or trying out a club your school offers. Volunteering for a cause can also be enriching for your mental health, as well as help you develop connections to others with similar values and passions.

  • Seek help. If you need immediate help and you aren’t sure where to turn, try calling Lines for Life’s Suicide Lifeline at 1-800-273-TALK (8255) or Youthline at 1-877-968-8491. Both helplines will keep your information private and have trained volunteers who can talk to you about how you’re feeling 24/7.

Developing social confidence

If you are feeling socially awkward, there are things you can do to develop more social confidence. Social skills can be learned. Things like how to start a conversation or how to join-in on a conversation, and how to listen well to others are all things you can learn to do. You can also learn about nonverbal skills like eye contact, head nodding, and smiling, as well as when and when not to use these. While some people learn these things easily through their interactions with others, others find these skills take more deliberate rehearsal and practice. If this sounds like you, you may find it helpful to speak with a counselor or other mental health professional who can help you identify skills to develop and even help you practice those skills step-by-step before trying them out in new social situations. Often times, the more practice you have and the more you do it, the easier it will become.


Acknowledgements: This article was partially developed by youth and staff for

Obsessive Compulsive Disorder (OCD)


Obsessive Compulsive Disorder

A closer look at what OCD is and how to treat it

What is OCD?

Obsessive Compulsive Disorder (OCD) is a type of anxiety disorder that involves repetitive, unwanted thoughts called obsessions, and repetitive behaviors called compulsions.

With OCD, a person feels as if he or she has to complete these rituals or behaviors to prevent something bad from happening. Performing the compulsions can temporarily reduce the anxiety that a person with OCD often feels.

People with OCD might realize that these thoughts are irrational, but the obsessions and compulsions are difficult to resist.

OCD affects people from all different backgrounds, classes, cultures and sexes. Currently, 3.3 million Americans are living with OCD.

What are the symptoms of OCD?

A person with OCD experiences some obsessive thoughts and a particular compulsion. The intensity and frequency of these thoughts can vary, and it’s not uncommon for it to be worse when a person is particularly stressed, like during exams or a breakup.

Examples of obsessions include:

  • Fear of germs or dirt

  • Fear of harming yourself or others

  • Intrusive sexual thoughts

  • Fear of illness

Common compulsions might be:

  • Cleaning or putting things in a particular order

  • Washing

  • Counting

  • Hoarding

  • Touching

You might also be experiencing a variety of emotions.

You might be feeling:

  • Stressed or anxious

  • Annoyed

  • Frustrated

  • Depressed

  • A sense of shame or a wish to hide your OCD from others

OCD can affect other parts of your life, too, and you might find you’re not able to enjoy the things you normally do. You might also feel more likely to abuse drugs or alcohol as a way to escape or numb overwhelming feelings.


There are a number of different approaches to treating OCD and using a combination of these might be the most effective.

Cognitive behavioral therapy (CBT). During this type of treatment, a mental health professional talks with a person about his or her symptoms, and discusses alternative ways of thinking about and coping with them. Check out the CBT article for more info.

Medication. In some cases, medication might be helpful. Certain drugs help the brain to restore its usual chemical balance and help control the obsessions and compulsions. A psychiatrist is the mental health professional who could provide more information about medications and could prescribe medications for your use.

Support groups. There are many support groups for people with OCD. Here, you can discuss your experiences with people who have had similar ones. This Obsessive Compulsive Foundation offers more information about support groups and where to find a group. You can also find out about groups through your local doctor, psychologist or psychiatrist.

Journal it. Write your feelings and experiences down in a journal, or on a password-protected or anonymous online space.

Exercise. Go for a run or walk to use up excess energy. You’ll feel better after you do.

Play video games. This can be a good way to distract yourself until the anxiety passes.

Try some relaxation techniques. Activities like yoga or meditation are often helpful in reducing anxiety.

Cry. Crying is a healthy and normal way to express your sadness or frustrations. It’s not weak or dumb to cry when you’re feeling down.

Talk to someone. Talk with a trusted friend or adult, or call a helpline like Lines for Life’s Suicide Lifeline, at 1-800-273-TALK (8255), or Your Life Your Voice at 1-800-448-3000, run by Boys Town (for everyone). Both of these hotlines are free and staffed 24-hours by trained volunteers who can help you work through your emotions and connect you to help in your area.

Give it time. Changes in behavior don’t happen overnight, and it might take some time before all OCD symptoms go away.

Information for this article was provided by:

Acknowledgments: This article was originally developed by youth and staff for



Feeling stressed?

A closer look into stress, its causes, and how you can manage it

What is stress?

Stress is a common feeling that comes from a physiological reaction your body has to certain events. It is the body’s way of rising to a challenge and preparing to meet a tough situation with focus, strength, stamina and heightened alertness.

Even though stress can be a positive thing (like motivating us to make positive changes in our lives or giving us that “extra push” for an exam) sometimes we have too much stress and begin to feel that our lives are out of balance. When this happens managing stress could become a challenge.

What causes stress?

Common events that can stress you out (also called stressors):

  • Tests and exams

  • Problems at school or work

  • Relationships

  • New and greater responsibilities

  • Sexual, physical, or emotional abuse

  • Moving to a new place

  • A traumatic event—such as the death of a loved one

  • New or chronic illness or disability

  • Peer pressure or being bullied

  • Unrealistic expectations placed on you by yourself, friends, family, or culture

  • Watching parents argue

  • Feeling guilty

Everyone’s threshold for handling stress is different, and can change from day to day. Depending on your own resiliency (or ability to thrive in spite of adversity), even dealing with one stressor could be enough to overwhelm you. Could you imagine trying to juggle several stressors at once?

How does stress affect the body?

The human body responds to stressors by activating the nervous system and specific hormones. The brain tells your glands to produce more of the hormones called adrenaline and cortisol, and to release them into the bloodstream. These hormones speed up your heart rate, breathing rate, blood pressure and metabolism. These changes within your body help prepare you to deal with pressure, which is also known as a stress response. When this natural reaction works properly, the body’s stress response improves your ability to perform well under pressure.

Can I be too stressed?

If you have too much stress in your life, it can do more harm than good, but sometimes stress is necessary to get through certain situations. For example, feeling stressed out about an exam might encourage someone to study more and prepare for the exam. However, there’s also a chance it could become overwhelming—making you panic and feeling so nervous about an exam that you can’t study or concentrate.

It’s important to remember that stress affects people in different ways, and what causes one person to become stressed may not have the same effect on someone else. Try not to compare yourself too much to others, they’re all experiencing things unique to them as well.

What can happen if you’re experiencing too much stress?

Too much stress may have negative consequences for your health, both physical and mental.

Psychological/Emotional Consequences

  • Feeling hostile, angry, or irritable

  • Feeling anxious

  • Avoiding other people

  • Crying

  • Moodiness, feeling frustrated with things that normally don’t bother you

  • Low self-esteem or lack of confidence

  • Anxiety attacks

  • Depression or sadness

Physical Consequences

  • Upset stomach, diarrhea, or indigestion

  • Headache

  • Backache

  • Inability to sleep

  • Eating too much or too little

  • Raised heart-rate

  • Smoking

If you are experiencing any of these problems you may want to talk to your local doctor, counselor or other mental health professional.

Managing stress

It may not be possible to get rid of the stress altogether in your life, however managing your stress is possible. Below are some ideas for managing stress:

  • Tackling the problem. When you’re feeling stressed, you might not realize right away what is causing you stress. First you need to figure out what the problem is and make it manageable. The problem will not go away on its own. In fact, if you ignore the problem, it will probably just get worse. Once you know what the problem is, there are a number of ways you can de-stress.

  • Go for a walk or run. Exercising can be a good way to relieve stress. It helps to get rid of pent up energy and can leave you feeling much calmer. Exercising also releases endorphins, the body’s natural feel-good hormones, which make you feel less pain and make you happier overall! Any sort of exercise can be helpful during stressful times. You may want to go and kick a football with friends, dance, or head to the gym.

  • Hang out with friends. If you are feeling stressed, hanging out with friends can be a great way to keep your mind off of things for a while. By talking with friends, you could realize that similar things that stress you out, also stress your friends out. If you are stressing out about school or work, remember that it is also important for you to have a social life. It is okay to go do something fun with your friends and take a break from your other responsibilities sometimes. Balance is key.

  • Turn the stressor into something fun. Sometimes you might find that the problem isn’t all that bad. It might even be fun! For example, locking yourself in your room or library to focus on doing work might help with stress. However, working in a silent room might also be making you more stressed. You might want to try getting a group of friends together to study in one place, and then maybe grabbing a bite to eat after. Studying together could lower everyone’s stress levels.

  • Take some deep breaths. Deep breathing can help to relax the body and calm you down. Taking deep breaths before an exam, game, job interview or before going on stage may help to calm you down and allow you to focus on the task at hand. The Developing Coping Strategies or Mindfulness articles may also be helpful.

  • Set realistic goals. With unrealistic goals, it is hard to keep things in perspective and cause you to get too stressed out. Setting realistic goals (both short-term and long-term ones) and managing your time and expectations may help to reduce or manage stress. You may also want to check out our Problem Solving and Putting Your Goals into Action articles.

  • Have multiple paths to achieve your goals. There is never one path to achieving your goals. It is important not to put all your eggs in one basket. You could investigate and plan other ways to get where you want to go, whether it’s a university degree, job, or holiday vacation. Everything might not always play out how you thought it would, but you might end up happy with the results. For example, you might get a new job and be very excited about it. After a few days, you might realize your tasks are not as enjoyable as you had hoped. Though your path to achieving job experience is not exactly what you thought it would be, in the end, you might reach your goal and be completely happy with it.

  • Try to avoid harmful behaviors. It may be tempting to use smoking, alcohol, drugs and caffeine as a means of managing your stress. Try to avoid using these substances as a coping mechanism because, in the long run, they may make you more stressed out and can be harmful to the body. Once you rely on something like caffeine, you may realize you are unable to function without it. You may also be tempted to engage in other negative behaviors besides using drugs or alcohol, such as procrastinating, overeating, skipping class, or blaming others. These behaviors will likely get you into trouble, create conflicts, or make you even more stressed out once everything begins piling up.

  • Watch what you’re thinking. Your outlook, attitude, and thoughts influence the way you see situations, people, and the world around you. Is your cup half full or half empty? A healthy dose of optimism can help you make the best out of stressful circumstances. Even if you’re out of practice, or tend to be a bit of a pessimist, everyone can learn to think more optimistically and reap the benefits. Learning to embrace the challenges that come up in your life will help you change how you view adversity. Embrace them and conquer them.

  • Speaking to someone. If you find that you are always stressed and have a hard time focusing on daily tasks, it may be helpful to talk to someone. It can be hard to ask for help, but your friends and family members might not be able to read your mind and know what’s going on with you. Talking to someone else might help you realize that something you are stressed out about is actually pretty manageable. Parents, teachers, or a school counselor may be able to help you cope.

Stress and relationships

Maintaining relationships with friends, family, co-workers, or boyfriends/girlfriends may cause you to become stressed, or your being stressed might affect those relationships. To help manage the stress, it could be helpful to talk to someone about what’s upsetting you. Talking to someone that you trust could help you work out why you are stressed out by the situation or relationship and also offer solutions about healthy ways to manage the stress. You can talk to a friend, family, member, or teacher, but if you feel more comfortable talking with someone else, you can also talk to a doctor, counselor, or even trained volunteers on a helpline.

For additional information:

Acknowledgements: This article was originally written by youth and staff for

Building Resilience


A closer look at what it means to be resilient and ways to build resiliency in your life

What is resiliency?

Resilience is the ability to thrive in spite of adversity. When you are able to regulate your emotions after a stressful event and come out okay on the other side, this is resilience. It is your ability to ‘bounce back’ from stressful external events.

How do I become more resilient?

A number of factors contribute to a person’s ability to be resilient when faced with adversity. We call these protective factors. Some protective factors exist outside of our control, based largely in our support system and environment.

These include such things as:

  • Having people in your life who care about you and help you through tough times

  • Having people who believe in your abilities and strengths and who have high expectations for you to be successful

  • Living in a community that provides opportunities for meaningful participation, including being involved in decision making, contributing your talents to the good of the community, and other forms of service

Other protective factors have to do with personal strengths, skills and abilities that buffer against stress and help an individual manage stressful situations. These are things that are in your control and things you can learn and develop.

Personal factors that help build resilience

Some skills to help manage stress and increase your ability to be resilient:

  • Positive social skills. Open, respectful and direct communication techniques, maintaining a positive attitude and having a sense of humor when faced with interpersonal challenges

  • Problem-solving skills. Being able to stop and think before reacting, being able to generate alternative solutions, weighing consequences of decisions before you act, and openness to seeking support when needed

  • Feeling secure about yourself. Having a sense of self-worth, and having a clear sense of self-identify so that you step away or create some physical or psychological distance from things that pull you down or give you stress

  • Having a sense of purpose. Feeling a deeper meaning in your existence that drives you, or having hope for the future by having personal goals, strong values and connectedness to others

If you find that you don’t have people in your life who provide the kinds of external supports that help build resilience, try to be proactive in searching out mentors who care about you and believe in your potential. Some high schools and colleges have mentoring programs. Some of these programs may be linked with career planning and the college application process. Church youth groups, athletic teams, and community sponsored programs like Big Brothers/Big Sisters programs could be potential sources of support.

So even if you don’t have all the external protective factors in your life – you can still develop skills and attitudes and take actions that will help you become resilient against the stressors that you encounter. It might be harder for you than someone who has a ready-made support system in place, but it is important to remember there are still things you can do to help yourself!

For more information:

Acknowledgements: This article was partially developed by youth and staff for

Body Dysmorphic Disorder

Body Dysmorphic Disorder

A closer look at body dysmorphic disorder and its symptoms, causes, and ways to cope with it

What Is It?

Let’s face it - at one time or another you’ve wished a part of your body looked a little differently. It might be that you think your thighs are too big, your skin is not perfect, or your nose has a little bump in the middle that EVERYONE can notice.

This kind of thinking is pretty common and relatively normal, whether it’s true or not. However, these thoughts become a problem when they start to rule your life. You become preoccupied with the part of your body that you think is not okay, and these beliefs can interfere with the quality of your life. This kind of obsessing over a part of your body is known as Body Dysmorphic Disorder (or BDD).

How BDD might affect you

There are many different types of behaviors and symptoms that you might experience if you have BDD, however you don’t necessarily have to experience all of them.

Some common symptoms include:

  • Frequently checking out how you look in mirrors

  • Picking at your skin

  • Constantly making sure you look clean and well groomed

  • Frequently touching the part of your body that you don’t like

  • Trying to hide or disguise the body part or yourself

  • Avoiding going out or being with others because you feel so self-conscious about an aspect of your appearance

  • Feeling depressed or anxious

  • Feeling suicidal

  • Trying to ‘fix’ the body part through exercise, medication, surgery, and other sorts of treatment

If you are concerned that these behaviors and feelings sound familiar, it is important that you speak to a doctor or psychologist, counselor or other mental health professional to find out more.

Why does it happen?

BDD does not have a single cause. It is often due to a variety of different physical and mental health issues.

Some causes might be:

  • Having low self-esteem and negative beliefs about yourself

  • Thinking negative thoughts such as “everybody hates me because I’m ugly” or “I’ll never be anything if I don’t look ‘perfect’”

  • A cultural emphasis and fixation of the ideal body

  • Not being able to cope well with stress

  • Feeling a lack of control in your life

  • Feeling as though you cannot manage difficult emotions any other way

  • Having relationship problems with family members or peers

  • Having been sexually abused or traumatized

  • Genetics and body chemistry could be relevant in some cases

Seeking support?

If you are concerned that you might have BDD, it is important that you see a doctor or a mental health professional to talk about and find out more about the best treatment options. Getting the right assistance can help you enjoy your life again.

Some treatment options may include:

  • Cognitive Behavioral Therapy (CBT) can be really helpful when dealing with BDD. It can give you a feeling of power and control over your thoughts, enabling you to learn ways of overcoming the tendency to think negatively

  • Response prevention is a type of treatment that helps you develop other ways of coping with the urges to participate in the behaviors that result from your BDD;

  • Medication from your doctor can sometimes be useful in reducing the intensity of your negative thoughts and behaviors.

BDD can sometimes exist with other psychological problems such as depression, obsessive compulsive disorder (OCD) and social anxiety. Therapy for these problems may also help your BDD.

Other things that might be helpful

  • Expand your ideas of beauty. Take a look at your local art gallery or in books at the library or bookstore. What do the people look like in these pictures? What makes them beautiful? What makes you want to look at them?

  • Join a support group. It may be helpful to share your experiences with people who are going through similar situations.

  • Write in your journal. Physically writing out your feelings can slow down your thought process and help you understand why you’re feeling the way you are. It can also be a relief to let those feelings out, so you no longer feel like you have to carry them around. Not only can you use pen and paper, but there’s lots of apps and websites that allow you to vent and post about your feelings anonymously.

  • Write down some positive affirmations. Put positive notes around the house or carry them with you. Writing them in dry erase marker or eyeliner on the mirror also works great. Some examples might include: “I am beautiful just as I am”, “I am good enough”, or “My body is strong, just like me”.

  • Write a list about the things that you like about yourself. It can be anything from being a good friend to liking your big toe! This can be particularly hard when suffering from BDD and low self-esteem. Be gentle with yourself. If you really can’t think of much, ask your friends why they like you.

  • Write a list of the things you like about your friends. You probably wouldn’t think the same things of your friends as you might about yourself. What are some things you admire about your friends? Are those things deeper than just looks?

  • Take the time to do nice things for your body. Give yourself a massage, take a bath, or go on a long walk. Find ways to bring self-care into your life, however that looks for you!

  • Make a list of things you can do to distract yourself from unhealthy behaviors. Imagine all the things you like to do or take a fair amount of your attention to accomplish and write them down. When you’re upset, turn to this list and start trying out some of these coping strategies.


For more information:

  • For more details about BDD, check out the Mayo Clinic website.

  • If you are feeling suicidal, it is important for you to share these feelings with your doctor or a mental health professional. You can also reach out to Lines for Life’s Suicide Lifeline at 1-800-273-TALK (8255) for someone who will listen. You might also find the Wanting To End Your Life article to be a helpful tool in helping you cope in a positive way with these feelings.

Acknowledgements: This article was partially developed by youth and staff for

Bipolar Disorder

Bipolar Disorder

A closer look at the different types of bipolar disorders, causes, and treatment options available

What is bipolar disorder?

Bipolar disorder, also known as manic-depression, is a mood disorder characterized by exaggerated mood swings. Bipolar means two poles or extremes, and if you have bipolar disorder you are likely to have intense ups and downs. You might experience varying extremes of mania (“up” periods) and depression (“down” periods).

Mood episodes

Everyone has ups and downs (including those related to hormonal changes in adolescence and to the menstrual cycle in women). However, bipolar disorder is a medical condition where you have extreme mood swings, or “mood episodes,” widely out of proportion, or totally unrelated to what’s happening in your life. These swings affect your thoughts, feelings, physical health, emotional health, behavior and day-to-day functioning. These symptoms can be extremely disruptive to your life, and distressing to your friends and family.

Every time you experience symptoms at one extreme for at least one week, it is called an episode. People with bipolar disorder experience four main mood episodes—mania, hypomania, depression and mixed mood.

Manic episode (or “Mania”)

A manic episode happens when you experience an unusual and constantly elevated or bad-tempered mood, lasting at least one week.

During times of mania, you might experience:

  • Elevated or euphoric mood. This can include being full of energy and being happy. Euphoria is often described as being on a high or “on top of the world”

  • Changes in activity levels. You might notice changes in your sleeping and eating patterns

  • Faster thinking and speaking patterns. Thoughts can be quicker than usual, which might lead you to speak faster and jump from subject to subject

  • Lack of inhibitions. You might find it more difficult to see what the consequences of your actions could be

  • Irritability. You might be more likely to be angry or annoyed with others, particularly if they seem to reject your plans or ideas

  • Unrealistic or grandiose plans and beliefs. You might have unrealistic beliefs about your talents. For example, you might believe that you’re a king, queen, film star or religious figure

  • Risk taking behavior. You might take unnecessary and unsafe risk

  • Hypersexuality. You might experience increased sexual thoughts, feelings, or behaviors, or use explicit sexual language

  • Measuring behavior. You might find it hard to decide what behavior is appropriate in a particular situation

A hypomanic episode is similar to a manic episode, with less extreme symptoms. These are more commonly seen in people with Bipolar II.

Depressive episode

A depressive episode is when you have either a depressed mood or the loss of interest or pleasure in nearly all activities. This episode typically lasts for at least two weeks.

When you are experiencing a depressed mood you might:

  • Lose interest in day-to-day activities

  • Feel unusually tired and exhausted

  • Have no appetite or an increased appetite, and experience changes in body weight

  • Feel worthless or guilty

  • Have difficulty concentrating

Check out the fact sheet on Depression for more information about the characteristics of depression.

Mixed episode

A mixed episode is when you experience both manic and major depressive symptoms nearly every day for at least one week. Your mood might vary with the time of the day.

Types of bipolar disorder

Diagnoses of different bipolar disorders are based on your experience of mood changes, what relatives and friends tell mental health professionals about what they’ve witnessed, professional observation, and an assessment by a psychiatrist or other mental health professional who is licensed to diagnose and treat mental health disorders. Understanding the different classifications of bipolar disorder can help you identifying the best way of managing it.

Bipolar I

Bipolar I is a type of disorder where you experience one or more manic episode or mixed episode, and often one or more major depressive episode. Each depressive episode can last for several weeks or months, alternating with intense symptoms of mania that can last just as long. Between these extremes, you might have periods where life continues normally. Your symptoms can also be affected by changes in the seasons or life situations that come up, like school exams.

Bipolar II

Bipolar II is a type of disorder where you experience one or more major depressive episode, along with at least one hypomanic episode. Between episodes, there might be periods of normal life functioning. Symptoms might also be related to seasonal changes and life situations.

Cyclothymic disorder

Cyclothymic disorder is a chronic, or long-lasting, fluctuating mood pattern that involves periods of hypomania and periods of depression. It is a milder form of bipolar disorder. The duration of the symptoms is shorter, less severe and not as regular.

Bipolar disorder not otherwise specified (NOS)

When symptoms don’t fit any other type of bipolar disorder; it is called bipolar disorder not otherwise specified. Although the experiences of this form of bipolar disorder vary from person to person, someone with bipolar disorder NOS will still experience some variation of manic and depressive episodes. Just like the other three types, bipolar disorder NOS is a treatable disorder.

Causes of bipolar disorder

Men and women have equal chances of developing bipolar disorder, although men are often diagnosed at an earlier age. Bipolar disorder might be associated with a combination of factors, including genetics, biochemistry, stress and in some cases the seasons. Approximately 1% to 5% of people suffer from bipolar disorder.

Getting help for bipolar disorder

Bipolar disorder is a treatable illness, and usually requires long-term management. Many people with bipolar disorder are creative and intelligent, and with proper management of this condition, can lead full and productive lives. Treatment options are available for managing both mania and depression. It is a good idea to speak to your doctor about which options might be best for you.

Medication. Your local doctor should be able to tell you about what medications are available for bipolar disorder. Most people are referred to a psychiatrist for diagnosis and medical treatment.  Mood stabilizers, antipsychotics and antidepressants can all be used to control bipolar disorder.

Seeing a counselor or psychologist. If you’re experiencing bipolar disorder, you might also find it helpful to talk with someone like a psychologist, counselor, social worker or other mental health professional. By doing this, you can gain a better understanding of what you’re experiencing. It can also be helpful just to talk about how you feel, and these professionals should help you work out why you feel this way. In most situations, a psychiatrist will manage any medication and monitor your situation, while another mental health professional can assist you to manage your life better.

Family/friend support network. Family members and friends can help with the day-to-day management of bipolar disorder by providing feedback on mood states, as well as by giving support, friendship, understanding and a non-judgmental listening ear.

Support groups. Bipolar disorder support groups offer valuable first-hand information from others who live with the disorder. You can find support both locally and on the Internet.

Lifestyle. Regulating your eating and sleeping patterns can help you manage bipolar disorder, and can help prevent manic, hypomanic, depressive or mixed episodes. You should also consider drinking less or no alcohol and not taking drugs.

Stress management and relaxation. Decreasing stress levels, planning ahead and learning relaxation techniques are also important strategies that can help control bipolar disorder.

Hotlines. When things get tough and you want to talk to someone anonymously about your emotions, or if you’re worried about a friend whom you suspect might be bipolar, you can call Lines for Life’s YouthLine at 1-877-968-8491 or by texting teen2teen to 839863. The helpline is free and staffed 24 hours a day with trained volunteers. If you are feeling suicidal, or worried about a friend who might be suicidal or in crisis, you can also call the Suicide LifeLine at 1-800-273-8255. For a directory of crisis services, check out our Crisis Helplines article.

Psychiatric hospital. To keep safe and get the best support, it might be necessary to be admitted to hospital during more extreme episodes of mania or depression.

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Acknowledgements: This article was originally developed by youth and staff for

Anger & Violence


A closer look at anger, violence, and how to cope with those feelings

Why do people get angry?

Anger is a normal and healthy emotion experienced by everyone at some point.Sometimes, anger can be a positive emotion, driving us to right wrongs or fix injustices. But sometimes a person’s anger can become uncontrollable and harmful—and it can even lead to violent behavior.

There are many different reasons why people get angry. Some reasons why you might be feeling angry include:

  • Being treated unfairly

  • Having no control over things

  • Being stressed or under a lot of pressure

  • Experiencing body changes, which cause major mood swings

  • Being depressed

  • Having a personality that has a short fuse

All of these things can lead to anger, which is an OK feeling to have. Anger can be a difficult emotion to express and manage, particularly because we have often been taught not to show or express our anger. It is not uncommon to feel guilty or ashamed about being angry, even though it’s a very normal and necessary emotion.

Anger only becomes unhealthy when it’s expressed in a way that hurts others or yourself. Likewise, if you bottle up your anger and don’t express it at all, you might find that it will come out in ways that you didn’t expect. There are many ways of expressing your anger, but becoming violent should never be an option.

Expressing your anger in negative ways

Just as everyone feels angry from time to time, everyone also expresses their anger in different ways. Some ways are more constructive than others, and chances are, you’ve learned how to express your anger and frustration from the people in your life or the situation you grew up in.

Violent behavior, toward oneself and others, can result from anger. It is one way that people express anger and try to control the situations that they find themselves in—but violence is never a positive or constructive way to deal with your emotions.

Certain factors might put you at a greater risk of acting out violently. For example, you might be violent because the people you hang out with use violence or other types of aggression. You might think violence is more acceptable because you’ve seen it on television, in the movies or in video games. You might also act violently because someone—like a bully or even a family member—is being violent toward you. If you grew up in a violent household, you might think that it’s OK to deal with your feelings in a physically aggressive way. Research shows that children who grow up with disruptive home situations might have a harder time controlling anger and are more likely to act out violently. This is often called a “cycle of violence.”

Recognizing the potential for violence

There are certain warning signs that people might have a hard time controlling their violent behavior. Here are a few examples:

  • Regular loss of temper

  • Frequent physical fighting

  • Drug or alcohol abuse

  • Vandalism or property destruction

  • Harming other living things, like animals

  • Making frequent threats toward others

Managing your anger and breaking the cycle of violence

The good news is that any learned behavior—such as violence—can also be unlearned. The key is to first take control of situations that make you angry and manage your reaction to frustration.

Here are some tips to get started:

Use your anger as a signal. When people are angry, they can say or do things that they regret later. If you feel that you are becoming angry, do something to cool down, like counting backwards from 100.

Think about the things that trigger your anger. By identifying common factors in the situations that seem to trigger your anger, you might be able to predict and prepare for future anger-producing circumstances.

Take a “time out”. If you feel that you might lose control, get yourself out of the situation that is provoking you. Tell the person or people you’re arguing with that you need some space to cool down and that you’ll continue this conversation when everyone is calm again. Take a break from the situation to reevaluate what’s happening and think about your next steps and whether any actions could be potentially harmful. Keep telling yourself “I can calm down” and “I’m not going to let this get to me.” Going to a quiet place to chill out will allow you the time to gather your thoughts and feelings to go back into the conversation feeling confident.

Use this time out to think about what really is going on. For example, if you’re feeling angry because your teacher or boss yelled at you, your anger might be stemming from a deeper feeling of inadequacy or disappointment in yourself. Your feelings are often deeper messages. Question why you’re actually feeling this way.

Use your coping skills. Doing something active like kicking a soccer ball, punching a pillow, working out, or going for a run can help you release some angry energy and calm down. Playing video games is another great way to channel anger and violence into a place where it’s more appropriate. If you feel as if you are going to get into a fight, it’s better to do it in a video game than in real life. Music is a great way to release extra energy and get over the intense feelings you have. Strap on the headphones and play your favorite music for a while. It might be helpful to even make a playlist with some jams on it you can listen to when you’re feeling angry.

Talk to the person who is making you angry. When feeling more in control of your emotions, explain your side of things and assert your opinions in a positive way. For example, use “I-statements” such as, “I feel this way because…” Be prepared to keep your cool if the other person doesn’t respond the way you think he or she should.

Respect others’ opinions and reactions. It is important to remember that you can only control your reactions to situations and you can’t control the other person’s. Remember, it’s OK to disagree. If you’d like more information on conflict resolution, check out our Resolving an Argument article.

Don’t let it all hang out! While it’s important to express yourself, it isn’t always best to “let it all out.” In fact, fully acting on your angry feelings without taking others into consideration could actually have negative and harmful consequences. Try to be mindful of the time and place you’re sharing your feelings and be mindful in how you’re doing it.

Avoid using drugs and alcohol. Sometimes it’s easy to turn to substances like drugs and alcohol to help you forget or suppress angry feelings, but the relief you get from drugs and alcohol is only temporary, and the side effects of abuse can make a situation worse.

Talk to someone. Friends and family can be great sources of support if you’re feeling angry and frustrated—as long are you’re talking with them in positive ways and not taking your anger out on them. It can be relieving to vent about your frustrations and get to a place where you can laugh about it. If you don’t have anyone to talk to in person, there are lots of apps and online support groups you can join to find support.

What can I do if I keep getting angry?

If you find that you keep getting angry, or that you are lashing out and regularly becoming violent toward people or things, it may be helpful to speak to a friend or family member, or a healthcare professional like a counselor or your doctor. Speaking to someone may help you identify why you’re getting angry and help you deal with your anger so you don’t need to resort to lashing out.


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