National Suicide Prevention Lifeline

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  • Substance Use Disorders | With Hope Foundation

    substance use disorders What is it? What Causes it? Signs / Symptoms Treatment / Therapies Substance Use Disorders What is it? What causes it? Signs/ Symptoms Treatments/ Therapies A Substance Use Disorder (SUD) is a mental disorder that affects a person's brain and behavior, leading to a person's inability to control their use of substances such as legal or illegal drugs, alcohol, or medications. Symptoms can range from moderate to severe, with addiction being the most severe form of SUDs. Researchers have found that about half of individuals who experience a SUD during their lives will also experience a co-occurring mental disorder and vice versa. Co-occurring disorders can include anxiety disorders, depression, Attention-Deficit Hyperactivity Disorder (ADHD), Bipolar Disorder, personality disorders, and Schizophrenia, among others. Source: National Institute of Mental Health (NIMH), U.S. Department of Health & Human Services While SUDs and other mental disorders commonly co-occur, that does not mean that one caused the other. Research suggests three possibilities that could explain why SUDs and other mental disorders may occur together: Common risk factors can contribute to both SUDs and other mental disorders. Both SUDs and other mental disorders can run in families, suggesting that certain genes may be a risk factor. Environmental factors, such as stress or trauma, can cause genetic changes that are passed down through generations and may contribute to the development of a mental disorder or a substance use disorder. Mental disorders can contribute to substance use and SUDs. Studies found that people with a mental disorder, such as anxiety, depression, or Post-Traumatic Stress Disorder (PTSD), may use drugs or alcohol as a form of self-medication. However, although some drugs may temporarily help with some symptoms of mental disorders, they may make the symptoms worse over time. Additionally, brain changes in people with mental disorders may enhance the rewarding effects of substances, making it more likely they will continue to use the substance. ​ Substance use and SUDs can contribute to the development of other mental disorders. Substance use may trigger changes in brain structure and function that make a person more likely to develop a mental disorder. Source: National Institute of Mental Health (NIMH), U.S. Department of Health & Human Services Substance use disorders can refer to substance abuse or substance dependence. Symptoms of substance use disorders may include: ​ Behavioral changes, such as: drop in attendance and performance at work or school frequently getting into trouble (fights, accidents, illegal activities) using substances in physically hazardous situations such as while driving or operating a machine engaging in secretive or suspicious behaviors changes in appetite or sleep patterns unexplained change in personality or attitude sudden mood swings, irritability, or angry outbursts periods of unusual hyperactivity, agitation, or giddiness lack of motivation appearing fearful, anxious, or paranoid, with no reason Physical changes, such as: bloodshot eyes and abnormally sized pupils sudden weight loss or weight gain deterioration of physical appearance unusual smells on breath, body, or clothing tremors, slurred speech, or impaired coordination Social changes, such as: sudden change in friends, favorite hangouts, and hobbies legal problems related to substance use unexplained need for money or financial problems using substances even though it causes problems in relationships Source: National Institute of Mental Health (NIMH), American Psychiatric Association (APA), MayoClinic, National Eating Disorders Association (NEDA) Generally, it is better to treat the SUD and the co-occurring mental disorders together rather than separately. Thus, people seeking help for a SUD and other mental disorders need to be evaluated by a health care provider for each disorder. Because it can be challenging to make an accurate diagnosis due to overlapping symptoms, the provider should use comprehensive assessment tools to reduce the chance of a missed diagnosis and provide targeted treatment. It is essential that treatment, which may include behavioral therapies and medications, be tailored to an individual’s specific combination of disorders and symptoms, the person’s age, the misused substance, and the specific mental disorder(s). Talk to your health care provider to determine what treatment may be best for you and give the treatment time to work. Behavioral Therapies: Research has found several behavioral therapies that have promise for treating individuals with co-occurring substance use and mental disorders. Health care providers may recommend behavioral therapies alone or in combination with medications. ​ Some examples of effective behavioral therapies for adults with SUDs and different co-occurring mental disorders include the following: Cognitive Behavioral Therapy (CBT): CBT is a type of talk therapy aimed at helping people learn how to cope with difficult situations by challenging irrational thoughts and changing behaviors. ​ Dialectical Behavior Therapy (DBT): DBT uses concepts of mindfulness and acceptance or being aware of and attentive to the current situation and emotional state. DBT also teaches skills that can help control intense emotions, reduce self-destructive behaviors (e.g., suicide attempts, thoughts, or urges; self-harm; and drug use), and improve relationships. ​ Assertive Community Treatment (ACT): This is a form of community-based mental health care that emphasizes outreach to the community and an individualized treatment approach. ​ Therapeutic Communities (TC): TCs are a common form of long-term residential treatment that focuses on helping people develop new and healthier values, attitudes, and behaviors. ​ Contingency Management (CM): CM principles encourage healthy behaviors by offering vouchers or rewards for desired behaviors. ​ Medications: Effective medications exist for treating opioid, alcohol, and nicotine addiction and lessening the symptoms of many other mental disorders. Some medications may be useful in treating multiple disorders. Talk to your doctor or mental health professional to discuss possible options & side effects. Source: National Institute of Mental Health (NIMH), U.S. Department of Health & Human Services

  • Eating Disorders | With Hope Foundation

    eating disorders What is it? What Causes it? Signs / Symptoms Treatment / Therapies Eating Disorders What is it? What causes it? Signs/ Symptoms Treatments/ Therapies Eating disorders are behavioral conditions characterized by severe and persistent disturbance in eating behaviors and associated distressing thoughts and emotions. They can be very serious conditions affecting physical, psychological, and social function. Types of eating disorders include Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Avoidant Restrictive Food Intake Disorder, Pica and Rumination Disorder, and other specified feeding and eating disorders. ​ Eating disorders affect up to 5% of the population and most often develop in adolescence and young adulthood. Several, especially Anorexia Nervosa and Bulimia Nervosa, are more common in women, but they can all occur at any age and affect any gender. Eating disorders are often associated with preoccupations with food, weight, or shape, or with anxiety about eating or the consequences of eating certain foods. ​ Behaviors associated with eating disorders include: Restrictive eating or avoidance of certain foods Binge eating Purging by vomiting Laxative misuse Compulsive exercise These behaviors can become driven in ways that appear similar to an addiction. Source: National Institute of Mental Health (NIMH), American Psychiatric Association (APA), MayoClinic, National Eating Disorders Association (NEDA), The exact cause of eating disorders is unknown. As with other mental illnesses, there may be many causes, such as: ​ Genetics and biology. Certain people may have genes that increase their risk of developing eating disorders. Biological factors, such as changes in brain chemicals, may play a role in eating disorders. Psychological and emotional health. People with eating disorders may have psychological and emotional problems that contribute to the disorder. They may exhibit low self-esteem, perfectionism, impulsive behavior, and troubled relationships. ​ Eating disorders often co-occur with other psychiatric disorders, most commonly, mood and anxiety disorders, Obsessive-Compulsive Disorder, and alcohol and drug abuse problems. Evidence suggests that genes and inheritability play a part in why some people are at higher risk for an eating disorder, but these disorders can also afflict those with no family history of the condition. ​ Treatment should address psychological, behavioral, nutritional, and other medical complications. The latter can include consequences of malnutrition or of purging behaviors including heart and gastrointestinal problems, as well as other potentially fatal conditions. Ambivalence toward treatment, denial of a problem with eating and weight, or anxiety about changing eating patterns is not uncommon. With proper medical care, however, those with eating disorders can resume healthy eating habits, and recover their emotional and psychological health. Source: National Institute of Mental Health (NIMH), American Psychiatric Association (APA), MayoClinic, National Eating Disorders Association (NEDA), The chance for recovery increases the earlier an eating disorder is detected. Therefore, it is important to be aware of some of the warning signs of an eating disorder. ​ (This isn’t intended as a checklist. Someone struggling with an eating disorder generally won’t have all of these signs and symptoms at once, and the warning signs vary across eating disorders and don’t always fit into neat categories. Rather, these lists are intended as a general overview of the types of behaviors that may indicate a problem.) If you have any concerns about yourself or a loved one, please contact the NEDA Helpline and seek professional help. Emotional and Behavioral Signs: In general, behaviors and attitudes that indicate that weight loss, dieting, and control of food are becoming primary concerns Preoccupation with weight, food, calories, carbohydrates, fat grams, and dieting Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g., no carbohydrates, etc.) Uncomfortable eating around others Food rituals (e.g. eats only a particular food or food group [e.g. condiments], excessive chewing, doesn’t allow foods to touch) Skipping meals or taking small portions of food at regular meals Any new practices with food or fad diets, including cutting out entire food groups (no sugar, no carbs, no dairy, vegetarianism/veganism) Withdrawal from usual friends and activities Frequent dieting Extreme concern with body size and shape Frequent checking in the mirror for perceived flaws in appearance Extreme mood swings ​ Physical Signs: Noticeable fluctuations in weight, both up and down Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.) Menstrual irregularities - missing periods or only having a period while on hormonal contraceptives (this is not considered a “true” period) Difficulty concentrating Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low white and red blood cell counts) Dizziness, especially upon standing Fainting/syncope Feeling cold all the time Sleep problems Cuts and calluses across the top of finger joints (a result of inducing vomiting) Dental problems, such as enamel erosion, cavities, and tooth sensitivity Dry skin and hair, and brittle nails Swelling around area of salivary glands Fine hair on body (lanugo) Cavities, or discoloration of teeth, from vomiting Muscle weakness Yellow skin (in context of eating large amounts of carrots) Cold, mottled hands and feet or swelling of feet Poor wound healing Impaired immune functioning Source: National Institute of Mental Health (NIMH), American Psychiatric Association (APA), MayoClinic, National Eating Disorders Association (NEDA) For Parents/ Caregivers: Although there's no sure way to prevent eating disorders, here are some strategies to help your child develop healthy-eating behaviors: Avoid dieting around your child. Family dining habits may influence the relationships children develop with food. Eating meals together gives you an opportunity to teach your child about the pitfalls of dieting and encourages eating a balanced diet in reasonable portions. ​ Talk to your child. For example, there are numerous websites that promote dangerous ideas, such as viewing Anorexia as a lifestyle choice rather than an eating disorder. It's crucial to correct any misperceptions like this and to talk to your child about the risks of unhealthy eating choices. ​ Cultivate and reinforce a healthy body image in your child, whatever his or her shape or size. Talk to your child about self-image and offer reassurance that body shapes can vary. Avoid criticizing your own body in front of your child. Messages of acceptance and respect can help build healthy self-esteem and resilience that will carry children through the rocky periods of their teen years. ​ Enlist the help of your child's doctor. At well-child visits, doctors may be able to identify early indicators of an eating disorder. They can ask children questions about their eating habits and satisfaction with their appearance during routine medical appointments, for instance. These visits should include checks of height and weight percentiles and body mass index, which can alert you and your child's doctor to any significant changes. ​ If you notice a family member or friend who seems to show signs of an eating disorder, consider talking to that person about your concern for his or her well-being. Although you may not be able to prevent an eating disorder from developing, reaching out with compassion may encourage the person to seek treatment. Treatment of an eating disorder generally includes a team approach. The team typically includes primary care providers, mental health professionals, and dietitians - all with experience in eating disorders. Treatment depends on your specific type of eating disorder, but in general, it typically includes nutrition education, psychotherapy, and medication. If your life is at risk, you may need immediate hospitalization. ​ Healthy eating: No matter what your weight, the members of your team can work with you to design a plan to help you achieve healthy eating habits. ​ Psychotherapy: Psychotherapy, also called talk therapy, can help you learn how to replace unhealthy habits with healthy ones. This may include: Family-Based Therapy (FBT): FBT is an evidence-based treatment for children and teenagers with eating disorders. The family is involved in making sure that the child or other family member follows healthy eating patterns and maintains a healthy weight. Cognitive Behavioral Therapy (CBT): CBT is commonly used in eating disorder treatment, especially for Bulimia and Binge-Eating Disorder. You learn how to monitor and improve your eating habits and your moods, develop problem-solving skills, and explore healthy ways to cope with stressful situations. Medications: Medication can't cure an eating disorder. However, certain medications may help control urges to binge or purge or to manage excessive preoccupations with food and diet. Drugs such as antidepressants and anti-anxiety medications may help with symptoms of depression or anxiety, which are frequently associated with eating disorders. ​ Hospitalization: If an individual has serious health problems, such as Anorexia, that has resulted in severe malnutrition, a doctor may recommend hospitalization. Some clinics specialize in treating people with eating disorders. Some may offer day programs, rather than full hospitalization. Specialized eating disorder programs may offer more intensive treatment over longer periods of time. Source: National Institute of Mental Health (NIMH), American Psychiatric Association (APA), MayoClinic, National Eating Disorders Association (NEDA)

  • Self Harm | With Hope Foundation

    Self Harm What is it? What Causes it? Signs / Symptoms Treatment / Therapies Self Harm What is it? What causes it? Signs / Symptoms Treatment / Therapies Self-harm or self-injury means hurting yourself on purpose. One common method is cutting with a sharp object. Any time someone deliberately hurts themselves is classified as self-harm. Some people feel an impulse to cause burns, pull out hair or pick at wounds to prevent healing. Extreme injuries can result in broken bones. Hurting yourself or thinking about hurting yourself is a sign of emotional distress. These uncomfortable emotions may grow more intense if a person continues to use self-harm as a coping mechanism. Learning other ways to tolerate the mental pain will make you stronger in the long term. Self-harm also causes feelings of shame. The scars caused by frequent cutting or burning can be permanent. Drinking alcohol or doing drugs while hurting yourself increases the risk of a more severe injury than intended and it takes time and energy away from other things you value. Skipping classes to change bandages or avoiding social occasions to prevent people from seeing your scars is a sign that your habit is negatively affecting school, work, and relationships. Source: National Institute of Mental Health (NIMH) Self-harm is not a mental illness, but a behavior that indicates a need for better coping skills. Several illnesses are associated with it, including Borderline Personality Disorder, Depression, Eating Disorders, Anxiety, or Post-Traumatic Stress Disorder (PTSD). Self-harm occurs most often during the teenage and young adult years, though it can also happen later in life. Those at greatest risk are people who have experienced trauma, neglect, or abuse. For instance, if a person grew up in an unstable family, it might have become a coping mechanism. If a person binge drinks or uses illicit drugs, they are at greater risk of self-injury because alcohol and drugs lower self-control. The urge to hurt oneself may start with overwhelming anger, frustration or pain. When a person is not sure how to deal with emotions, or learned as a child to hide emotions, self-harm may feel like a release. Sometimes, injuring oneself stimulates the body’s endorphins or pain-killing hormones, thus raising their mood. If a person doesn’t feel many emotions, they might cause themselves pain in order to feel something “real” to replace emotional numbness. Once a person injures themselves, they may experience shame and guilt. If the shame leads to intense negative feelings, that person may hurt themselves again. The behavior can thus become a dangerous cycle and a long-time habit. Some people even create rituals around it. Self-harm isn’t the same as attempting suicide. However, it is a symptom of emotional pain that should be taken seriously. If someone is hurting themselves, they may be at an increased risk of feeling suicidal. It’s important to find treatment for the underlying emotions. There's no one single or simple cause that leads someone to self-injure. In general, self-injury may result from: ​ Poor coping skills. Non-suicidal self-injury is usually the result of an inability to cope in healthy ways with psychological pain. Difficulty managing emotions. The person has a hard time regulating, expressing or understanding emotions. The mix of emotions that triggers self-injury is complex. For instance, there may be feelings of worthlessness, loneliness, panic, anger, guilt, rejection, self-hatred or confused sexuality. ​ Through self-injury, the person may be trying to: Manage or reduce severe distress or anxiety and provide a sense of relief Provide a distraction from painful emotions through physical pain Feel a sense of control over his or her body, feelings, or life situations Feel something - anything - even if it's physical pain, when feeling emotionally empty Express internal feelings in an external way Communicate depression or distressful feelings to the outside world Punish themselves for perceived faults Source: National Institute of Mental Health (NIMH), Signs and symptoms of self-injury may include: Scars, often in patterns Fresh cuts, scratches, bruises, bite marks, or other wounds Excessive rubbing of an area to create a burn Keeping sharp objects on hand Wearing long sleeves or long pants, even in hot weather Frequent reports of accidental injury Difficulties in interpersonal relationships Behavioral and emotional instability, impulsivity, and unpredictability Statements of helplessness, hopelessness, or worthlessness Self-injury usually occurs in private and is done in a controlled or ritualistic manner that often leaves a pattern on the skin. Examples of self-harm include: Cutting (cuts or severe scratches with a sharp object) Scratching Burning (with lit matches, cigarettes, or heated, sharp objects such as knives) Carving words or symbols on the skin Self-hitting, punching, or head banging Piercing the skin with sharp objects Inserting objects under the skin Most frequently, the arms, legs, and front of the torso are the targets of self-injury, but any area of the body may be used for self-injury. People who self-injure may use more than one method to harm themselves. Becoming upset can trigger an urge to self-injure. Many people self-injure only a few times and then stop. But for others, self-injury can become a long-term, repetitive behavior. Risk Factors: Most people who self-injure are teenagers and young adults, although those in other age groups also self-injure. Self-injury often starts in the preteen or early teen years, when emotions are more volatile and teens face increasing peer pressure, loneliness, and conflicts with parents or other authority figures. Certain factors may increase the risk of self-injury, including: Having friends who self-injure. People who have friends who intentionally harm themselves are more likely to begin self-injuring. Life issues. Some people who injure themselves were neglected, were sexually, physically or emotionally abused, or experienced other traumatic events. They may have grown up and still remain in an unstable family environment, or they may be young people questioning their personal identity or sexuality. Some people who self-injure are socially isolated. Mental health issues. People who self-injure are more likely to be highly self-critical and be poor problem-solvers. In addition, self-injury is commonly associated with certain mental disorders, such as Borderline Personality Disorder, Depression, Anxiety disorders, Post-Traumatic Stress Disorder (PTSD), and Eating Disorders. Alcohol or drug use. People who harm themselves often do so while under the influence of alcohol or recreational drugs. Source: National Institute of Mental Health (NIMH) There are effective treatments for self-harm that can allow a person to feel in control again. Psychotherapy is important to any treatment plan. Self-harm may feel necessary to manage emotions, so a person will need to learn new coping strategies. The first step in getting help is talking to a trusted adult, friend or medical professional who is familiar with the subject, ideally a psychiatrist. A psychiatrist will ask that person questions about their health, life history and any injurious behaviors in the past and present. This conversation, called a diagnostic interview, may last an hour or more. Doctors can’t use blood tests or physical exams to diagnose mental illness, so they rely on detailed information from the individual. The more information that person can give, the better the treatment plan will be. Depending on any underlying illness, a doctor may prescribe medication to help with difficult emotions. For someone with depression, for instance, an antidepressant may lessen harmful urges. A doctor will also recommend therapy to help a person learn new behaviors if self-injury has become a habit. Several different kinds of therapy can help, depending on the diagnosis: Psychodynamic Therapy focuses on exploring past experiences and emotions Cognitive Behavioral Therapy (CBT) focuses on recognizing negative thought patterns and increasing coping skills Dialectical Behavioral Therapy (DBT) can help a person learn positive coping methods If your symptoms are overwhelming or severe, your doctor may recommend a short stay in a psychiatric hospital. A hospital offers a safe environment where you can focus your energy on treatment. Prevention: There is no sure way to prevent your loved one's self-injuring behavior. Reducing the risk of self-injury includes strategies that involve both individuals and communities. Parents, family members, teachers, school nurses, coaches, or friends can help. ​ Identify someone at risk and offer help. Someone at risk can be taught resilience and healthy coping skills that can be used during periods of distress. ​ Expand social networks. Many people who self-injure feel lonely and disconnected. Helping someone form connections with people who don't self-injure can improve relationship and communication skills. ​​ Raise awareness . Learn about the warning signs of self-injury and what to do when you suspect it. ​ Encourage peers to seek help. Peers tend to be loyal to friends. Encourage children, teens, and young adults to avoid secrecy and reach out for help if they have a concern about a friend or loved one. Talk about media influence. News media, music, and other highly visible outlets that feature self-injury may nudge vulnerable children and young adults to experiment. Teaching children critical thinking skills about the influences around them might reduce the harmful impact. Source: National Institute of Mental Health (NIMH)

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"With Hope, the Amber Craig Memorial Foundation is dedicated to suicide prevention through improving mental health awareness and education in our schools and throughout our community."

DISCLAIMER: The diagnosis and treatment of depression and other psychiatric disorders require a trained medical professional. Information contained in this website reflects the opinions of With Hope Foundation and is intended for educational purposes only. It should NOT be used as a substitute for professional diagnosis and treatment of any mental/psychiatric disorders. Please consult a medical professional if the information here leads you to believe you or someone you know may be depressed or suicidal.

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