Feeling better…

Find out why you might develop mental health problems as a young person

If you're feeling anxious or depressed, or affected by eating disorders, it's a sign that you might be struggling with stresses or personal difficulties.
Because adolescence and early adulthood are full of changes and challenges - sexuality, friendships and pressure to prove yourself in exams, for example - you can start to experience mental health problems around this age. If you're dealing with other problems too, such as family conflict, bullying, bereavement, poverty, emotional deprivation or abuse, it can feel like a vulnerable time.

How do I know if I'm struggling?

You may be:
 sad, withdrawn, and less interested in things you used to enjoy
 worried and anxious
 critical of yourself and the way you look
 eating and sleeping much more, or much less, than in the past
 harming yourself (for example, drinking too much or taking too many drugs, cutting yourself or intentionally putting yourself in dangerous or risky situations)
 angry and aggressive
 confused and acting in unfamiliar ways
 avoiding college, work or social situations
Alcohol and drugs can seem to provide an escape from your problems, but can create an extra layer of difficulty if your use of them becomes excessive.

People who can help

If you’re worried about the stigma attached to mental illness it can be very difficult to ask for help. The thing to remember is that a lot can be done to prevent and treat mental health problems, but it’s crucial you get help early on.

What kinds of help might I be offered?

• therapy
• medication (this can sometimes help in the short term, but many psychiatric medicines aren’t recommended for people under 18)
• creative therapies (art, music or dance)
Alongside counselling and therapies, anything that helps you find trusting relationships and the sense that you belong somewhere and that you’re valued will improve your mental health and wellbeing.
What can I do to keep myself mentally healthy?
• make time to relax and enjoy yourself
• spend time with friends, having fun
• do something physical that you enjoy like playing football, dancing etc
• organise your time so you feel on top of the things you need to do
• spend time every day thinking about the things you really like about yourself
• take a thoughtful, compassionate attitude to yourself when you’re struggling with something, as you would with a friend
• find things you can laugh about – humour is good for your physical and mental health

Self-harm

Self-harm is a way of dealing with very strong emotions. For some people it gives the relief that crying may provide for the rest of us. Some self-harming people feel so angry and aggressive they can't control their emotions. They become afraid that they may hurt someone, so they turn their aggression inwards to get relief.

People who self-harm are often labelled as 'attention seeking'. However, a person who self-harms may believe this is the only way to communicate their distress, and self-harm can be a hidden problem that goes on for years. It may start as a spur-of-the-moment outlet for anger and frustration (such as punching a wall) and then develop into a major way of coping with stress that, because it remains hidden, generates more stress.
The severity of self-harm doesn't depend on the severity of a person's underlying problems. Usually, as time passes, the person who is self-harming becomes more accustomed to the pain they inflict on themselves and so has harm themselves more severely to get the same level of relief.
This spiral can lead to permanent injury and serious infections.

Types of self-harm

The most common forms are cutting the arms, hands and legs, and less commonly the face, abdomen, breasts and even genitals. Some people burn or scald themselves, others inflict blows on their bodies, or bang themselves against something.
Other forms of self-harm include scratching, picking, biting, scraping and occasionally inserting sharp objects under the skin or into body orifices, and swallowing sharp objects or harmful substances.
Common forms of self-injury that rarely reach medical attention include people pulling out their own hair and eyelashes, and scrubbing themselves so hard they break the skin (sometimes using cleaners such as bleach).

How common is it?

About ten per cent of admissions to Greek medical wards are as a result of self-harm. Women are at the most risk of self-harming between the ages of 15 and 19; men, between 20 and 24. Women have higher rates of self-harm than men.

Methods of self-harm vary, but the majority of hospital admissions are for drug overdoses - only five to 15 per cent are caused by cutting. These figures probably hide another group of people who regularly self-harm to relieve stress. These people have usually found ways to keep their problem hidden and, when they do harm themselves badly enough to need treatment, will often have a story prepared, or will not seek help at all. The result can be permanent disfigurement or a serious infection.

About half the men admitted to hospital for self-harm and a quarter of women have drunk alcohol in the hours beforehand. This is a very worrying figure. A person who has taken a drug overdose runs the risk of the drugs interacting with the alcohol. Both could become more potent when mixed, with tragic consequences.

You're not alone

If you self-harm as a way of coping with stressful or difficult feelings, such as anger, frustration or worthlessness, the important thing to realise is that you're not alone. Many people do this and come through it. There is help out there.
The kind of personal exploration needed to resolve these issues is often best done with a mental health professional or counsellor. But this doesn't mean that people who self-harm can't take some control of their situation.

Self-help

Most people who self-harm want to stop hurting themselves and they can do this by trying to develop new ways of coping and communicating. However, some people feel a need not only to change their behaviour but also to understand why they have resorted to harming themselves.
There are a number of techniques that can reduce the risk of serious injury or minimise the harm caused by self-inflicted injury. This list is not exhaustive - different people find different things useful in various situations. So if one doesn't work, try another.
• stop and try to work out what would have to change to make you no longer feel like hurting yourself
• count down from ten (nine, eight, seven)
• point out five things, one for each sense, in your surroundings to bring your attention on to the present
• breathe slowly - in through the nose and out through the mouth.

If you still feel like cutting, try:
• marking yourself with a red water-soluble felt-tip pen instead of cutting
• a punch bag to vent the anger and frustration
• plunging your hands into a bowl of ice cubes (not for too long, though)
• rubbing ice where you'd otherwise cut yourself

Professional help

Self-harm is almost always a symptom of another underlying problem. While the problem can be addressed directly through behavioural and stress-management techniques, it may also be necessary to look at and treat other problems. This could involve anything from medication to psychodynamic therapy.
Most local mental health teams are prepared to see and assess people who self-harm but, where the underlying problems are too complex, may decide to refer the patient to more specialist services.
Drugs used to treat heroin addicts may behelpful with self-cutters, but mostly for those who describe a 'high' after they've cut themselves.

Suicidal feelings

To take one's own life is probably the single most extreme expression of hopelessness that any person can make. It's important to distinguish between impulsive acts of self-harm and planned, organised attempts to end your own life. In most suicides, the person has taken steps to ensure they aren't discovered until afterwards.
Having said that, most people contemplating suicide do try to raise the subject with a relative, friend or doctor.
Unemployed men living on their own are the most likely to commit suicide. While about one per cent of deaths in Greece are because of suicide, this number is higher for people with:
• depression
• alcohol or drug problems
• schizophrenia
• personality disorders
• long-term physical illnesses.

If you're considering suicide

If you're reading this, you're probably in a lot of pain emotionally or physically, or both. No one takes the decision to end their life without believing there is very good reason. Many people feel that the burdens they have to bear outweigh their coping resources.
But before you finally decide, please consider these points:
1. By reading this page you've already put space between your suicidal feelings and your actions. It's worth making more space, and putting off the decision until you've spoken to someone who might be able to help you with your pain. Don't burden yourself by trying to cope alone. Just talking about how you came to feel this way releases a lot of pressure, which might be exactly the additional coping resource that you need.
2. Be careful who you speak to about your feelings. Some people simply won't understand. They may feel frightened or angry - this has more to do with their state of mind than yours - and may make your pain worse. But there are people who understand and can help you through this traumatic time. One option is getting in touch with your local community mental health team (you can reach them via your GP or your local accident and emergency department).
3. Feeling suicidal is in itself a traumatic experience, quite apart from the circumstances that led you to feel this way. Once you've got through this, it's absolutely essential that you continue to look after yourself and get the support that you need.

What to do if someone discusses suicidal feelings with you

If a friend or relative comes to you with feelings of depression or hopelessness, then you're clearly seen as someone who's sensitive and who can be trusted. It may not feel like it at the time, but it's quite a compliment if someone feels able to talk to you about this. Try to remember the following points:
• They have come to you because of the person you are - don't try to be any different.
• There are no 'right' things to say. If you're genuinely concerned, you will show it without having to put on an act.
• Try to remain calm and be sympathetic. Don't argue, try to solve problems or give advice. A problem that may seem not so bad to you could be a major life trauma for someone else.
• Rather than trying to find the right thing to say, encourage the other person to talk about how they feel - and listen. Don't be afraid of silences. Ask questions that need more than a "yes" or "no" answer. Letting the person unload their feelings will probably make them feel much better.
• Statements such as "I want to go to sleep and never wake up," or "I feel so low, I can't go on like this" may suggest suicidal feelings. If this does happen, ask in a calm, clear manner: "Are you thinking about suicide?" You're not putting the idea in their head. If they haven't considered suicide they'll probably just dismiss the idea. If they have considered it they'll probably feel relieved that someone has realised just how desperate they're feeling.
• If they answer "yes", ask how far they've got in planning their suicide. Have they worked out the 'how,' 'where,' and 'when?' If they've worked out two or more of these they are probably seriously considering suicide. Continue to offer a listening ear and sympathy, but also be clear that they need to get professional help. They may well be nervous about doing so, but an offer to go with them could be enough to persuade them to go. You could try your family doctor, your local community mental health team