Survivors of Suicide

After someone ends their life by suicide

A guide to understandings your feelings

Questions you might ask after someone has succumbed to suicide

If someone you love has taken their life, you might be feeling devastated. You could be feeling shock, disbelief and horror. You might be asking yourself: Why did they do it? Could I have prevented it?

All these and so many other emotions can overwhelm you leaving you feeling hurt, helpless and confused. At times you might even question whether you’re going crazy. You may wonder whether you are the only person in the world experiencing such trauma. All these thoughts are very normal.

But you are not alone. Many people before you have faced the same crisis.

When someone takes their own life, it can deeply affect not only the closest family and friends, but it also brings pain to more distant relatives and acquaintances like grandparents, cousins, friends, classmates, teachers and co-workers. Those directly affected by someone’s suicide is considered a survivor of suicide or suicide survivor.

Why didn’t I see it coming?

You might be saying to yourself: I’ve known this person for so long. I should have seen it coming. We talk every day. Why didn’t I know they were in so much pain?

Changes in a person’s behavior leading up to a death from suicide are often gradual. It can be extremely difficult to identify them and to recognize the point when they become significant. Often times, there are no obvious warning signs and the event is seemingly out of nowhere.

Once a person has made up his or her mind to do this, they might go to considerable lengths to conceal their distress and plans from loved ones. Even doctors and mental health professionals who specialize in this field can have difficulty seeing the warning signs.

It’s possible to survive

Many people feel such intense emotional pain after the suicide of a loved one that they wonder whether they can survive. These feelings can sometimes be so intense that you might want to take your own life. If you feel this way, it is best to talk about your feelings with someone you trust. You can always call Lines for Life at 1-800-273-TALK (8255) or another crisis helpline to speak with a trained volunteer who will listen and understand what you are going through.

It is extremely important to take care of your own mental health, especially in the case of losing someone to suicide. Suicide is a known contagion, meaning people that were affected by the suicide are at a higher risk of engaging in suicidal behavior or having suicidal thoughts. In order to end the cycle, we need to process what has happened to this person, how it has affected us, and seek help when we need it.

No matter the circumstances leading up to the death of your loved one or acquaintance, try to remove any personal blame you may have in the situation. Their death is not your fault. If you cannot shake the feeling of guilt or blame, consider joining a Suicide Survivor group online or in-person, or unpacking your own trauma from the suicide by scheduling one-on-one appointments with a therapist specializing in grief and loss.

You might find it hard to believe now, but your grief will not always feel like this. Grief changes as you work through it, and though you’ll never forget, time will change some things. Everyone’s process looks differently, and however that looks to you, that’s okay. If you choose to and if you have the necessary support, you might grow as a person from the experience and integrate what happened into your life.

What to tell others

Many people find it extremely difficult to tell others the truth about the cause of their loved one’s death. They might be tempted to give other reasons. This strategy can seem to ease the initial feelings you might have like embarrassment but in the long run though, it adds to the stress because you might feel like you have to keep the lie going. When the truth eventually comes out, it can also be hard to explain the original deception.

Although suicide can be very hard to talk about, the more it is brought up in casual conversation or the more vulnerable we are in talking about our experiences with it (without going into detail), the more we can fight the stigma against it. The less stigma there is, the more people will be willing to talk openly about what they’re feeling, which is the goal of suicide prevention. As stated earlier, suicide is a contagion, so make sure your needs are met and that loved ones know there are other options too. Suicide prevention is a community effort.

You might find yourself in the position to have to tell people about your loved one’s death, which is a very difficult task regardless of the reason for their death. It might be easier to tell a number of people at once or by giving a simple statement in regards to their passing. Try not to go into too many details, as it can be triggering for you and others you tell.  

Information in this article was provided by:

  • Psychology Today

  • 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

Counseling and Therapy

What kind of counseling is right for me?

A brief look at different styles of counseling and therapy

What kind of counseling is right for me?

There are many different types of therapy or counseling out there. Some mental health professionals specialize in one type of therapy, and others are trained in multiple styles. Some techniques are better suited for one or two specific mental health concerns while others can be used for a broad range of issues. This fact sheet explains some of the most popular kinds of therapy available.

If you are looking for a counselor, you can ask them what kind of therapy they practice, if that style is recommended for what you are struggling with, and what sessions with them are like. Using the Find a Therapist tool on, you can easily screen what types of therapy and clientele each therapist specializes in. This makes it easy and effective in finding a new therapist that can match your needs. It’s also recommended to give your therapists a brief interview to make sure they’re the right fit for you.

Here are the most common types of therapeutic approaches:

Behavioral Therapy

The main idea: Behavioral therapy focuses on changing patterns of behavior by adopting techniques derived from learning principles, like rewarding positive actions. In this type of therapy, a therapist assumes that certain behaviors are learned, and these learned behaviors can be changed.

What it looks like in practice: Behavioral therapy includes an array of methods such as stress management, biofeedback, and relaxation training.

Who typically finds it most helpful: Behavioral therapy is an approach that is often used to help change compulsive behaviors and is a common approach in treating autism spectrum disorders.

Cognitive Therapy or Cognitive Behavioral Therapy (CBT)

The main idea: Cognitive therapy or CBT focuses on identifying and changing unhelpful thoughts (called cognitions) that can lead to unproductive feelings and behaviors. Beliefs and thoughts are explored to identify how they affect your behavior.

What it looks like in practice: CBT is a short-term, focused approach that often lasts about 12 weeks, where the therapist helps you recognize negative thought patterns and behaviors to replace them with positive ones.

Who typically finds it most helpful: CBT is commonly used for obsessive compulsive disorders, anxiety and depression. Learn more about CBT by visiting our Cognitive Behavioral Therapy article.

Dialectical Behavior Therapy (DBT)

The main idea: In DBT, you learn ways to tolerate your intense feelings, cope when emotions feel overwhelming, and express your feelings to others in more productive and healthy ways.

What it looks like in practice: DBT often combines individual counseling with group therapy sessions, and homework in between.

Who typically finds it helpful: This type of therapy is commonly used with people who have borderline personality disorder, and people who have strong mood shifts or difficulty regulating their intense emotions.

Family Therapy

The main idea: Family therapy involves a whole family working together to improve communication, relationships, and the struggles of individual family members.

What it looks like in practice: The therapist guides the family in problem-solving or helps them adjust to a new situation. Usually, the whole family goes along to the initial appointment with a counselor or therapist. Later in treatment, the therapist might also want to periodically meet with smaller groups of family members (just the kids, or mom and daughter only, etc).

Who typically finds it most helpful: Family therapy is often used to address relationship conflicts, eating disorders and substance abuse concerns.

Group Therapy

The main idea: Group therapy can take many forms, but most involve bringing together people dealing with similar issues. Groups can be structured and education-focused, where members share coping skills for depression or self-harm, or learn anxiety management techniques. Other groups are less structured and provide a space for members to talk about their experiences and get support, like a grief support group.

What it looks like in practice: Some groups meet for a specific, short period of time and some are open-ended that keep going for years. Therapy groups will be led by one or more trained mental health professionals. In self-help groups, everyone shares equally and there is no trained facilitator.

Who typically finds it most helpful: Groups can be helpful for almost any issue. Read a description of the group or talk to the group facilitator to see if a particular group is right for you.

Interpersonal Therapy

The main idea: Interpersonal therapy (IPT) is a short-term treatment that focuses on relationships and the ways you can improve your social support, develop better communication skills, learn how to express emotions more effectively, and become more confident with people at school and at work.

What it looks like in practice: Sessions are likely to be focused more on tasks and learning skills than on talking about what's going on in your life.

Who typically finds it most helpful: IPT is most often used to treat depression, and can also be helpful for other mood disorders including anxiety and bipolar.

Mindfulness-based Therapies

The main idea: Mindfulness therapies help you build awareness of your thoughts, feelings, and body sensations and develop acceptance of yourself.

What it looks like in practice: Many types of therapies can include mindfulness tools, including CBT, DBT, psychodynamic and relational therapy. "Mindfulness" means being aware of what is happening in the present moment, without judgment.

Who typically finds it most helpful: These approaches are helpful for many issues, and especially anxiety and self-criticism. Mindfulness-Based Cognitive Therapy (MBCT) is a specific kind of mindfulness treatment that is designed to prevent depression relapse.

Psychodynamic Psychotherapy

The main idea: This is usually an open-ended or longer-term therapy, where you and your therapist explore your thoughts and feelings and examine their root causes.

What it looks like in practice: While most psychotherapists will set goals with you and talk about what's going on in the present, they will also want to talk about your past and be curious about when and how your distressing feelings and patterns started.

Who typically finds it most helpful: This therapy can be used to address a wide range of issues, as well as provide a place for people who want to know themselves better or work on personal growth.

Relational Therapy

The main idea: This is a common type of therapy that focuses on your relationships with important people in your life.

What it looks like in practice: Through talking about your relationships with family and friends, as well as paying attention to the way you relate to your therapist during sessions, you and your therapist work to address patterns that are preventing you from having the connections you want.

Who typically finds it most helpful: This type of therapy is used for a broad range of issues, including depression, anxiety, and relationship problems.

Information for this fact sheet was provided by:

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


Cognitive Behavioral Therapy (CBT)


Cognitive Behavioral Therapy

A brief look at CBT and how it can help you

What is Cognitive Behavioral Therapy or CBT?

Different therapists use different approaches when helping people. Cognitive behavioral therapy is a frequently used approach that has strong evidence supporting its effectiveness with a variety of problems. CBT has been shown to be particularly effective with feelings of depression and anxiety and aggressive behavior.

Cognitive behavioral therapy focuses on helping you understand, manage and change your thoughts or cognitions as a first step in changing patterns of behavior and feelings. So from this perspective, if you change the way you think, you will begin to feel and behave better.

This counseling approach is used by many clinical psychologists, psychiatrists and counselors. Some therapists will specialize in this form of therapy while others will integrate some of the techniques with other approaches to help you work through your difficulties. Cognitive behavioral therapy is often used in conjunction with medication.

How does CBT work for depression?

If you are depressed you may feel hopeless, lacking in energy, empty, and possibly anxious. These feelings make it difficult to think positively about yourself, your relationships with other people and life in general.

Cognitive behavioral therapy will help you review how you managed certain events and situations in your life. Together with a therapist you look at troubling events in your life and talk about your thoughts related to those events.

Someone who uses cognitive behavioral therapy believes that depressive feelings come from a person’s illogical or negative thinking patterns. When a therapist works with a person using this approach the therapist will teach the person how to challenge negative thoughts (“I’m worthless”, “I’ll never be any good at this)”, and then helps the person develop more positive ways of thinking (I might not be able to do this perfectly, but that doesn’t mean I’m worthless”).

Through this process, negative, unhelpful, or irrational thoughts are identified along with more positive thoughts about the situation. Through this process you learn how to replace negative thinking patterns with more positive ones that will eventually help you to feel better about yourself, your relationships and life in general.

Cognitive behavioral therapy will help give you strategies for managing problems both small and large so they don’t get on top of you.

How does CBT work for anxiety?

CBT for anxiety disorders aims to help a person develop a more adaptive, or positive, response to a fear. The cognitive part helps people change the thinking patterns that support their fears, and the behavioral part helps people change the way they physically react to the situations that provoke their anxiety. Another name for this CBT approach is stress inoculation training.

A CBT therapist may expose the person gradually to the object or situation that is feared, perhaps at first only through pictures or video, then later face-to-face. At the same time, the person practices new thought patterns and new behaviors. When the time comes to confront the feared situation in person, the therapist often accompanies the person to provide support and guidance.

How does CBT work for aggressive behavior?

Aggression replacement training is the name of the approach used with a person who has difficulty managing anger and behaves aggressively. Aggression replacement training is based on CBT principles. With this approach, the therapist helps the person identify the triggers that lead to angry feelings and aggressive behavior, how to anticipate and prepare for these triggers, and then how to keep calm when faced with situations that arouse anger and aggressive responses. The person learns a variety of skills, including things to say to themselves (also known as “self-talk”) to keep from losing control. This type of therapy also focuses on helping the person develop positive social skills and moral reasoning.

What is likely to happen when you visit a therapist who practices CBT?

Usually, CBT is structured so that you have regular sessions with the counselor or therapist. How often will depend on a number of factors, but at the start it will likely be weekly and then become less often over time.

Many therapists will also agree with you to come for a set length of time. For example you may see the therapist weekly for eight weeks and then assess progress and reassess the need for future sessions.

Reviewing progress is often an important part of the process. The sessions may vary in length but are usually an hour long. It is not uncommon for the therapist to also give you some tasks that you do between sessions.

The first time that you see your therapist, you will likely talk about what is the best arrangement for you; if they don’t you may want to raise this yourself.

Information for this article was provided by:

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

Challenging Negative Self-Talk


Challenging Negative Self-Talk

A brief look at self-talk and how to reframe our negative thinking patterns


What is self-talk?

As we go about our daily lives, we constantly think about and interpret the situations we find ourselves in. It is like we have an internal voice that determines how we perceive every situation. We call this inner voice our “self-talk”, and it includes our conscious thoughts as well as our unconscious assumptions and beliefs.

Negative self-talk often causes us to feel bad, and can make us feel hurt, angry, frustrated, depressed or anxious. It can also make us behave in a self-defeating way. For instance, thoughts like ”I’m going to fail for sure” might discourage you from working hard when you are preparing for your exams, and you might actually fail as a result.

Positive self-talk is challenging the negative or unhelpful aspects of your thinking, and replacing them with more reasonable and helpful thoughts. This is a powerful way to feel better either about yourself or a situation.

Negative self-talk

An example of negative self talk would be if you tell yourself that there’s no reason to study for an upcoming test because you already know that you’re going to fail. You may not even try to study because you believe you won’t pass, regardless. However, if you believe that you will do well on the test or that studying will help, then you’re much more likely to do well on the test. Don’t doubt yourself, you’re capable of achieving a lot more than you think.

A challenge with negative self-talk is that what you think or say to yourself might seem true. You might assume that your thoughts are facts, when in reality they are based on your perceptions. If you are feeling down on yourself for some reason, this can lead to your thoughts being especially harsh.

Negative self-talk can also affect your self-esteem. When you feel down, it is likely that you’re hard on yourself, and you might criticize and judge yourself unfairly. The worse you feel, the more negative your self-talk is likely to become. It can be helpful to put a more positive perspective on things. For example, challenge your self-talk by imagining it's a friend in your situation and reframe it based on what you'd say to them. We're often nicer to friends than we are to ourselves!

Challenging the negative or unhelpful aspects of your thinking enables you to feel better and to respond to situations in a more helpful way. You can practice noticing your own negative self-talk as it happens, and consciously choose to think about the situation in a more realistic and helpful way. You might be surprised to realize how distorted some of your previous thoughts were before.

Challenging negative self-talk

Identifying self-talk can sometimes be tricky because it's so automatic, you might not even be aware of what’s going on in your own mind. However, whenever you find yourself feeling depressed, angry, anxious or upset, use this as a signal to reflect on your thinking. A good way to test the accuracy of your perceptions is to ask yourself some challenging questions. These questions will help you check out your self-talk and see whether your current interpretation is reasonable. It can also help you discover other ways of thinking about your situation. Recognizing that your current way of thinking might be self-defeating—and prevent you from getting what you want out of life—can sometimes motivate you to look at things from a different perspective.

1. Reality testing

  • What evidence supports my thinking?

  • Are my thoughts based on facts or my interpretation of the situation?

  • Am I jumping to negative conclusions?

  • How can I find out if my thoughts are true?

2. Alternative explanations

  • Are there other ways that I could look at this situation?

  • What else could the situation mean?

  • If I were being positive, how would I perceive this situation?

3. Perspective

  • Is this situation as bad as I’m making out to be?

  • What’s the worst thing that could happen?

  • What’s the best thing that could happen?

  • What’s most likely to happen?

  • Is there anything good about this situation?

  • Will this matter in five years?

4. Goal-directed thinking

  • Is thinking this way helping me feel good or achieve my goals?

  • What can I do that will help me solve the problem?

  • Is there something I can learn from this situation to help me in the future?

Try it out

Think of a situation in the last week when you have found yourself feeling bad. You might have been feeling upset, stressed, angry, sad, depressed, embarrassed or guilty. Try applying some of the above tools.

For example:

  • ”I tried on my jeans and I looked so disgusting and ugly and fat” turns to ”I tried on my jeans and they were too small”

  • ”Sally said ’hi’ to me and I made a total idiot of myself" to ”Sally said ’hi’ to me and I blushed and looked away. It's perfectly okay to be shy”

  • "I totally messed up that exam, I'm a loser and I'll never get a good job" turns to "I didn't do as well in that exam as I would have liked but that doesn't mean I'm not going to get the job that I want".

For more tips on challenging negative thinking patterns, check out the Common Thinking Errors article.

Information from this article was provided by:

  • This fact sheet comes from Taking Charge! A Guide for Teenagers: Practical Ways to Overcome Stress, Hassles and Upsetting Emotions by Dr. Sarah Edelman and Louise Rémond.

  • Foundation for Life Sciences

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

Common Thinking Errors


Common Thinking Errors

Thinking errors are irrational patterns of thinking that can cause you to feel bad and sometimes act in self-defeating ways. If you feel more upset the more you think about a situation, you may want to consider the possibility of thinking in a different way.

Challenging your thinking errors

Here are 10 common thinking errors and ways to challenge them.

1. Black-and-white thinking

When you’re thinking in black-and-white, you see everything in terms of being either good or bad with nothing in between. For example: either you’re great, or you’re a loser; If you don’t look like a model, you must be ugly; if you do something wrong, then you are completely bad.

The challenge: Look for shades of gray

It’s important to avoid thinking about things in terms of extremes. Most things aren’t black-and-white, but somewhere in-between. Just because something isn’t completely perfect doesn’t mean that it’s a total disaster.

Ask yourself:

  • Is it really so bad, or am I seeing things in black-and-white?

  • How else can I think about the situation?

  • Am I taking an extreme view?

2. Unreal ideal

Another common thinking error is to make unfair comparisons between certain individuals and yourself. When you do this, you compare yourself with people who have a specific advantage in some area. Making unfair comparisons can leave you feeling inadequate.

The challenge: Stop making unfair comparisons

Ask yourself:

  • Am I comparing myself with people who have a particular advantage?

  • Am I making fair comparisons?

3. Filtering

When you filter, first you hone in on the negative aspects of your situation. Then you ignore or dismiss all the positive aspects.

The challenge: Consider the whole picture

Ask yourself:

  • Am I looking at the negatives, while ignoring the positives?

  • Is there a more balanced way to look at this situation?

4. Personalizing: The self-blame game

When you personalize, you blame yourself for anything that goes wrong, even when it’s not your fault or responsibility.

The challenge: Find all the causes

Ask yourself:

  • Am I really to blame? Is this all about me?

  • What other explanations might there be for this situation?

5. Mind-reading

We often think we know what other people are thinking. We assume that others are focused on our faults and weaknesses—but this is often wrong! Remember: your worst critic is probably you.

The challenge: Don’t assume you know what others are thinking

Ask yourself:

  • What is the evidence? How do I know what other people are thinking?

  • Just because I assume something, does that mean I’m right?

6. Exaggerating

When things go wrong, you might have a tendency to exaggerate the consequences and imagine that the results will be disastrous.

The challenge: Put it in perspective

Ask yourself:

  • What’s the worst that can happen?

  • What’s the best that can happen?

  • What’s most likely to happen?

  • Will this matter in five years?

  • Is there anything good about the situation?

  • Is there any way to fix the situation?

7. Over-generalizing

Over-generalizing is a lot like exaggeration. When you over-generalize, you exaggerate the frequency of negative things in your life, like mistakes, disapproval and failures. Typically you might think to yourself: I always make mistakes, or everyone thinks I’m stupid.

The challenge: Be specific

Ask yourself:

  • Am I over-generalizing?

  • What are the facts? What are my interpretations?

8. Fact versus feeling

Sometimes you might confuse your thoughts or feelings with reality. You might assume that your perceptions are correct.

The challenge: Stick to the facts

Ask yourself:

  • Am I confusing my feelings with the facts? Just because I’m feeling this way, does that mean my perceptions are correct?

  • Am I thinking this way just because I’m feeling bad right now?

9. Labeling

When you use label, you might call yourself or other people names. Instead of being specific—for example, saying “That was a silly thing to do”—you make negative generalizations about yourself or other people by saying things like “I’m ugly” or “she’s an idiot”.

The challenge: Judge the situation, not the person

Ask yourself:

  • What are the facts and what are my interpretations?

  • Just because there is something that I’m not happy with, does that mean that it’s totally no good?

10. ‘Can’t Stand-itis’

Some people get intolerant when they have to do things they don’t enjoy. They tell themselves that they “can’t stand” certain things instead of acknowledging that they don’t enjoy them. As a result, they easily become frustrated and angry.

The challenge: Accept that frustration is a normal part of life

Ask yourself:

  • I don’t enjoy it, but I can stand it.

  • This is a hassle, and that’s O.K.! Life is full of hassles.

The effect of challenging thinking errors

What is the effect of challenging your thinking errors? It can make you feel better and encourage you to change some of your behavior.

Remember: When you’re feeling down, try to examine your thoughts. If they’re negative or critical, try challenging them. Once you get into the habit of disputing your negative self-talk, you’ll find it easier to handle difficult situations, and as a result, you’ll feel less stressed and more confident and in control.

Write it down

It can be useful to write down the changes that occur after you’ve challenged your thinking, as this helps you see the advantages of working on your thoughts, and motivates you to keep at it. While you’re learning to identify and challenge your thinking patterns, it’s a good idea to write it all down in a diary or notebook to help you to develop your skills. Initially it might feel like work, but the more often you do it, the easier it will become, and the better you will feel.

Try it out

Now that you know a few common thinking errors and how to challenge them, why don’t you try it out? It might not be easy at first, and it can take some time. But the rewards can be huge! People who choose the way they think about things, are at peace with the past, live in the present, and are optimistic about the future are generally happier.

Information for this article was provided by:

  • This fact sheet comes from Taking Charge! A Guide for Teenagers: Practical Ways to Overcome Stress, Hassles and Upsetting Emotions by Dr. Sarah Edelman and Louise Rémond

  • Foundation for Life Sciences “Tyranny of the Shoulds”

  • The “Ten common thinking errors” are derived from the work of David Burns, MD, author of Feeling Good

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


Mental Illness Overview


Mental Illness

A brief look at mental health & common mental disorders

What is a mental health?

Mental health includes our emotional, psychological, and social well-being. Mental health can affect the way we think, feel, act, make decisions, relate to others and handle stress. It can vary over time and across circumstances.

It’s entirely normal for everyone to have good and bad days. On good days, we may feel like we are flexible and can adapt to many different stressors and circumstances (like school, work, relationships, and how we feel about ourselves). However, on bad days, we may feel like we can’t cope with the stressors in our lives and feel overwhelmed and stuck.

Sometimes, these variations in well-being can change from hour to hour or day to day, and can last for weeks, months, or longer. In most cases, they are manageable, and with the right kind of help, most people who experience these difficulties are able to live happy and successful lives.

What influences mental health?

Many factors influence our mental health, including:

  • Biological facts: physical health (or illness), genetics, neurotransmitters (brain chemistry), medications, alcohol and drugs, or sleep

  • Psychological factors: emotions and attitudes, learning, beliefs, and stress management

  • Social factors: family, peer relationships, culture, socioeconomics, and life experiences such as trauma, abuse and neglect

Mental illness can affect people from any religion, culture, economic background, or nationality. A number of factors are associated with mental illness. Some of these factors include:

Family history: Most illnesses, both mental and physical, have a genetic component. This means that if someone related to you has a mental health difficulty, then you may be at higher risk for a mental health problem.

Chemical imbalance: An imbalance of chemicals, called neurotransmitters, in the brain can cause mental illness. Most drugs that are used to manage mental health illnesses try to correct this imbalance.

Stressful life events: Stress, like grief, anxiety, or experiencing violence or a traumatic event might trigger a mental health problem.

Drug use: Research shows that drug use can be associated with mental health problems. Sometimes the drug used can change the brain chemistry, making a person more likely to develop a mental illness. When using drugs as self-medication for a mental illness, this is called a co-occurring disorder or co-morbidity. Although it is common for substance use disorders to occur with other mental illnesses, this does not mean that one is the cause of the other, even if one appeared first. For more information on the relationship between drug use and mental illness, check out the National Center for Biotechnology Information, U.S. National Library of Medicine website.

How common is mental illness?

Mental health problems are common in at least one out of every five people. In most cases, they are manageable and with the right kind of help, most people who experience these difficulties are able to live happy and successful lives.

Mental illness can cause people to think, act, and feel differently than they usually do. Some mental illnesses are more severe than others, and have more noticeable symptoms. For a person going through these difficulties, the different feelings are often scary.

Different types of mental illness

There are many different types of mental illness. Below is an explanation of some of the common terms used by mental health professionals.

Depressive disorder

When someone feels sad for a period of time longer than a couple of weeks, he or she might be depressed. People experiencing depression may show some or all of these symptoms:

  • Feelings of hopelessness or helplessness

  • Loss of interest in usual hobbies or activities

  • Lack of energy

  • Changes in sleeping and eating patterns

  • Crying a lot for no reason

  • Feeling anxious

  • Isolating themselves

  • Persistent feelings of sadness or emptiness

If you or a friend are showing these symptoms, then check out the Depression article for more information.

Anxiety disorder

Everyone experiences fear or anxiety every now and then, especially when they’re in new or unfamiliar situations. Check out the Anxiety article for more on how you can manage these feelings. People sometimes experience intense forms of anxiety that can prevent them from going about daily activities. These anxiety disorders can cause people to have sudden, unexplained panic attacks that can seem beyond their control. Other people become anxious about more specific things. This can lead to obsessive behavior, causing them to check and recheck things.

People, who experience high levels of anxiety, can learn to manage and reduce their anxiety levels. A form of therapy called cognitive behavioral therapy has been shown to be effective in managing anxiety. Stress management techniques and meditation can help people with anxiety disorders calm themselves and may enhance the effects of therapy. Check out the Anxiety Disorder: Causes, Types and Symptoms article for more information.

Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder, or OCD, is an anxiety disorder that is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors, such as hand washing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these “rituals” only gives temporary relief and not performing them markedly increases anxiety.

Panic disorder

Panic disorder is another type of anxiety disorder that can cause someone to suddenly become frozen with fear. These panic attacks usually include sweating, dizziness, chest pain and difficulty breathing. Panic disorder can also prevent people from engaging in everyday activities, like going to the store or hanging out with friends. But on a positive note, panic disorder is one of the most treatable forms of anxiety disorder. For more information on panic attacks, including how to treat them, check out the Panic Attacks article.

Attention Deficit Hyperactivity Disorder

When someone has problems concentrating and staying focused on tasks, he or she might have an attention deficit hyperactivity disorder (ADHD), which usually starts in early childhood. People with ADHD can be easily distracted, excessively active, or have a tendency to daydream more than others.

People with ADHD find situations like paying attention in class particularly difficult, which can lead to conflicts with teachers or other authority figures. Because of the inability to concentrate, a person with ADHD might feel like they’re at odds with the world and people surrounding them.

People with ADHD may also have a lot of energy, which can be great for extracurricular activities. Young people with ADHD might need help from their family, friends, teachers, medical doctor, or mental health professional. After a medical assessment, medication can be helpful in managing symptoms.

Eating disorders

An eating disorder is an illness that causes someone to have a distorted view of his or her body, and a preoccupation with eating, food and weight. There are a number of different eating disorders including anorexia nervosa, bulimia nervosa and binge eating disorder.

Someone with an eating disorder should get help as soon as possible. This help can come from a local doctor who then might refer him or her to a psychiatrist or other mental health professional. To learn more about overcoming an eating disorder, check out the fact sheet here.

Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder (PTSD) is a disorder that develops as a reaction to painful or shocking experiences, like sexual assault, violence, war, or a natural disaster. The effects of PTSD can prevent people from living their day-to-day lives as they normally would, like having trouble sleeping or concentrating. It can also cause people to become hypersensitive, jumpy and irritable, or emotionally distant, especially in situations that remind them of the original traumatic event.

Bipolar disorder

Bipolar Disorder, also known as manic-depressive illness, is a serious mood disorder that causes shifts in a person’s mood, energy, and ability to function. The symptoms of bipolar disorder are more severe and are different from the normal ups and downs that everyone goes through.

Bipolar disorder causes dramatic mood swings from overly “high” and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. The periods of highs and lows are called episodes of mania and depression. Severe changes in energy and behavior go along with these changes in mood.

Most people with bipolar disorder can achieve substantial stabilization of their mood swings and related symptoms over time with proper treatment. A strategy that combines medication and therapy is optimal for managing the disorder over time.


If someone becomes confused and appears out of touch with everyone else’s perception of the world, he or she might be experiencing a psychotic episode.

Some common symptoms of psychosis include:

  • Hallucinations such as hearing voices that might not be heard by anyone else

  • Having false beliefs, known as delusions

  • Paranoia

  • Strange and disorganized thinking

  • Unusual behavior

  • Difficulty speaking coherently

Some drugs such as hallucinogens, marijuana, and amphetamines can trigger a psychotic episode. Treatment of psychosis usually involves medication, and also achieving stability after a psychotic episode may take some time. If someone is experiencing a psychotic episode, it is important that he or she seek help from a doctor, psychiatrist, or psychologist. Friends and family can also provide support.


People with schizophrenia may experience psychosis. People with schizophrenia might have:

  • Confused speech patterns

  • Ongoing delusions, which means they might think things about themselves that no one else believes, like they are being watched or have particular powers or abilities they don’t actually have

Schizophrenia does not mean someone has more than one personality or “split personalities.” With medication and support, schizophrenia can be managed. Having the support of family and friends may also be very helpful. The earlier people can receive help for schizophrenia, the greater the chance of a better outcome.

Getting help

If you’re experiencing any of the symptoms of these types or suspect that you might be dealing with one of these mental health issues, it’s important that you seek help. Your doctor is a good first step, and he or she might refer you to a mental health professional, such as a counselor, psychiatrist or psychologist.

Information for this article was provided by:

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

Deliberate Self-Harm

Self-Harm and Coping

What is self-harm? What if my friend is self-harming? What can I do if I don’t want to self-harm, but still have the urge?

What is deliberate self-harm?

Deliberate self-harm (also known as self-injury or non-suicidal self-injury) is when you deliberately inflict physical harm on yourself, usually in secret. Some examples are cutting, burning, biting or hitting your body, pulling out hair, or scratching and picking at sores on your skin.

Deliberate self-harm is not necessarily a suicide attempt, and engaging in self-harm may not mean that someone wants to die. Most commonly, deliberate self-harm is a behavior that is used to cope with difficult or painful feelings.

Why do people deliberately harm themselves?

People who deliberately harm themselves have often had tough experiences or relationships in their lives. They may have:

  • Been bullied or discriminated against;

  • Lost someone close to them, such as a parent, sibling or friend;

  • Broken up with a boyfriend or girlfriend;

  • Been physically or sexually abused;

  • Experienced a serious illness or disability that affects the way you feel about yourself;

  • Experienced problems with family, school or peer groups.

Deliberate self-harm may be used as a way to cope with experiences and strong feelings. Self-harm might:

  • Provide a way to express difficult or hidden feelings. It’s not uncommon to feel numb or empty as a result of overwhelming feelings you may be experiencing. Engaging in deliberate self-harm may provide you with a temporary sense of feeling again. It may also provide a way to express anger, sadness, grief or emotional pain;

  • Be a way of communicating to people that you need some support when you feel unable to use words or any other way to do so;

  • Act as a form of self-punishment for times you feel you may have failed;

  • Be a way of proving to yourself that you are not invisible;

  • Provide you with a feeling of control: You might feel that self-harm is one way you can have a sense of control over your life, feelings or body, especially if you feel as if other things in your life are out of control.

Deliberate self-harm can bring an immediate sense of relief, but it is only a temporary solution. It can also cause permanent damage to your body if you injure nerves. Psychologically, it may be associated with a sense of guilt, depression, low self-esteem or self-hatred along with a tendency to isolate yourself from others.

Coping without harming yourself

Along with support from a friend, family member or health professional, it might also be helpful to write a list of alternative strategies to self-harm for managing your emotions.

If you feel like you want to harm yourself, there are a number of things that you can try to distract yourself until the feelings become more manageable. If you can, make sure that you’re around other people and remove any sharp objects from the area.

Some ideas for releasing energy or feelings include:

  • Choose to put off harming yourself until you’ve spoken to someone else or waited for 15 minutes. See if you can extend it for another 15 minutes beyond that, continuing to do it again until you no longer feel the urge. Delaying it or putting yourself in a place where you can’t do it may help the urge pass.

  • Write in a journal. If you’re fearful someone may read a hard copy of your journal, there’s lots of other options you can use. You could try to using an online journal or blog that is password protected or anonymous. There are also a lot of apps where you can vent about your feelings anonymously and receive support from people going through similar things.

  • Draw or write in marker over your body. Expressing difficult feelings through actions can be helpful. However, if you are able to verbalize and symbolize difficult feelings through words and/or artwork, this can be a healthier, more sophisticated way of coping. Sometimes, writing a message of support over your scars can also be helpful, such as using a semicolon to represent not giving up, writing lyrics that speak to you, or drawing the word “love” in a special font.

  • Exercise. Go for a run or walk in the park to use up excess energy.

  • Play video games. This might be a good way to distract yourself and help until the anxiety passes.

  • Yell or sing at the top of your lungs on your own or to music. You might do this into a pillow if you don’t want other people in the house to hear. It might be a good idea to create a playlist that’ll make you feel better.

  • Use relaxation techniques. Activities like yoga or meditation are often helpful in reducing anxiety. Taking a hot shower or bath can also be soothing.

  • Cry. Crying is a healthy and normal way to express your sadness or frustrations. Allow yourself to let it out.

  • Talk to someone. Sometimes it can be helpful to talk about what you’re feeling with a trusted friend or by calling a helpline. Talking about things other than your problems can also help in the short-term, distracting you from wanting to self-harm. It is important, however, to find someone you can share things with so you don’t feel alone in your struggles.

Alternatives to deliberate self-harm

If the above suggestions don’t help and you still feel the need to self harm, there are a number of things that you can do that won’t cause injury like:

  • Punching a pillow or punching bag

  • Squeezing ice cubes until your fingers go numb, or holding them over your scars

  • Eating a chili, or something really spicy

  • Taking a cold shower

  • Putting vapor rub under your nose (it stings and makes you cry)

  • Waxing your legs (or getting them waxed)

  • Painting your nails (keeps you from doing much with your hands)

  • Love on your pets

Finding help

Although it might seem hard, it’s important that you reach out to someone who can help you find healthier, positive alternatives to alleviate the pain you feel inside. It may take time, but it’s important to remember that you can move to a happier and healthier outlook.

Speaking to someone about your self-harm might be hard, and it’s important to trust the person you’re speaking with.

If you’re having a hard time talking about what you’re going through, you might start with sentences such as ”Right now, I’m feeling…”; ”I think it started when…”; “I’ve been feeling this for…”; ”My sleep has been…”; “Lately school/work has been…”

Like any relationship, building trust with your counselor, psychologist or psychiatrist may take time and it is important you find someone you feel comfortable with. This may mean seeing several people before finding the one that you “click” with.

If there is a family member you feel comfortable telling, it might be helpful for you to have their support in finding a counselor that is right for you. It’s likely that the person you feel comfortable telling will already be worried about you and will be relieved to have the opportunity to listen and help.

If you don’t get a positive response, try to remember that it’s not because you’ve done something wrong, but because the person you have told may not know how to respond to what you have told them, or might not understand much about deliberate self-harm.

Don’t give up! Either try again or speak to someone else you think you might receive a more supportive response from.

If talking with someone is too overwhelming, an alternative is to e-mail or write down what you want to say. Otherwise, a first step might be to call a 24/7 helpline, such as Lines for Life at 1-800-273-8255 if you are feeling in crisis or having suicidal thoughts, or youth helpline YouthLine at 1-877-968-8491 or by texting teen2teen to 839863.

If you or a friend are harming yourselves, it’s also important that you take care of the injuries caused and if necessary, seek medical help through your doctor or, if it’s serious, a hospital’s emergency department.

In most situations, doctors and other health professionals must keep your information confidential. However, they are required to report information they receive if they have serious concerns about your safety.

Take care of yourself

It’s important to eat well, exercise and be kind to yourself. While not a solution in itself, doing all these things contribute to a higher sense of self-worth, increased stability of moods, and a general better sense of well being — making you feel more happy on the outside and the inside.

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