Much Talks

Let's bust the stigma surrounding Stress, Anxiety and Depression. Devon Soltendieck hosts a look into mental health issues in this series of Much Talks.

Brought to you in partnership with the Mental Health Commission of Canada.

Question & Answer

Dr. Michael Cheng (with the help of adult and youth colleagues from the Provincial Centre of Excellence for Child and Youth Mental Health), has provided answers for your questions. Please note that this service is meant to provide general advice, but cannot replace advice from your doctor, therapist, counsellor or other professional.

Dr. Michael Cheng, MD, FRCP(C) is a child and family psychiatrist at the Children's Hospital of Eastern Ontario (CHEO), Ottawa, Ontario, Canada. Dr. Cheng works on the Consultation Clinic at CHEO and is an Assistant Professor in the Department of Psychiatry at the University of Ottawa. Dr. Cheng believes that knowledge is power, and in between patients, works with eMentalHealth.ca, an initiative of the Provincial Centre of Excellence for Child and Youth Mental Health.

Question:
I've been fighting this overwhelming sadness I've had since last May. My friends have started to notice something wrong with me, but I keep just denying anything's wrong. I don't want them to worry about me. The thing is this sadness just won't go away... Nothing I do helps. I just want it to stop. What should I do?

Answer:
When you describe having overwhelming sadness that can't go away, that is causing severe enough problems that your friends are noticing, it definitely suggests that this is not normal, and that you may actually have a mood condition such as clinical depression, also known as major depression. This is a medical condition where people can have symptoms such as sad mood, troubles with sleep, appetite, energy, concentration. The good news is that there are many things that can be done to help - it is possible to feel better. You have done the right thing in reaching out to us in this forum. Things you can do include 1) telling a trusted adult how you feel so that s/he can support you through this and help you find help; 2) tell your family doctor or paediatrician; 3) talk to a school guidance counselor. Another great way to get help is to speak with a professional counselor with KidsHelpPhone 1-800-668-6868, where you can talk anonymously and privately, 24/7, 365 days a year. For more information about depression, check out www.mindyourmind.ca.

General topics that apply to this: Depression

Question:
My friend is acting like nothing even matters anymore like she's trying to cut off the world from her and she wants to not be around anyone. I tried to help and I need some advice. I've told her that I would always be there for her and she just doesn't care.

Answer:
Definitely, it sounds like your friend isn't her usual self. You've done the right thing by starting off gently, and telling her that you'll always be there for her. Are there other people that she trusts? You might consider tell those people about your concerns, and perhaps they can also let them know they are worried. Sometimes people need to hear a message a few times, or from different people before they get it. Other people usually includes 1) her parent(s) or caregivers; 2) teachers, guidance counselors or others at school; 3) your own parent(s).

General topics that apply to this: Depression; Getting Help for a Friend

Question:
I've been suicidal and been cutting myself and I'm on pills to help but I'm still depressed. What do I do?

Answer:
Thanks for your question. The fact that you are still depressed is not good, but the good news is that things can be done to improve your mood.

Tell your doctors that things are still bad with the depression. It sounds like you've done the right thing in getting help, but that even with the treatment, things are still tough. So make sure you tell your doctor(s) that even with the medication, things are not better. If things aren't getting better, then something different needs to be done. Perhaps your medication(s) need to be changed or adjusted.

Its also possible that there are other ways to help that can be tried. If counselling/therapy hasn't been tried, then ask your doctor(s) about that.

Things you can do. If you want to start with some things on your own, you can try 1) getting at least 30-60 minutes of aerobic exercise a day (like running, working out), since studies show exercise is an antidepressant; 2) make sure you are eating healthy and getting enough sleep; 3) deal with stress in your life, like school, family, friends and bullying. For example, what is stressing you out about school? What is stressing you out about family? About friends? What would you like to see different?

It sounds like bullying has been a big stress. This is one that is likely complicated and where perhaps seeing a counselor to talk about it in depth might help.

So in summary - it sounds like you have already reached out for help, which is a great first step. Tell those people that are helping you that you are still struggling, so that they can keep working with you to get things better. Hang in there! If you try these things and are still feeling depressed, then please speak to one of the professional counselors at KidsHelpPhone 1-800-668-6868.

General topics that apply to this: Depression

Question:
My best friend is acting really strange lately. I know she's going through issues at home, but she never talks to me about it, but I try to get her to. She's been very quiet and doesn't want to hang out with any of her friends. I'm worried that she's keeping it all to herself, she is super private about this stuff, but I can see how it's starting to get to her. What should I do to help her?

Answer:
First, your friend is lucky to have someone as concerned and caring as yourself!

It's possible that your friend is just stressed out and overwhelmed by some things happening in her life right now. It's possible too, that she can cope with it on her own. But being a friend is all about offering support. Here are some tips:

- Express your worry and concern for your friend. What you might say: "Hey, is everything okay?" "I've noticed you don't seem yourself lately."

- Be there for your friend. Ask her what type of support she wants and don't assume you know what your friend needs. What you might say: "Is there anything I can do to help?" "How can I support you?" "Do you want to talk about it? If not, that's cool. But whenever you want, I'm here for you." "Can I give you a hug?"

- If your friend wants to talk, then above all, listen and don't judge. Try not to jump in with giving advice, unless your friend is appreciative. What you might say: "Yeah, I think anyone would find that tough..."

- Continue to hang out and spend time with your friend. Accept that your friend might be more withdrawn, but don't take it personally. Realize your friend might prefer doing things one on one rather than in a large group. What you might say: "Its been a while since we've done anything together - do you want to hang out on Saturday?"

- Know your own limits about what you can and cannot do for your friend. Remember that you are a friend, not a therapist. Don't try to "analyze" or offer "interpretations". What you might say:

- If your friend seems to be getting worse, then encourage your friend to talk to an adult (like a parent, teacher, guidance counsellor or family doctor...) What you might say: "You know, another friend was really depressed, so she told her parents and they saw a counsellor, and it really helped. I can look into that for you. What do you think?"

- If you are worried that your friend is feeling suicidal, then speak immediately with a responsible adult (like a teacher or parent) or contact a crisis line such as Kids Help Phone 1-800-668-6868. Even if your friend has made you promise not to tell anyone, what is more important is that your friend stay alive. When your friend is feeling better and no longer suicidal, your friend will appreciate that you helped get him/her help... What you might say: "Hi, I'm really worried about my friend and I need some help... I think she's feeling suicidal..."

Question:
I feel like I have a pretty good life, but sometimes I get really depressed about things and lash out at my family and friends, which I don't think is very normal. It's not even like I can pinpoint why I feel like this. I try to keep myself busy to help myself forget about it, but it's starting to really bug me. How do I stop being so moody?

Answer:
First, it's definitely a good thing that you recognizing that there might be something wrong. Fortunately, a lot of things can be done to help get things better.

Healthy Body, Mind and Spirit.

It's important to have a healthy body, mind and spirit.

- Get enough sleep and exercise
- Eat properly, which means breakfast, lunch and dinner, as well as snacks.

Learn How to Chill

When you get too stressed out, its important to chill out and relax. But first we'll need to figure out what helps you chill out. You've probably already got some idea about what helps you relax...

How do you like to relax or chill out?

1. _______________________
2. _______________________
3. _______________________

Here are some more ideas about things to try:

Doing something physical
- Taking the dog for a walk

Doing something social
- Calling or instant messaging a friend
- Going for coffee or a walk with a friend
- Play video games with a friend

Going out for a hot chocolate with a parent
- Doing something creative or artistic
- Music, whether it be singing, playing or listening
- Drawing
- Poetry

Doing absolutely nothing at all
- Just going to your room and "chilling out"

Deal with stresses

In addition to being able to chill out, its also important to try and deal with the actual things that are stressing you out. We all have things that we have to deal with, like school (teachers, school work), family and friends. Sometimes we can have stresses with these things (e.g. troubles with school, fights with friends or family). Sometimes these stresses become more than we can handle, and it can make us feel upset, sad, anxious or irritable.

Make a list of your top stresses:

1. _______________________
2. _______________________
3. _______________________

Problem-solving. Once you've figured out what some of your stresses are, you'll need to come up with a plan to deal with them. For example:

StressPossible solutions
1. Fighting with my brother Talk to my brother and let him know I want to stop fighting with him Ask my parents for advice
2. Low marks in math Look over my math notes every day Ask the math teacher if there is anything I don't understand Ask my mom for math help


Get help

If things are not getting better on their own, then the next step is to get help and support from others. Unfortunately, people often feel embarrassed about getting help -- they often try to deal with things on their own. Quick question -- if you had a condition like cancer, would you try to deal with it all on your own? Of course not, you'd tell your parents, see a doctor and get help. So it's the same with conditions like depression - it is important to talk with someone and get help.

Responsible adults that you can turn to may include 1) parents; 2) teachers; 3) your family doctor or pediatrician; 4) other services such as KidsHelpPhone, 1-800-668-6868, www.kidshelpphone.ca

Counselling and Therapy

Depending on your situation, someone might suggest that you go for counselling or therapy. This is where you meet with a counsellor or therapist (which could be a social worker, psychiatrist, doctor or other professional) and you talk about your situation. And together, your counsellor/therapist would help you to find a way to make things better.

Question:
When ever I get my period I always get really sad, and I usually cut myself. But once my period is over, I feel perfectly normal. I was wondering if there is anything to fix this?

Answer:

What might be going on:
Many (young) women can have emotional and physical changes around the same time that they get their periods:

Mild to moderate changes: You may have heard of the term PMS - which stands for "pre-menstrual syndrome" - and it describes various symptoms that people can notice around their periods: a) physical symptoms such as bloating in your belly; cramps; your breasts feeling tender; acne; headache and fatigue; b) emotional symptoms such as mood swings, feeling sad, irritable, or being tearful. Symptoms usually start up to a few days before your periods, and then get better after the period is over.

Severe changes: Other people can have quite severe changes in their moods, to the point where they are feeling depressed or even suicidal around their periods. There's even a name for this condition, which is premenstrual dysphoric disorder, or PMDD.

What you can do about it:
The good news is that there are many things that you can do to help you feel better and get rid of the severe sadness:

1. The number one thing to do is speak to your family doctor (or paediatrician), who can ask more questions to figure out what might be happening.

2. There are various lifestyle changes that many women report can be helpful such as making changes in your diet (i.e. what you eat everyday): try having a low-fat or low-salt diet (so avoid salty things such as potato chips or pizza which you haven't made yourself); have a diet with complex carbohydrates (whole grain breads, pasta and grains; reduce simple sugars (found in candy, ice cream, cookies and sweets); avoid caffeine; avoid alcohol. Other lifestyle strategies include getting regular aerobic exercise.

So in summary - hang in there, and see your doctor!

Question:
I am new to my school, and I feel like all the girls talk about me behind my back and stuff, I'm always nice to them. But they just get mad for things I do? And like they always give me dirty looks and I go to like ask someone a question and they just call me stupid and retard, what should I do?

Answer:
It's definitely not easy being the new person - you do have to put more effort into making friends than the others. (No, it's not fair, but let's face it - life isn't fair)

Here are some thoughts:

- Perhaps the other girls feel jealous or threatened by you, the new girl: It's good to hear you say that you are being "always nice to them". That is the right thing to do. Keep on being nice, and hopefully with more time, they'll eventually be nicer to you. (By the way, I'm sure you might feel like being mean at times, but that would only give them an excuse to be mean back to you). So definitely, continue being nice!

- Let's just review some quick "making new friends when you are the new person" tips:
   - Be a positive, happy person with positive energy, so that others will want to be around you
      Smile a lot
      Be friendly and introduce yourself to other people
      Give compliments and say nice things about other people
      Don't be a complainer or a whiner
      Join others when they are talking
      Don't hog a conversation
      Don't interrupt or butt in
      Be humble -- Don't brag, don't be a show off, or try to make yourself appear better than the other girls
   - Seek out people with positive energy: Hang out with the nice people. There must be at least one or more people in your class that are nice, so if you have a choice between hanging out with the nice people or the mean people, then hang out with the nice ones.
   - A hilarious book packed full with friendship-making tips is "How Rude! Handbook of Friendship and Dating Manners for Teens: Surviving the Social Scene" by Alex Packer

- It never hurts to ask others for advice, so tell some responsible adults about your challenge making new friends so that they can help. You might consider talking to a) your parents; b) your teacher; c) your family doctor or paediatrician; or d) Kids Help Phone, 1-800-668-6868.

So in summary - don't give up, keep being nice and speak to an adult if it isn't getting any better!