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relaxation exercises
Being able to relax is vital for your physical and mental well-being, particularly when you are under stress. It is a way of renewing your energy so that you are able to cope better. However, it is often when you are at your most anxious and tense that you find it hardest to relax. Tension builds up and you become even more stressed. If you find yourself in this situation, relaxation exercises will usually help to relax your body, and in the process, your mind will become calmer, too.

All relaxation exercises involve learning to breathe more fully using the diaphragm and a method of muscular relaxation, such as tensing and relaxing the main muscles in turn. Your GP or practice nurse can probably suggest relaxation exercises for you. Once you have learned them, you should practise regularly at home until you find it easy to relax in stressful situations.
[relaxation exercises]

Ritalin See attention deficit hyperactivity disorder (ADHD)

schizophrenia
This is the most common form of severe mental illness, affecting about 1 in 100 people before the age of 45. It usually first occurs in adolescence, though it can begin at any time, and the onset can be sudden and dramatic or build up over time. Some people have one episode and fully recover, while others may have a number of episodes and recover in between or need considerable support throughout their lives.

In schizophrenia, the different parts of the mind such as thoughts, sensations, memories and emotions no longer function harmoniously together but become confused and disordered. As a result, you are no longer able to trust your own reactions and may have difficulty in distinguishing between fantasy and reality.

There is a wide range of symptoms in schizophrenia and you may experience different ones at different times. They include symptoms such as disturbances in thinking, delusions and hallucinations (including 'hearing' voices), which often respond well to treatment with antipsychotic drugs. Other symptoms – such as lack of energy and motivation, difficulties in concentrating and loss of interest in other people or activities – respond better to a supportive routine and just the right amount of stimulation.

If you are affected by schizophrenia, you are probably aware that things are not right, but you are unlikely to know that you need help. Friends or relatives will need to persuade you to see your GP who may in turn refer you to a psychiatrist.

Drug treatment may be suggested if appropriate, but you should always be offered other forms of support as well. This might include regular supportive discussions with a health professional to help you re-establish some sort of structure in your life, social skills training to restore your confidence, or attendance at a day centre, drop-in centre or training project. Professionals may also work with your family to help them find ways of offering you the right sort of support (see family therapy).
[schizophrenia] [schizophrenia] [schizophrenia]

school nurses
These are qualified nurses who have extra training in working with young people and work in some schools. A school nurse can offer information, advice and support on a range of problems such as relationships, bullying, exam worries and taking drugs. Young people often find it helpful to talk to a school nurse in confidence (see confidentiality).

school phobia
Also known as 'school refusal', this is a reluctance or a refusal to attend school usually caused by anxiety. It is not the same as bunking off school because the person is bored or wants to do something else.

School phobia occurs across all age groups and abilities, but it is more common in early adolescence and usually develops gradually. You may have physical symptoms of anxiety such as aches or pains or feeling sick as the time to go to school approaches. If you remain at home, these symptoms will disappear and they will not occur at all at weekends and on holidays.

It is important to sort out as soon as possible just why you are feeling anxious. The more school you miss, the harder it will be for you to return. If your reluctance to go to school is due to teasing, bullying or other school pressures, these should be sorted out with the school. Your family or a professional such as an education welfare officer can help you to do this. If it is due to other anxieties or stresses, talk to your GP. He or she may be able to help or may suggest that you have counselling, family therapy or social skills training, for example, to help you cope and support your return to school.
[school phobia]

'I sit in my room and cry even though there is no reason to be unhappy. I worry about my GCSEs even though everybody tells me to slow down because I work too hard.'

sectioning See compulsory detention

selective serotonin re-uptake inhibitors (SSRIs) See antidepressants

self-harm
Also known as self-injury, this involves deliberately hurting yourself. This might be through cutting, burning or bruising yourself or by taking an overdose of tablets. It often starts around the age of 14 or 15 and can continue for many years. Self-harm is usually carried out in secret as many of the people who do it feel very ashamed and guilty.

People who self-harm may get relief from unpleasant feelings for a while but, at other times, are likely to feel anxious or depressed and have low self-esteem. While the reasons why people self-harm are not clear, it is known that some have suffered trauma or abuse of some kind, including sexual abuse. Although some forms of self-harm, such as cutting, do not involve thoughts of suicide, people who self-harm repeatedly are more at risk of suicide.

If you self-harm and want to stop, get support for yourself. Talk to your GP or another health professional who will understand. If that is too difficult, ring a telephone helpline.
[self-harm] [self-harm] [suicide and self-harm]

'What helped was having someone to talk to who was reliable and didn't rush me. I haven't done anything to myself for ages now. Sometimes I feel like it, but I don't need to do it any more and the feeling goes.'

sexual abuse
This can include different types of activities ranging from showing pornographic material and inappropriate kissing, touching or fondling to sexual intercourse. It happens to both boys and girls and can be either heterosexual or homosexual.

It occurs when you are trapped in a sexual situation against your will because you are too young, frightened and/or confused to object. Sexual abusers are often known to those they abuse. For instance, they may be relatives or family friends who are betraying a position of trust. They are likely to insist on secrecy, frightening you about what will happen if you tell.

People affected by sexual abuse react in different ways, but the effects – in both the short and the long term – can be very serious unless appropriate help and support is given. If you have been abused, you may feel guilty, unclean, worthless, powerless and ashamed even though it was not your fault. Sexual abuse is often a major contributory factor in anxiety, depression, eating disorders, running away, alcohol and drug misuse, sexual and relationship problems, self-harm and suicide.

If you are being or have been sexually abused, it is important to tell someone who will be believe you, however hard that may seem. This is necessary to stop the abuse, to prevent others from being abused in the same way and to get support for yourself. Your GP, a social worker or school nurse can refer you for specialist help that may include counselling or group therapy. If you find it difficult to talk to someone face to face, take the first step by ringing a helpline to talk things through.
[child abuse] [sexual abuse]

smoking See tobacco

social phobias
These involve worries about performing ordinary activities in front of other people. If you have a social phobia, you might be worried about speaking in front of other people in case you suddenly dry up, eating in public in case you choke, or writing in public in case your hand shakes. Treatment usually involves some form of behaviour therapy. See also phobias.
[phobia]

social worker
The social services department of your local authority will have social workers who have experience in working with young people and families, as well as social workers with experience in mental health problems. They can help by offering information on practical matters, advising on ways of coping with pressures and stresses and suggesting other sources of help. Who you see will depend on your age and the way your local social services is organised. See also approved social worker.

solvents
These are products whose vapours act as depressants (downers) when inhaled. They include various glues, cleaning fluids and paints, gas lighter fuel, petrol and the gases in aerosols and fire extinguishers.

The effects of inhaling solvents may partly depend on your mood, your personality and the situation you are in. You may lose your inhibitions and feel more outgoing and sociable. On the other hand, if you already feel down, you may become more depressed. You may also feel giddy, sick or drowsy. Afterwards, you may experience a sort of hangover – for instance, headaches and poor concentration – for about a day. Larger doses can make you feel out of control and confused, and you may even pass out. Long-term use can cause health problems and lead to serious depression.

You need to be aware that, if you pass out while using solvents, you could die through inhaling your own vomit, and if you pass out with a plastic bag over your head, you could die through suffocation. Aerosols or butane gas sprayed directly into the mouth can also cause breathing difficulties or suffocation.
[solvent misuse] [solvents]

stress
Too much stress over a long period of time can lead to anxiety, depression and other mental health problems. The amount of stress each person can cope with varies considerably and may also vary at different times in their lives. Finding the right balance for you is important, as too little activity and stimulation can sometimes be just as stressful as too much.

There are a number of situations that can give rise to stress:

• problems at school or work
• difficulties with relationships
• taking on too many responsibilities
• working constantly against the clock
• confronting new situations
• experiencing big changes in your life
• coping with uncertainty
• feeling unappreciated
• feeling that you are not in control
• past difficulties that have not been sorted out

It can sometimes be hard to deal with stress on your own. You may need to sort out your priorities and what you want from life, find ways of saying 'no' to inappropriate demands or improve your low self-esteem. Talking things over with your GP or another health professional may help you to find ways of coping. Depending on the causes of your stress, counselling, cognitive behaviour therapy or assertiveness training may be helpful.
[stress]

'I'm under lots of stress and my family don't understand. They don't know how hard it is for me to keep up my grades and cope with all the homework thrown at me.'

suicide
Intentionally killing yourself is now the second most common cause of death – after accidents – among young people aged 15-24. More men than women commit suicide, though more women make suicide attempts that are unsuccessful ('parasuicide'). About 90% of people who attempt suicide take a drug overdose. Violent methods of taking one’s life are far more common among men.

Difficulties such as severe depression, alcohol or drug misuse, eating disorders, manic depression and schizophrenia may make suicide more likely. However, many young people who are not affected by such problems may attempt it. Overwhelmed by problems or strong emotions, they may lack the experience to know that they will come through it in the end.

It is impossible to prevent all suicides, but everyone should be aware of the warning signs. A person contemplating suicide may:

• become very withdrawn
• express feelings of uselessness and hopelessness
• constantly dwell on problems for which there seem to be no solutions
• set their affairs in order
• talk about killing themselves

Suicide can be a very real risk if someone has had severe depression, although people often kill themselves just when their depression starts to improve. In some cases, there may be no obvious warning signs.

The idea that people who talk about suicide never actually do it was discredited a long time ago. If someone brings up the subject of suicide, even as a casual remark, always be prepared to listen and encourage them to talk. It may be upsetting for you, but it is often a relief for the person to be able to say openly what they feel. Never express disbelief about what they are saying or you may push them into a 'dare' situation. Show them that you take their feelings seriously and stay with them if they are distressed. You don’t have to find solutions to their problems, but you can emphasise how important they are to you and others. If you feel it is urgent, persuade them to see their GP immediately. If they refuse to do this, you could ring the doctor or the Samaritans for advice.

If someone has taken a drug overdose, however small, they should be taken at once to the nearest hospital accident and emergency department. Even if the attempt seems trivial or was carried out very publicly, it should be treated as serious. Some drugs, such as paracetamol, can cause serious permanent damage to health or can be fatal, even in small amounts.

Anyone who makes an unsuccessful suicide attempt will need a great deal of support afterwards. Some attempts are carried out in such a way that rescue is possible and, indeed, likely. These should be regarded as serious cries for help rather than as ways of seeking attention. Appropriate help following a suicide attempt can sometimes prevent it happening again. This may involve identifying someone who the person can talk to if they feel suicidal again or help with resolving family or relationship problems.

It is an overwhelming shock when someone close to you takes their own life. You may find yourself experiencing the emotions associated with any bereavement with the additional burden of blaming yourself because you were unable to prevent it. Even if the person wasn't successful in their suicide attempt, it can be hard to deal with your feelings. Make sure you get support for yourself - for instance, by talking to understanding friends or to your GP.
[suicide] [suicide] [suicide and self-harm]

'I didn't think there was any way out of my situation, so I took loads of tablets. I felt so bad, I just wanted to die … and I nearly did. Now things are different, and I'm so glad to be alive.'

tobacco
As well as many other substances, this contains nicotine, which is responsible for the extremely high proportion of smokers who become dependent on tobacco. It acts almost instantaneously, stimulating the central nervous system and thus reducing fatigue, increasing alertness and improving concentration. People often find it helps to relax them and reduce stress. Its effects decline rapidly.

Nicotine is particularly habit-forming because its effects are so brief and because tolerance builds up so quickly. Sudden withdrawal can cause headaches and insomnia as well as anxiety and depression and a craving to smoke. The more and the longer you smoke, the greater the risks to your health from illnesses such as lung cancer, heart disease and bronchitis. If you want to stop smoking, seek support.
[smoking] [smoking] [smoking]

tolerance
People using drugs, including nicotine and alcohol, for some time are said to develop a tolerance to them. This means that they gradually have to take more to achieve the same effect.

tranquillisers See antipsychotic drugs, benzodiazepines

tricyclic antidepressant drugs See antidepressants

Valium See benzodiazepines

violence at home
Violence in the family may take the form of shouting or threats or physical abuse such as one parent hitting the other or one of the children.

Any form of violence gives rise to an atmosphere of fear. Sometimes parents resort to violence as a way of expressing their own angry feelings about a divorce or unemployment. Sometimes it may be due to too much drink or a mental health problem (see parents with mental health problems). In other cases, it may be because they have never learned that violence is not an acceptable way of dealing with situations.

The experience of violence can lead to low self-esteem and problems such as depression, eating disorders or drug and alcohol addiction. Some young people react with rebellious behaviour such as truanting and lawbreaking, while others become overachievers, almost as if they think they will make things better by behaving perfectly. Moreover, although you have found the violence very frightening, you may – as you get older – also see it as a way of solving your own conflicts.

If you are in a family where violence occurs, you will need support for yourself and sometimes even protection. Seeking help is not being disloyal. It is a way of helping you to deal with problems or prevent them from occurring. It can also be a means of helping the whole family.

If the situation is very serious, you may decide to contact your GP or social services. However, once these are involved, they may have to take action under the law. You may first prefer to talk things through with organisations such as the Samaritans, ChildLine or the NSPCC Child Protection line. You could also approach your school tutor to see if any confidential counselling is available at school, or contact Youth Access to find your nearest youth information, advice or counselling service.
[youth counselling services] [youth counselling, advice and information centres] [violence]

voluntary hospital admission
The majority of young people who are admitted to mental hospitals or to psychiatric units of general hospitals are voluntary patients – that is, they have agreed to go into hospital of their own free will. Although parents or others responsible will make the arrangements for you if you are under 16, you should always be consulted. Voluntary patients are also known as 'informal patients'.

youth counselling, advice and information centres
These are run by a variety of organisations for young people, usually between the ages of 13 to 25. Help, which is always confidential, may be free or charged on a sliding scale, depending on your income. Some centres focus on specific issues such as drug problems, while others deal with a wide range of problems and/or offer counselling.
[youth counselling services] [youth counselling, advice and information centres]

'I didn't think I could talk to anyone I knew. I thought it would just make things worse. I just felt completely alone. I wrote to a problem page and they encouraged me to phone a helpline. Once I did that, they helped me have more confidence to get help.'

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