Welcome to the Student Mental Health Toolkit - Stigma-Free Student Mental Health Toolkit (2022)

Mental Health

Everyone has mental health, just like everyone has physical health. In the course of one’s lifetime, they may not experience mental illness, but they will experience struggles and difficulties, which will challenge their mental health. Mental health is essentially one’s mental well-being involving one’s emotions, thoughts and feelings, the ability to solve problems and overcome difficulties.

Mental Illness

Mental illness is different from mental health because it affects the way individual’s think, feel, behave, and interact with others. The symptoms of mental illness impact one’s life on a much more substantial level that can impede one’s daily functioning and can be chronic, lasting a lifetime.

Bipolar Disorder:

Bipolar disorder is a category that includes three different diagnoses under one umbrella: bipolar I, bipolar II, and cyclothymic disorder. Bipolar disorder is a brain disorder that causes changes in a person’s mood, energy, and ability to function. People with bipolar disorder experience intense emotional states that typically occur distinctly, ranging from days to weeks, called mood episodes. These mood episodes are characterized as being manic/hypomanic (abnormally happy or irritable mood) or depressive (sad mood). Generally, people with bipolar disorder also experience neutral moods. When treated, people with bipolar disorder can live fulfilling and productive lives.

Prevalence:

  1. Bipolar I Disorder → The development (onset) of a bipolar disorder (I) is approximately 18 years old. However, onset can occur at any age. Bipolar is not to be confused with typical mood fluctuations. Bipolar disorder is characterized by intense shifts in one’s mood which can affect their daily routine, social interactions, and significantly disrupt their relationships.
  2. Bipolar II Disorder → The development (onset) of bipolar II disorder is slightly later, beginning most typically in mid-20s, though it can begin earlier as well. This is a rough timeline estimate.

Depressive Disorder:

Depression, also known as major depressive disorder (MDD) is a mood disorder in which those who suffer experience persistent feelings of sadness and hopelessness and tend to lose interest in activities they previously enjoyed.

Prevalence:

The development (onset) of major depressive disorder is typically puberty. It is more common for females to experience than males. It is also important to address one’s feelings of severe sadness and hopelessness as the risk of suicide is prominent with this disorder.

Anxiety Disorder:

Anxiety is an adaptive response to stress in our environment. Anxiety disorders differ from typical feelings of nervousness or anxiousness to involve excessive fear, worry, or anxiety. It is the most common mental illness that can also include other types of anxiety, such as generalized anxiety, social anxiety, and more. Anxiety disorders are manageable and treatable.

Prevalence:

An anxiety disorder can begin as early as 1 year of age, though is more commonly seen in school-age children, with nearly 1 in 3 adolescents (13-18) experiencing an anxiety disorder.

Feeding and Eating Disorders:

A persistent disturbance of eating or eating-related behaviour that results in the altered consumption or absorption of food and significantly impairs physical health or psychological, behavioural, and social functioning. Eating disorders are ranked the third most common chronic illness in adolescent females.

Prevalence:

  1. A restrictive eating disorder such as anorexia nervosa most commonly begins around puberty in adolescent females, with the ratio of 10:1 female to male prevalence and is often associated with a stressful life event (i.e., moving away from home for college).
  2. A bulimic eating disorder such as bulimia nervosa is more common in older adolescent females, with the same ratio as anorexia, being 10:1 females to males
  3. Both of these eating disorders are associated with serious biological, psychological and sociological morbidity, and significant mortality.

Substance and Addiction:

Substance-related disorders involve 10 separate classes of drugs: alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics, stimulants, tobacco, and others (unknown substances). All drugs that are taken in excess similarly activate the brain reward system, which produces feelings of pleasure or euphoria. Whenever this reward system is activated, our brain notes that something is happening that should be repeated because it is enjoyable. This is the addictive property drugs hold onto the brain.

Prevalence:

  1. The first episode of alcohol intoxication and cannabis use is likely to occur during the mid-teens
  2. Alcohol-related issues such as negative effects on the organ systems and suicidal risk can occur prior to the age of 20 years
  3. Cannabis is the most widely used illicit psychoactive substance in North America — with the prevalence of developing cannabis use disorder increasing among adolescents
  4. Teens who misuse drugs may become dependent, leading to an addiction, which can result in harmful effects such as dropping out of school and cause disturbances in brain development

Attention-Deficit/Hyperactivity Disorder (ADHD):

ADHD is one of the most common neurodevelopmental disorders typically diagnosed in childhood. The two pillars of ADHD are Inattention and Hyperactivity. Inattention may look like wandering off task, having difficulty staying focused, or inability to stay organized. Hyperactivity may look like excessive motor activity, such as excessive fidgeting, tapping, restlessness, or talkativeness when it is not appropriate. ADHD interferes with one’s functioning and development such as school performance and academic achievement, which can have a substantial impact on the child and their family

Prevalence:

  1. It occurs in about 5% of children, with it being more common in males than females at a 2:1 ratio
  2. This is not to say females experience ADHD less, it is more accurate to say that females often go underdiagnosed because they show symptoms of ADHD in different ways than males — they tend to have more inattentive features, whereas males tend to show more hyperactivity features

Obsessive-Compulsive Disorder (OCD):

OCD is to have a tendency towards excessive orderliness, perfectionism, and/or great attention to detail characterized by obsessions and/or compulsions. Obsessions are recurrent, persistent thoughts, urges, or images that are perhaps unwanted. Compulsions are repetitive behaviours or mental acts that are done in response to the obsession, to prevent it from happening, or according to the rules one has made that they apply rigidly to avoid the obsession. Not performing these behaviours leads to great distress.

Prevalence:

  1. Males are more commonly affected in childhood, however females are affected at a slightly higher rate in adulthood
  2. Most cases of OCD begin around late adolescence, early adulthood
  3. If OCD is untreated, especially in childhood or adolescence, it can result in chronic OCD lasting a lifetime

Trauma- and Stressor-Related Disorders:

Trauma is a lasting response to a stressful event. Experiencing a traumatic event can have a lasting impact on an individual’s sense of self, safety, and ability to regulate emotions. Psychological distress following a traumatic event can also look a lot like anxiety. It is not uncommon for a traumatic or anxious response to look alike.

Prevalence:

  1. Trauma and stressor-related disorders are less commonly seen in youth as resilience is high within this population
  2. However, they can still be experienced in childhood and adolescence and pervade into adulthood if left unaddressed
  3. Symptoms of a traumatic and/or a stress-related response typically begin within the first 3 months after the event, though there can be a delay of months or even years before criteria is met for a diagnosis, which is noted as a “delayed expression”

Schizophrenia:

Schizophrenia is a psychotic disorder and is attributed to an individual if they have two or more core symptoms; delusions, hallucinations, disorganized thinking and/or speech. The other core symptoms are significantly disorganized or abnormal motor behaviour, and negative symptoms. Delusions are fixed beliefs that are resistant to change despite conflicting evidence. For example, this might be a strong belief that someone is going to be harmed by another individual, despite there being no evidence of that being true. This is defined as a specific delusion called a persecutory delusion, which is the most common. Hallucinations are experiences that occur without an external stimulus (outside reason or cause). They are vivid and clear, like a voice speaking to you which is not just one’s individual inner thoughts; this is called an auditory hallucination. Disorganized thinking and speech can be quite sporadic in nature, whether a person jumps from idea to idea, or their ideas are completely unrelated, or their words or sentences just do not make sense. Disorganized or abnormal motor behaviour can be observed as a childlike “silliness” to unpredictable agitation. It can be seen as odd posture, excessive motor activity, staring, and more. Negative symptoms are diminished emotional expression seen in one’s face, eye contact, or delivery of speech and avolition which is a decrease in motivated self-driven activities such as sitting for long periods of time without interest in participating in work, school, or social activities

Prevalence:

  1. The psychotic features of schizophrenia typically emerge between the late teens and mid-30s; onset prior to adolescence is rare
  2. The peak age at onset for the first psychotic episode is in the early- to mid-20s for males, and late-20s for females
  3. Schizophrenia affects less than 1% of the population, meaning it is fairly uncommon and is highly genetically related
  4. There is a high suicide risk among those with schizophrenia as it can be a response to a command hallucination to harm oneself or others and must be taken seriously
  5. In general, schizophrenia tends to be slightly lower in females than males

Therapy:

Therapy is generally defined as treatment for an injury, disability or illness with psychotherapy being specific to treatment of mental health conditions. Psychotherapy, or talk therapy, can be done by many different professionals ranging from social workers to psychiatrists. Therapy can be beneficial to all types of people, and helpful in many different situations. It can range in intensity and be short or long term. Mental health professionals can have different areas of specialty and work under one or a combination of different “theories”. In all cases, the goal is to help people make sense of their emotions and thoughts to live more happy, productive and healthy lives.

Social Worker:

A professional, usually with a master’s degree in social work, who helps individuals in disadvantaged situations. They can provide some counselling but are usually not trained to use psychotherapy theories. Instead, social workers usually help clients attain resources they need to change their circumstances. Social workers are generally involved in government or community services and specialize in family, child and school issues. They generally assist those with limited resources, victims of abuse, families adjusting to a child with mental health struggles, or families adjusting to a member who is differently abled.

Counsellor/Therapist:

A professional, with a master’s degree in counselling specific psychology, trained in psychotherapy. Those seeking out counselling range from dealing with trauma, anxiety, depression or just needing some extra support during stressful life events such as mourning a lost one or divorce. Anyone needing some extra support, guidance, a safe place to express their feelings or looking for something potentially long term should consider counselling.

Psychologist:

A professional, with a doctorate degree in psychology, trained in psychotherapy who is also able to assign a diagnosis. Psychologists are able to offer support to those with symptoms of a suspected mental disorder and those with more severe mental health struggles looking for a treatment plan more catered to their diagnosis.

Psychiatrist:

A professional, with a medical degree, trained in psychotherapy. They are able to assign a diagnosis, prescribe medication and other medical treatments. Those with mental health struggles such as severe depression or schizophrenia where medication is required should seek out a psychiatrist. Even those with moderate depression and anxiety who have been prescribed drugs by their general practitioner can benefit from a psychiatric consultation as they often have a more comprehensive understanding of disorders and their effective treatments. In Canada a referral from your doctor is needed to book an appointment with a licensed psychiatrist.

Psychotherapy Theories:

The guidelines, themes and general attitudes that counsellors, psychologists and psychiatrists use to guide their treatment method. This is the framework they use to define client/counsellor relationship, intervention methods and the overall mood of the session. Different theories will appeal to different people and be more useful for different challenges. Don’t be afraid to try out a few different types until you find one that works best for you!

Psychodynamic Theories:

These theories are more long term and focused on the individuals and their life experience. They tend to attempt to treat the person as a whole and not just specific problems, and this generally leads to improvements in self-awareness. A few of the most common are listed below.

Psychoanalysis:

The original theory of talk therapy developed by Freud. Focuses on making sense of the subconscious and the past. A more intensive form of psychodynamic therapy characterized by a close working partnership between therapist and patient.

Person centered therapy:

Created by Carl Rogers, this holistic method uses empathy to help motivate people to find solutions to their problems themselves.

Existential therapy:

This theory helps people find meaning in their life and overcome the fear of death through self-determination.

Adlerian Therapy:

This theory is goal oriented and works to help people find success , connectedness with others, and a sense of belonging in the world

Behavioral and Problem-Based Theories:

These theories tend to be more short term and focus on specific behaviors or symptoms that are causing the most issues. A few of the most well known are listed below

Cognitive Behavioral Therapy (CBT):

One of the most popular of the behavioral theories, this method focuses on identifying unhealthy ways of thinking and finding a healthier substitute. This has been shown to be very effective for those suffering from anxiety, depression, trauma related disorders, eating disorders and addiction.

Dialectical Behavioral Therapy (DBT):

One of the newest forms of therapy, this was developed specifically to help treat those with borderline personality disorder. It focuses on helping people find acceptance as well as managing their emotions. This is also very effective in those dealing with other personality disorders, addiction, suicidal ideation and post-traumatic stress disorder.

Play Therapy:

This type of therapy is used specifically for younger children and uses games, toys and different forms of “play” to help children express confusing emotions, feelings or life events

Family Therapy:

Focuses on helping families communicate and deal with major conflicts that are affecting the household.

Couples Therapy:

Focuses on helping people in relationships settle differences, improve communication and find ways to have a more content life together.

Group Therapy:

Generally led by a therapist, this type of therapy will be a small group of those suffering from similar mental health struggles who come together to find support from each other as well as the therapist. This is common for those suffering from eating disorders, addiction and is used often in DBT.

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