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Words written in bold indicate that there is an entry on that subject. At the end of an entry, clicking on , or will take you to details of a relevant organisation, website or book, respectively.

dance and movement therapy
If you are distressed, you may well be concentrating on problems in your head and ignoring your body’s reactions. Dance and movement therapy enables you to become more aware of your body and find ways of expressing your feelings through gesture and movement. See creative therapies.

delusions
These are distorted ideas about the world, and people who have delusions may be out of touch with reality. They may, for example, believe that someone is deliberately putting thoughts into their mind or extracting their thoughts with a machine. Other common delusions include believing you are being pursued by secret agents, or that someone is plotting to harm you in a particularly bizarre way, or that you are someone else, such as a member of the royal family. No amount of rational argument or reassurance will change these beliefs. See schizophrenia and manic depression.

depression
It is quite normal to feel down or miserable from time to time. However, if these kinds of feelings begin to dominate your life so that you can no longer cope, or if they are more severe or long-lasting than might have been expected, you may well be 'clinically' depressed. Depression often occurs alongside other mental health problems such as anxiety.

There are a number of symptoms:

• sad, hopeless or irritable mood
• loss of interest or pleasure in nearly all activities
• lack of energy
• slowing down of mind and body
• increased agitation and restlessness
• changes in eating and/or sleeping patterns
• problems in concentrating, remembering and making decisions
• low self-esteem
• guilt
• feeling isolated and cut off from others
• difficulty in showing affection

In very severe depression, there may be delusions or hallucinations and recurrent thoughts of death or suicide.

Anyone can become depressed, but some people are more vulnerable to depression than others. The causes vary from person to person and may include stresses and upsetting events that have occurred recently or in the past.

Left untreated, depression can last for months or even years, causing great distress to the person and to those close to them. Early treatment can often prevent depression from worsening and can alleviate the symptoms, so see your GP as soon as possible.

Not all treatments work equally well for everyone and your doctor will need to find the one suitable for you. If antidepressants are prescribed, other treatments or support should also be offered, such as counselling, cognitive behaviour therapy or supportive discussions on ways to cope.
[depression] [depression] [depression]

'If you break your leg, you can talk about it, but if you are depressed, you're often treated as though you are mad.'

desensitisation
In this behaviour therapy technique, you will be asked to list the situations that make you most anxious. If you are frightened of spiders, for example, these might range from seeing a picture of a spider to holding a spider in your hand. Starting with the least threatening, you will gradually overcome your anxiety in each situation with the help of relaxation exercises and the support of the therapist. You may prefer to work through the situations in your imagination before gradually confronting them in reality.

drama therapy
In this, you might be asked to act out a story, improvise a scene, interpret a poem or create a character. This kind of activity gives you the opportunity to explore various sides of your personality and test your reactions in imaginary settings. See creative therapies.

eating disorders See anorexia nervosa, bulimia nervosa

ecstasy
Also known as 'XTC', 'pills', 'jubes', 'smarties' and 'doves', this is a mind-altering stimulant drug that is usually sold in capsule or tablet form and taken by mouth. People usually take ecstasy to feel more relaxed, energetic and exhilarated and able to experience things with more intensity, especially music. However, some people have adverse reactions such as feeling unsteady, sick, anxious or persecuted.

Ecstasy speeds up the heart and breathing. It also raises body temperature, and this, combined with dehydration and exhaustion from dancing in a hot atmosphere, can be dangerous. Sipping water - but no more than about a pint an hour - and taking frequent rests can help to reduce the risks. Drinking alcohol will make dehydration worse.

The drug usually takes 30–60 minutes to take effect and may last several hours. Once it wears off, you will feel tired and possibly anxious and depressed. This is even more likely with high and repeated doses. Some long-term users report symptoms such as general anxiety, panic attacks, depression, insomnia and confusion; general health may also be affected.

Ecstasy is dangerous if you suffer from high blood pressure, heart problems, diabetes, asthma or epilepsy. It also is dangerous to mix ecstasy with other drugs, particularly other stimulants or antidepressants. It is important to be aware that some ecstasy tablets contain other drugs, which could be dangerous. Testing a small amount first could help to reduce the risk.

If you feel you have become dependent on taking ecstasy and want to stop, seek support.
[drug misuse] [ecstasy] [drugs]

ECT (electroconvulsive therapy)
In this, the person is given a short-acting anaesthetic and a muscle relaxant. An electric current is then passed through the brain causing a minor convulsion ('fit'), which appears as not much more than a twitch. The person then rests for a couple of hours and, afterwards, may experience some minor discomfort.

A course of ECT usually consists of six to eight sessions over a two- to three-week period. Most people notice considerable improvements after just two or three sessions. There may be some memory loss, usually temporary, relating to the weeks during which the treatment took place.

ECT is an uncommon form of treatment. It may be given to people with very severe depression who fail to respond to other forms of treatment or to people whose symptoms are so severe that they are a danger to themselves. It is very rarely given to young people.

education welfare officer (EWO)
An education welfare officer, also known as an education social worker (ESW), can provide help if you are having problems that affect your schooling such as missing school, falling behind in your work or being unable to settle down at school. The EWO will try and find the reasons for your difficulties and then look for ways of enabling you to deal with them. These might include getting support from your teachers or other sources of help. See school phobia.

educational psychologist
In addition to having a degree in psychology, which includes the study of normal and unusual behaviour, and further specialist qualifications, educational psychologists are also trained and experienced teachers. They may help you sort out problems that are related to learning and to school, or they may advise your school on ways to help you.
[psychologists]

exposure treatment
This behaviour therapy technique, also known as 'flooding', encourages you to confront completely whatever frightens you, with the support of a therapist. At first, your anxiety will increase, but if you can remain in the situation for half an hour or so, you will find that it subsides naturally. Once you have overcome your fear with the therapist present, you can practise with friends and then on your own. If you are happier with a more gradual approach, the therapist may set more limited weekly targets.

This technique might also be helpful if you have problems with compulsions. The therapist will place you in circumstances that normally give rise to your compulsive behaviour and ask you to refrain from carrying it out for as long as possible. At first, your anxiety will mount, but after a time, it will subside. This will help you to realise that nothing dreadful occurs if the compulsive behaviour is not carried out

family therapy
Children and young people are usually affected by any problems occurring within their families, and other family members can be affected if a young person becomes distressed or starts behaving in an unusual way. If you or other members of your family are upset and finding it hard to cope, you may be offered family therapy.

This involves family members working with specially trained professionals to try and find the reasons for the problem and discover ways in which everyone can help. Family therapy is usually concerned with how people are getting on here and now, but it is sometimes helpful to think about the past and how important events have affected the family. Quite often you discover a new way of looking at the situation or that small changes in behaviour by different family members are all that are needed.

'You have to talk about problems or have a nervous breakdown.'

flooding See exposure treatment

gay or lesbian orientation
Although being gay or lesbian is, in itself, quite natural, many young people feel very anxious and confused when they first discover they are attracted to someone of the same sex. They may worry about being different, and they may try to hide or suppress their feelings for fear of disapproval or rejection by their family or friends. Worries about their sexual orientation may begin to get out of hand, sometimes resulting in depression and other problems.

Sometimes attraction to someone of the same sex is a passing phase, but many young people feel quite certain of their sexual orientation. The more open you can be with family and friends, the better, but if you find this difficult, you may find it helpful to approach an appropriate organisation for support.
[gay and lesbian]

general practitioner (GP)
Your GP is there to look after your psychological as well as your physical health. If you are feeling very anxious, stressed or depressed, for example, or if you are worried about your own behaviour or ability to cope, go to see your GP. The sooner your problem can be identified, the more quickly appropriate support and treatment can be offered.

Our minds and bodies interact very closely (see mind–body interaction), and your GP will want to make sure that there is no physical illness or condition that may be causing or contributing to your problems before exploring other possible reasons. Your doctor may offer you support or treatment him/herself or may refer you to other sources of help.

Many young people share their GP with other family members, but you can ask your doctor to keep things confidential unless your safety is at stake (see confidentiality).

group therapy
This is a way in which a number of people can explore their problems and anxieties together with the help of professionals. Group therapy can often be particularly helpful when individuals are experiencing similar difficulties, or if they feel more relaxed and able to communicate with people their own age rather than with an individual therapist. You may find that it is easier to be honest with young people than with adults and to accept their suggestions and criticisms. You will also probably gain in understanding and confidence through helping other people work through their problems.
[counselling and other therapies]

'My first choice would be an outsider who'd been through what I'd been through. You could click through that – you relate on that level. They can handle it, they know where to stop and what to ask.'

hallucinations
These are perceptions that others do not share but which are very real to the people experiencing them. They may see, hear, touch, feel or smell things that are not apparent to others and for which there is no external evidence. For example, they may hear voices commenting on what they are thinking or urging them to take certain actions. They may then reply to these voices either silently or out loud.

Quite a lot of young people experience hallucinations, especially when they have a high fever or are under the influence of drugs, but this may be a sign that the person is out of touch with reality. See schizophrenia.

heroin
Also known as 'smack', 'skag', 'H', 'junk' and 'brown', this is an opiate – one of the drugs derived from the opium poppy, which also include opium, morphine and codeine, and synthetic drugs such as pethidine and methadone. Many opiates, including heroin, are used for medical purposes.

Heroin is also commonly used illegally. It can be snorted up the nose, injected in a solution or heated on tin foil and smoked ('chasing the dragon'). Opiates slow down the heart and breathing and, in higher doses, produce drowsiness. People take heroin to stop worrying and to feel safe, warm and contented.

If you use heroin or other opiates illegally, you run the risk of becoming dependent, particularly if you are using them because you feel anxious or unable to cope. After a few weeks of frequent doses, many people experience withdrawal symptoms if they stop using abruptly ('going cold turkey'): vomiting, sweats, chills, cramps, insomnia, hallucinations. This can encourage them to continue using the drug.

Long-term use of heroin or other opiates can sap your motivation and affect relationships, work, study and your general health. Injecting heroin presents the greatest health risk. Unexpectedly pure heroin may lead people to overdose. Taking heroin or other opiates with alcohol or tranquillisers is dangerous and can lead to breathing failure or coma. Sharing needles is one of the main causes for the spread of AIDS in the Western world. And because it is illegal and maintaining a 'habit' is expensive, using heroin often leads to criminal behaviour and its consequences.

If you want to stop using heroin, seek appropriate support.
[drug misuse] [heroin] [drugs]

lesbian orientation See gay or lesbian orientation

Librium See benzodiazepines

lithium
This drug is sometimes prescribed for very severe depression or to help control mild bouts of mania. It is also sometimes prescribed as a maintenance treatment to help prevent episodes of mania and depression or reduce their severity and frequency (see manic depression).

If you are prescribed lithium, you need to be very careful as there is only a very narrow margin between a dose that is high enough to be effective and one that is dangerous.

LSD (lysergic acid diethylamide)
LSD, also known as 'acid', is a powerful hallucinogen – that is, a drug that alters the way you perceive things. Its effects usually occur 30-60 minutes after taking the drug and last 8–12 hours or longer.

LSD's effects depend very much on your state of mind when taking it. For example, you may feel a sense of heightened self-awareness and colours may appear intensified and patterns distorted. Familiar objects and people may seem new and fascinating, and some individuals report feeling as though they have moved outside their bodies.

However, LSD is unpredictable and you may experience unpleasant and even frightening reactions – a bad 'trip'. You may feel dizzy, confused, anxious, panicky or persecuted or as though you are dying or losing your mind. Occasionally a bad trip may have longer-lasting effects, such as recurring anxiety attacks, but these usually fade with time. Even following a good experience with LSD, you may feel anxious and depressed afterwards, and flashbacks of the experience can occur several days or weeks later.

Long-term use of LSD may increase anxiety and depression or trigger other mental health problems.
[drug misuse] [LSD] [drugs]

magic mushrooms
These contain natural hallucinogens – substances that alter the way you perceive things. The most commonly used type in the UK is the liberty cap, but other mushrooms are also used. Magic mushrooms are eaten or boiled and mixed with tea and drunk.

At low doses, magic mushrooms can give you a mild feeling of elation. You may feel very relaxed and laugh a lot. At higher doses, the effects can be very similar to those of LSD, but they are not as long lasting. If you have a bad experience with magic mushrooms, you may feel anxious or even terrified. In some cases, you may still feel upset even when the effects of the drug have worn off. You may also have stomach pains, feel sick or throw up afterwards.

The biggest risk from magic mushrooms is poisoning yourself by taking the wrong sort. Identifying mushrooms is tricky, and consuming ones that appear to be magic mushrooms but are not could prove fatal.
[drug misuse] [magic mushrooms] [drugs]

manic depression
Also called 'bipolar affective disorder'. In this condition, people experience swings of mood, to mania (extreme elation and over-activity) or severe depression or both. These periods are usually interspersed with times of more or less normality. Manic depression is very rarely diagnosed in young people below the age of 14, but can occur at any time in life from then on. The frequency, intensity and length of episodes varies between individuals and often at different times of a person’s life.

Many of the symptoms experienced in mania and mild mania (hypomania) are almost the reverse of those experienced in depression. They include greatly increased activity and energy, a decreased need for sleep, excessive self-confidence and lack of self-criticism. In the early stages, ideas flow rapidly, speech accelerates and you may be highly creative and amusing.

In later stages, however, thoughts race, speech becomes incessant and incoherent, you are less inhibited and your judgement is affected. This may lead to highly confrontational behaviour, hurtful comments, numerous sexual liaisons or disastrous spending sprees. Those with severe mania may experience unintelligible speech, delusions and hallucinations.

It is important to seek help from your doctor at an early stage as prompt treatment can limit the severity or length of an attack. At a later stage, you may no longer be in control of your own actions, and others may be forced to seek help for you (see compulsory detention).

Antipsychotic drugs may be prescribed for episodes of mania and antidepressant drugs for severe depression. Lithium may be prescribed for mild bouts of mania or as a maintenance drug to help control the condition. You should also be offered support to enable you to regain your confidence and readjust to a normal life. Some form of therapy such as counselling may be helpful at an appropriate time.
[manic depression] [manic depression] [manic depression]

mental health officer (MHO) See approved social worker (ASW)

mind–body interaction
Our minds and bodies are very closely linked. Emotional and psychological factors play a part in many physical illnesses, just as physical illness may affect our emotional and psychological well-being. For instance, someone who is emotionally stressed may experience various aches and pains, and someone who is unwell may become anxious or depressed. You should also be aware that emotional problems such as depression can sometime follow certain illnesses such as influenza or glandular fever or occur as side-effects of certain drugs. See also psychosomatic illness.

Monoamine oxidase inhibitors (MAOIs) See antidepressants

music therapy
In this, you will use your voice or a simple instrument such as a drum to explore sounds and express your feelings. The music therapist will respond musically in the same mood, thereby showing that he or she understands your emotions. Once trust has been built up, you may feel more confident to look at some of your anxieties. See creative therapies.

neuroses
Mental health problems such as anxiety, phobias, obsessions and some forms of depression may sometimes be referred to as neuroses or neurotic disorders. Those affected by neuroses may be very distressed, but they usually know that something is wrong and are able to cope with most aspects of their lives in a rational way. See psychoses.

'If I were to tell my mates how I really feel, they would think I was off my head. I known I'm not mad, just bloody unhappy.'

nicotine See tobacco

nitrites (poppers)
Amyl and butyl nitrites are stimulants derived from nitrous oxide ('laughing gas'). Yellow in colour, they are highly flammable. When used recreationally, they are inhaled.

Nitrites lower blood pressure and make the heart beat more quickly, pumping blood to the brain. This often results in a rush of energy, which heightens sensory experiences; afterwards, you may feel light-headed for a few minutes. However, some people experience a severe headache, flushes, dizziness or nausea, and there is a small risk that you may black out. Repeated use can cause a rash around the mouth and on the neck.

Nitrites will burn the skin if they come into contact with it and they can be fatal if swallowed. They should never be used by someone with low blood pressure, heart or breathing problems or glaucoma. Using nitrites at the same time as other stimulants or other drugs that lower blood pressure is also extremely dangerous.
[drug misuse] [nitrites] [drugs]

obsessions
In the context of mental health, these are unwanted and intrusive thoughts, ideas, images or impulses that keep recurring despite efforts to resist them. There are many different types, including worries about becoming contaminated or of harming yourself or someone you care about. Obsessions about doing wrong or having done wrong or having the odd bad thought become more common during adolescence. They sometimes occur alone, but often they give rise to compulsions that may or may not be connected with the obsessions.

It is not clear what causes obsessions, but if you experience them, you will probably find them quite distressing as they will seem to be uncontrollable even though you realise that they are irrational. Try and seek help at an early stage. Behaviour therapy can be an effective treatment.
[obsessions]

'I wonder if I'm going to be run over by the next car. Nobody's safe any more. You're not even safe at school.'

occupational therapist (OT)
You may come into contact with an occupational therapist if you are admitted to hospital or attend an adolescent unit. The OT’s aim is to help you to become more confident and independent through developing your skills and interests. This may include improving your practical skills such as shopping, cooking, budgeting and filling in forms, or improving your social skills in situations such as a job interview or asking a friend for lunch. You may work with an OT individually or in a group.
[occupational therapist]

panic attacks
These are periods of intense fear and discomfort that often seem to come out of the blue and may last from several minutes to up to an hour. If you have a panic attack, you may experience one or more distressing symptoms:

• difficulty in breathing
• faintness
• dizziness
• palpitations
• choking sensations
• flushes or chills
• trembling or shaking
• chest pain
• tingling or numbness in the hands and feet
• nausea
• feelings of unreality
• fear of losing control, going mad or even dying

Because panic attacks are usually unpredictable, you may also become anxious about having one at an inconvenient time and may restrict your activities accordingly. This can disrupt your life and make you less confident.

If you have had several panic attacks, see your GP. He/she will check that there is no physical cause for your symptoms and will advise you how to cope. Relaxation exercises and cognitive behaviour therapy can usually help.
[panic attacks]

parents with mental health problems
If you have a parent with a mental health problem or drug or alcohol addiction, you are likely to feel isolated and under a lot of stress. Your parent’s behaviour may be very unpredictable and you may be faced with a great deal of responsibility, both for your parent and for the rest of the family. You may well find it hard to concentrate on work or studies or lead a normal social life.

You should not struggle on alone. There is confidential help available. By taking advantage of it, you are not being disloyal to your parent and you will benefit the whole family.
[general] [general]

personality disorder
This term is used to describe people who have difficulty in learning from experience or in dealing appropriately with other people or the demands made by society. Odd or disturbed ways of behaving may become apparent in late childhood or adolescence and may continue throughout life, often leading to depression and anxiety.

There are a number of different types of personality disorders. They include people who behave in a very eccentric way or who are suspicious or mistrustful of others without reason or have difficulty in forming social relationships. Those who demonstrate persistent anti-social or aggressive behaviour, without understanding its effect on other people may also have a personality disorder. In addition, there are individuals who are highly anxious and unable to function independently or who express their anger in a passive-aggressive way by, for example, persistently and deliberately failing to complete work.

Of course, even if you recognise that you behave in a way similar to any of the above descriptions, this does not necessarily mean that you have a personality disorder. However, if you are worried that you may have one, talk to your GP. Some form of counselling or behaviour therapy may be helpful.
[personality disorder]

phobia
This is an acute fear that is quite out of proportion to the actual object or situation involved. Phobias range from fear of spiders to fear of public places (agoraphobia) or of eating in public (a type of social phobia). If you have a phobia, you will be aware that your fear is quite irrational, but knowing this will not help you to reason it away.

People with phobias experience extreme anxiety and sometimes even panic attacks when faced with the object or situation they fear. They may also become distressed simply by worrying about the possibility of such an occurrence and how they would cope, which further adds to their anxiety. Most people with phobias cope by avoiding the object or situation of their fear, but this can considerably restrict their lives and undermine their self-confidence and may even make the phobia worse.

Sometimes phobias disappear of their own accord after several months, but if yours persists for longer and affects your life, you should seek help. Behaviour therapy is often a very effective treatment.
[phobia]

'I know things like cotton wool and stairs can't really hurt me, but it doesn't stop them making me nervous.'

post-traumatic stress disorder (PTSD)
If you have experienced a very upsetting event, either as a victim or eyewitness, you may feel distressed for a long time afterwards. Such events might include a serious accident such as a train or car crash, sexual abuse, a violent crime or a disaster such as war or an earthquake. This distress – known as post-traumatic stress disorder – may occur soon after the event or some time later and can take a number of forms:

• repeated intrusive memories or dreams of the incident
• flashbacks in which you feel you are reliving the experience
• feeling very upset by any reminders of the incident
• inability to remember important aspects of what took place
• difficulty in sleeping or concentrating
• irritability
• loss of interest in activities you have previously enjoyed

All these reactions are quite normal, given the circumstances, but it is very important that you have help and support to deal with your painful feelings. Emotional support from friends and family and professional help at an early stage in the form of individual counselling or cognitive behaviour therapy may make it easier for you to cope.

Longer-term problems such as difficulties in making close relationships may result if you try to suppress your feelings rather than working through them with appropriate support. However, it is never too late to seek help.
[PTSD] [PTSD]

psychiatrist
This is a qualified medical doctor who has undertaken further specialist training in mental health. Some psychiatrists will have additional specialist skills in certain areas such as eating disorders or addiction, and some may specialise in certain groups of people such as children and adolescents.

A 'consultant psychiatrist' is someone who holds a senior hospital post and works closely with other doctors who are at various stages of training in psychiatry. Even if you are referred to a consultant, you may be seen by one of these other doctors, who will then discuss your situation and treatment with the consultant concerned.

Psychiatrists usually work closely with other health professionals such as nurses and therapists as members of a team. See also child and adolescent psychiatrist.

psychologist See clinical psychologist, educational psychologist

psychoses
Mental health problems such as schizophrenia and manic depression are sometimes referred to as psychoses or psychotic disorders. Those affected by them are often out of touch with reality and have little or no understanding of their own condition. Their perceptions are likely to be distorted so that they are unable to distinguish between what is happening in the outside world and what is going on in their own internal world of confused thoughts and feelings. See also neuroses.

psychosomatic illness
The word 'psychosomatic' is derived from psyche meaning 'mind' and soma meaning 'body'. Psychosomatic illnesses are physical disorders that are largely caused or aggravated by emotional upset or psychological stress.

You might, for example, develop a skin rash in response to anxiety or you might develop back pain because you are depressed. The mind and body are very closely linked (see mind–body interaction) and your body is responding to your feelings in a physical way that is outside your control. Because of this, you may sometimes need help in dealing with your emotional or psychological difficulties before your physical symptoms can improve.

Sometimes people use the term 'psychosomatic' to imply that others are simply pretending to be ill. But psychosomatic disorders are just as real as purely physical ones – they just have an added psychological dimension to them.

psychotherapy
Psychotherapy offers people the chance to explore their feelings and anxieties on a one-to-one basis in confidence. The psychotherapist should listen without making judgements and offer support while you work through your problems at your own pace.

Counselling and psychotherapy are quite similar, but whereas counselling is more likely to focus on the present situation, psychotherapy will look more closely at the past, in the belief that the roots of many of problems lie in early childhood experiences. The psychotherapist will try to build up a relationship of trust with you so that you feel safe to explore your past to gain a better understanding of your present difficulties. Such an approach is sometimes referred to as 'psychodynamic'.

If you see a psychotherapist privately, make sure that the one you chose has been recommended by someone you trust or by a suitable organisation.
[counselling and other therapies]

'It would be good if everyone could talk freely about how they feel, without being made to feel there is something wrong with them.'

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