2.9.2. Mental Health Disorders

While support is an essential part of helping someone with a mental health disorder, it is also important to encourage individuals to seek professional help.

Anxiety Disorders

This section is adapted from “Mental Health – Anxiety Disorders,” a Government of Canada webpage.

The Issue

Anxiety disorders are the most common of all mental health problems. It is estimated that one in 10 Canadians is affected by them. These disorders can be successfully treated so it is important to recognize the difference between being anxious in response to a real event, and an anxiety disorder which produces fear or distress that is out of proportion to the situation.

Background

Everyone feels anxious at certain times. Workplace pressure, planning a big event or writing an exam can cause feelings of wariness, or even fear. While these situations are uncomfortable, they may be more severe for those who suffer from an anxiety disorder.

People who suffer from anxiety disorders have long periods of intense feelings of fear or distress out of proportion to real events. Their brains interpret real or imagined events to be much more risky or dangerous than they really are. Their lives are full of unease and fear, which interferes with their personal and professional relationships.

Anxiety disorders affect children as well as adults. All too often, people mistake these disorders for mental weakness or instability. The social stigma attached to mental illness often prevents those with anxiety disorders from asking for help.

Anxiety disorders affect behaviour, thoughts, emotions and physical health. It is believed that a combination of biological factors, brain functions, personal circumstances, combined with social and economic factors, cause anxiety disorders, the same way that heart disease or diabetes are caused by a combination of factors.

People often suffer from more than one anxiety disorder, and those with anxiety disorders often suffer from depression, eating disorders or substance abuse as well. The good news is that anxiety disorders can be successfully treated once they are recognized.

Types and Symptoms of Anxiety Disorders

Panic Disorder

People with this disorder have panic attacks in which they are suddenly terrified, without warning. They may also have one or more of the following symptoms:

  • chest pain
  • heart palpitations
  • shortness of breath
  • dizziness
  • stomach discomfort
  • feelings of unreality
  • fear of dying

If you avoid situations that may cause a panic attack, the condition is known as panic disorder with agoraphobia.

Phobias

Phobias are only considered disorders if they keep the affected person from leading a normal life. For example, people who have a phobia (or fear) of being in places or situations from which escape might be difficult (or embarrassing) may be too fearful to even leave the house. This type of phobia is called agoraphobia.

There are two categories of phobias:

  • social phobia (fear of social situations), and
  • specific phobias, such as fear of flying, spiders, blood or heights.

Social Phobia

People with a social phobia are intensely fearful of a social situations. Being with people can paralyze them and make them feel unnaturally self-conscious. They’re worried about being judged, and are terrified of doing something wrong in front of other people. Because their feelings are so intense, they tend to avoid situations that might trigger their fear. This dramatically limits their ability to lead a normal life or to interact with others.

Specific Phobia

People with a specific phobia have an overwhelming, irrational fear of a specific environment or object. Examples include fears of flying, bugs, snakes, heights or open spaces. They are unable to control their terror, even though they may recognize that their fears are ungrounded. Exposure to the feared situation causes them extreme anxiety and panic

Post-Traumatic Stress Disorder

This is a disorder that is triggered by a victim reliving a terrifying experience in which they were threatened with, or suffered, physical, mental or emotional harm. Survivors of rape, natural disasters, child abuse or war may all develop post-traumatic stress disorder. The most common symptoms are the following:

  • flashbacks, in which you re-live the terrifying experience
  • nightmares
  • depression
  • feelings of anger or irritability.

Obsessive-Compulsive Disorder

People with this disorder suffer from persistent unwanted thoughts (obsessions) and/or behavioural habits (compulsions), which they cannot control. Typical obsessions are:

  • contamination (there are germs all over you)
  • doubt (Did I turn off the stove or the iron?)
  • disturbing sexual thoughts
  • disturbing religious thoughts.

Compulsions include constant:

  • washing
  • organizing
  • checking
  • counting.

Generalized Anxiety Disorder

With this disorder, people worry excessively about ordinary, everyday situations and events. The condition usually lasts for at least six months. During this time the affected person expects the worst to happen, even when there is no evidence that it will. The physical symptoms may include the following:

  • nausea
  • trembling
  • fatigue
  • muscle tension
  • headache

Treatment of Anxiety Disorders

Anxiety disorders can be successfully treated. The most common form of treatment is a combination of drug therapy and cognitive-behavioural therapy (CBT).

Because most anxiety disorders have some biological basis, the most common drugs prescribed are anti-depressants and anti-anxiety drugs.

CBT involves helping people to turn their anxious thoughts and feelings into more rational ones. Sometimes people will benefit from being exposed in a controlled way to the object and situation they fear. Some CBT techniques have been developed to deal with specific disorders. For example, people with panic disorder can benefit from learning new breathing and meditation techniques, which can help them deal with their anxiety.

Support groups and learning more about the disorder can also help a great many people deal with anxiety disorders. Involving family and friends who are also affected by the disorder, can help people recover or learn how to cope with their condition.

The most important first step in treatment is to get a proper diagnosis from a specialist in anxiety disorders. Many people suffer for 10 years or more before getting the right treatment.

Minimizing Your Risk

If you suspect that you or someone you know suffers from an anxiety disorder, talk to your health care provider. They can recommend you to a specialist in anxiety disorders or direct you to a specialized anxiety disorder clinic. These points may also help you cope:

  • Pick a time and place to do your worrying and make it the same time and place every day. Spend 30 minutes thinking about your fears and what you can do about them. Don’t dwell on what ‘might’ happen, focus on what is actually happening.
  • Learn to relax. Yoga, muscle relaxation, biofeedback and deep breathing can all help you deal with your anxieties. See the link in the Need More Info? section for more information. For muscle relaxation, simply lie down and focus on one muscle group at a time, starting with your feet or your head. Tense the muscle for a few seconds then let it go. Move on to the next muscle.
  • Get plenty of sleep; it will help you put things in perspective.
  • Confront the things that have made you anxious in the past. You might start by making a list. Then picture yourself confronting these situations. This way you can develop techniques to deal with them before you are actually anxious. You might also try examining the level of your anxiety, on a scale of one to 10.
  • Exercise regularly; it can give you a sense of well-being and help lessen the anxiety.
  • Avoid alcohol and recreational drugs. Although they may seem to relax you while you are taking them, afterwards they can lead to even more anxiety and depression.
  • Avoid the caffeine found in coffee, tea, soft drinks and chocolate. They can increase your level of anxiety. Also avoid over-the-counter diet pills, and cough and cold medications.
  • For more information and help, contact the mental health organizations listed in the Need More Info? section.

Depression

This section is an adaptation of “What is Depression,” a Government of Canada webpage.

Everybody goes through “ups and downs” in their lives. Sometimes we use the term “depression”, or “depressed” to describe these everyday feelings.

But the normal experiences of life shouldn’t be confused with the serious medical illnesses known as mood disorders. There are different kinds of depressive mood disorders, including bipolar disorder (manic-depressive illness), perinatal depression, but clinical depression, or major depression is the most common mood disorder.

Mood disorders are very real illnesses that can have serious and sometimes fatal results. They affect the entire body and not just the mind. Their physical symptoms can range from fatigue to stomach complaints or muscle and joint pain. Many people never realize that they are suffering from depression.

Mood disorders are one of the most common mental illnesses in the general population. According to Statistics Canada’s 2012 Canadian Community Health Survey (CCHS) on Mental Health, 5.4% of the Canadian population aged 15 years and over reported symptoms that met the criteria for a mood disorder in the previous 12 months, including 4.7% for major depression and 1.5% for bipolar disorder.

Further, almost one in 8 adults (12.6%) identified symptoms that met the criteria for a mood disorder at some point during their lifetime, including 11.3% for depression and 2.6% for bipolar disorder.Footnote 1

Studies have consistently documented higher rates of depression among women than among men: the female-to-male ratio averages 2:1.Footnote 2

What Causes Mood Disorders?

Mood disorders have no single cause, but several risk factors interact to produce the clinical symptoms of the various mood disorders. Individuals with depression and bipolar disorder often find a history of these disorders among immediate family members.Footnote 3 ,Footnote 4  Many different genes may act together and in combination with other factors to cause a mood disorder. Research is getting closer to identifying the specific genes that contribute to depression.

One episode of major depression is a strong predictor of future episodes. More than 50% of individuals who have an episode of major depression experience a recurrence.3 Traditionally, stress has been viewed as a major risk factor for depression. Recent research suggests that stress may only predispose individuals for an initial episode, but not for recurring episodes.Footnote 5  Some individuals are more susceptible than others to depression following traumatic life vents, when in difficult or abusive relationships, or as a result of socio-economic factors such as income, housing, prejudice and workplace stress. A strong association exists between various chronic medical conditions and an increased prevalence of major depression.Footnote 6  Several chronic medical conditions, such as stroke and heart disease, obesity, Parkinson’s disease, epilepsy, arthritis, cancer, AIDS, chronic obstructive pulmonary disease (COPD), and dementia and Alzheimer’s Disease may contribute to depression. This association may result from physiological changes associated with these conditions, such as changes in various neurotransmitters, hormones and the immune system, or from associated disability and poor quality of life. In addition, some medications used to treat physical illnesses tend to cause depression. People who cope with more than one medical condition may be at particular risk for depression. Effective treatment of chronic physical illness includes the assessment, early detection and treatment of depression.

What Are the Symptoms of Depression?

Each person is different and will have unique symptoms, but here are some of the more common symptoms of depression:

  • depressed mood
  • feelings of guilt, worthlessness, helplessness or hopelessness
  • loss of interest or pleasure in usually-enjoyed activities
  • change in weight or appetite
  • sleep disturbances
  • decreased energy or fatigue (without significant physical exertion)
  • thoughts of death
  • poor concentration of difficulty making decisions

If you or someone you know has had any of these symptoms most days for more than two or three weeks, contact your doctor, or a registered mental health professional to discuss the symptoms.

If you or someone you know is having recurring thoughts of suicide it’s very important that they get medical help right away.

Additional Resources

 

Bipolar Disorder

This section is an adaptation of “What Should I Know About Bipolar Disorder (Manic-Depression)?,” a Government of Canada webpage.

What Should I Know About Bipolar Disorder (Manic-Depression)?

Bipolar disorder (formerly called manic-depression) is a bio-chemical condition that results in an imbalance of the neurotransmitters in the brain. Genetic make-up is thought to play a role but so too are environmental pressures such as your family, work and social environment, stress, injury, illness and hormone imbalances.

Bipolar disorder is characterized by mood swings that can last for days, weeks or even months. These swings range from mild to severe. The “bi” in bipolar disorder refers to the dual nature of these mood swings – from feelings of great happiness and elation to sadness and despair. In its most severe expression, bipolar disorder can result in mania which is defined as strongly held beliefs that you are a famous person, have special physical abilities or knowledge, or that you are invincible. People can experience mania as a euphoric period. Unfortunately, mania is also accompanied by unwise behaviours tied to the false beliefs. These can include spending sprees, risky sexual activity, excessive drinking or drug use, and other reckless activities or decisions. Bouts of mania are followed by the depths of depression where people feel worthless and hopeless. This phase of bipolar disorder is excruciatingly painful. The mood swings of bipolar disorder deeply affect relationships, social and work functioning and can, in the extreme, bring people into contact with the law.

Symptoms of mania can include the following:

  • feelings of invincibility
  • more physical energy
  • less need for sleep
  • inappropriate excitement
  • irritability or excessive anger
  • increased activity, talking and moving
  • increased sexual thoughts and activity, sometimes resulting in promiscuity and inappropriate or unsafe behaviour
  • disconnected and racing thoughts
  • racing speech
  • loss of self-control and impulsive or reckless behaviour
  • inappropriate spending
  • hallucinations and delusions

Some symptoms of depression may include the following:

  • feelings of sadness and loss
  • feelings of guilt and worthlessness
  • feelings of extreme impatience, irritability, or a short temper
  • loss of interest or pleasure in usually-enjoyed activities
  • changes in weight or appetite
  • changes in sleeping patterns like insomnia
  • reduced ability to think clearly or make decisions
  • difficulties in concentrating or with short-term memory loss
  • constantly feeling tired
  • noticeable lack of motivation
  • anxiety and restlessness, sometimes leading to panic attacks
  • muscle and joint pain
  • constipation or other intestinal problems
  • frequent headaches
  • lack of interest in sex
  • recurring thoughts of suicide or self-harm
  • withdrawal from friends and family

The aftermath of a manic episode can be devastating both for individuals and for families and loved ones. They may now be dealing with financial hardship, the health and relational effects of risky sexual practices or the physical consequences of substance abuse or personal injury accidents or assaults that may have occurred during mania. The depressive phase can involve the risk of suicide.

Bipolar disorder is a serious illness but with treatment, people can recover and lead fulfilling lives.

If you think you or someone you know has bi-polar disorder it is important to get help from mental health professionals, most often a psychiatrist alone with a team of providers who have a variety of skills. Help involves a diagnosis – which can take some time while the mental health professional gets to know you or person you are concerned about and their symptoms. Next, psychiatric medication will be prescribed. Again, it may take time to get the right one at the right dosage level. You or the person you are concerned about will also learn that people with bipolar disorder do best with a combination of medication and personal therapy – which may extend to family therapy. Peer support and self-help are invaluable as nothing can substitute for the message that “you are not alone.”

Living with bipolar illness is not easy but full recovery is possible. The first step is taking personal responsibility for your own health.

Some Statistics

  • One percent (1%) of Canadians aged 15 years and over reported symptoms that met the criteria for a bipolar disorder in the previous 12 months. About 1 in 50 adults aged 25-44 years or 45-64 years reported symptoms consistent with bipolar disorder at some point in their lifetime. The proportion of men and women who met the lifetime criteria for bipolar disorder decreased slightly with age. (2002 Mental Health and Wellbeing Survey, Statistics Canada)
  • Nearly 9 out of 10 Canadians who reported symptoms that met the 12-month criteria for bipolar disorder (86. 9%) reported that the condition interfered with their lives. (2002 Mental Health and Wellbeing Survey, Statistics Canada)
  • While most people with bi-polar disorder (or depression) will not commit suicide, the risk of suicide among those with bipolar disorder is higher than in the general population.

Additional Resources

More information on bipolar disorder can be found in the Public Health Agency Report: “The Human Face of Mental Health and Mental Illness In Canada 2006“.

More information and resources on bipolar disorder can be found at the following web sites:

 

Eating Disorders

This section is a reproduction of “Eating Disorders in Teens: Information for Parents and Caregivers,” a Government of Canada webpage.

What Are the Warning Signs of an Eating Disorder?

If they are not recognized and addressed, eating disorder behaviours can result in serious physical and emotional problems.

Here are some signs that your teen may be struggling with an eating disorder and needs immediate help:

  • irritability, depression and social withdrawal
  • excessive preoccupation with calories, food or “healthy eating”
  • frequent negative comments about their weight and shape
  • restriction of food intake
  • making excuses to avoid eating
  • significant weight loss or weight gain (regardless of previous weight)
  • compulsive exercising
  • frequently eating excessive amounts of food in a short period of time
  • consuming food alone, at night or secretly
  • using laxatives or diet pills
  • going to the bathroom immediately after eating

How To Help Someone With an Eating Disorder

You know your teen better than anyone. If you notice unusual behaviours and are concerned your teen may have an eating disorder, your first step will be to talk to them. Encourage them to express their worries and concerns. Use “I” statements and let them know that you are aware they are struggling. For example, you may say: “I’ve noticed that you may be going through a rough time lately. I’m happy to listen or talk and see if I can help.”

Stay calm and avoid judging or blaming your teen. A teen who is struggling with an eating disorder may resist disclosing his or her behaviours or feelings. Let your teen know you care about them no matter what and you will support them through difficult times.

You can find out more about eating disorders and how to help your teen by checking out the links at the end of this information sheet.

Prevention and Treatment of Eating Disorders

Eating disorders can be prevented if action is taken at the first signs of recurrent preoccupation with body weight and image.

Teens can learn healthy ways to cope with their worries and life challenges. Parents, schools and the community all have a role to play in building healthy coping skills that will help avoid eating disorders.

If the symptoms of an eating disorder are severe, medical treatment may be needed to reverse a physical condition that could otherwise become critical. If you notice that your teen’s mental and physical health is rapidly deteriorating, don’t hesitate to seek immediate help from your primary health care provider or community health care centre.

The majority of teens with eating disorders are able to recover with support from their family, friends and community. There are many resources available across Canada that can help you find reliable information and connect to your local resources.

Where Can I Find Information and Resources About Eating Disorders?

  • National Eating Disorder Information Centre (NEDIC)
    1-866-663-4220 or 416-340-4156 in TorontoCategory: National information resource centre and help lineNEDIC provides information and resources about eating disorders, helps individuals find local treatment and support and offers support through Canada’s only national toll-free helpline. NEDIC holds a national database of service providers that work with eating disorders.
  • Canadian Mental Health Association (CMHA)Category: Raising awareness and providing resources on a national levelCMHA is a nation-wide, voluntary organization that promotes the mental health of all and supports the resilience and recovery of people experiencing mental illness.
  • Eating Disorders Association of Canada (EDAC)Category: Canadian organization of professionals working in the field of eating disordersEDAC is a Canadian organization whose mandate is to best serve the needs of those whose lives are impacted by eating disorders.
  • National Initiative for Eating Disorders (NIED)Category: Raising awareness and providing resources on a national levelNIED aims to increase awareness and education of the chronic situation facing those with eating disorders and their families in Canada.
  • Families Empowered and Supporting Treatment of Eating Disorders (F.E.A.S.T.)Category: Canadian task force of parents supporting parents and providing resourcesF.E.A.S.T. is an international non-profit organization of and for caregivers of loved ones suffering from eating disorders. Their mission is to support, promote evidence-based treatment and advocate for research and education.
  • Eating Disorder Foundation of Canada (EDFC)Category: Support to community groups making progress in the field of eating disordersThe EDFC raises funds to support education, treatment, research and supportive housing and plays a leadership role in bringing local, provincial and national initiatives together.
  • Anorexia and Bulimia QuébecCategory: Resources and information in English and in French for those suffering directly and indirectly from eating disordersAnorexia and bulimia Quebec guarantees immediate, free professional support to people affected by eating disorders. All services are offered in French and in English.
  • The Link Program – New BrunswickCategory: Provides assistance for individuals to access local services in French and EnglishThe Link Program enables individuals with any kind of problem including eating disorders to access local help services through a Link Companion in New Brunswick.To find community-specific information about eating disorders go to “Helping Tree” on the top menu bar of THE LINK Program web site and then choose your community.

Schizophrenia

This section is a reproduction of “Schizophrenia in Canada,” a Government of Canada webpage.

Schizophrenia in Canada

Schizophrenia is a psychotic disorder that can affect the way a person interacts with and understands the world.

Symptoms of active schizophrenia include delusions, hallucinations, disorganized speech and/or behaviour, and impaired cognitive ability.Footnote 1 The severity, duration and frequency of these symptoms can cause social and occupational challenges.

Causes of schizophrenia are not fully understood. Structural changes in the brain and genetics, combined with lifestyle and environmental factors, may play a role.

While there is no cure for schizophrenia, programs and treatments are available to help manage symptoms in the community and at work. Reducing public misunderstanding and fear of the disease can reduce stigma and support affected individuals.Footnote 2
According to national data (2016-2017), of Canadians aged 10+:Footnote 3

  • 1 out of 100 were living with diagnosed schizophrenia:
    • 56% were men
    • 44% were women
  • About 30% of newly diagnosed cases were aged 20 to 34 years old.
  • Among this group, the rate of new cases was more than 2x higher in men compared to women. In general, men experience an earlier onset of schizophrenia than women.
  • The all-cause mortality rate in people diagnosed with schizophrenia was 2.8x higher than those without.
  • Of people aged 1+, over 147,500 Canadians used health services for schizophrenia.Footnote 3
    • 60% were men
    • 40% were women

Have Rates of Schizophrenia Changed Over Time?

Between 2002-2016:

  • The number of Canadians living with diagnosed schizophrenia increased by an average of 3% per year.Footnote 3
  • The number of new cases declined during this period.Footnote 3Footnote 4

The Canadian Chronic Disease Surveillance System (CCDSS) is supported by a pan-Canadian partnership between the Public Health Agency of Canada and all provinces and territories. Schizophrenia data in CCDSS are updated biennially.

Learn More About Schizophrenia

Get Data Canadian Chronic Disease Surveillance System – Public Health Infobase
More Schizophrenia Society of Canada | World Health Organization

Personality Disorder

This section is adapted from Statistics Canada “Section F – Personality Disorders” (2015). This does not constitute an endorsement by Statistics Canada of this product.

A personality disorder (PD) is characterized by a stable pattern of inner experience and behaviour that deviates significantly from the expectations of society, and can lead to marked impairments in social and occupational functioning. PDs are considered a major mental health problem because of their prevalence and the disability they produce.69 Ultimately, individuals with a PD have difficulties with interpersonal relationships, and often demonstrate irritability, hostility, and fearfulness. Their personality traits (i.e., attitudes, thoughts, behaviours, temperament) are expressed inappropriately and become maladaptive. According to the DSM-IV,7 there are ten PDs that are distinctively diagnosed and are grouped into three clusters based on descriptive similarities: Cluster A includes Paranoid, Schizoid, and Schizotypal PDs—individuals with these disorders likely appear odd or eccentric; Cluster B includes Antisocial, Borderline, Histrionic, and Narcissistic PDs—individuals with these PDs often appear dramatic, emotional or unpredictable; Cluster C includes Avoidant, Dependent, and Obsessive-Compulsive PDs—individuals with these disorders tend to appear anxious or fearful.7 The functional limitations associated with all personality disorders are similar in terms of attribute levels, therefore only one health state is described for an individual diagnosed with an unspecified personality disorder.

PDs affect between 6% and 15% of the population.125,126 The most common of the PDs are obsessive-compulsive (with a prevalence rate of 7.7% according to DSM-IV criteria), avoidant (6.6%), paranoid (5.6%), borderline (5.4%), and schizotypal (5.2%).126PDs typically become recognizable by adolescence or early adulthood, although some individuals may not seek clinical attention until much later. It is possible for a PD to become exacerbated after the loss of a significant supporting person or situation.7 The course of a PD is relatively stable over time.

The DSM-IV diagnoses a PD if an individual exhibits maladaptive behavioural and cognitive patterns which are evident in at least two of the following areas: cognition, affectivity, interpersonal functioning, or impulse control. In addition, the pattern must be pervasive and inflexible across a wide range of personal and social situations, and cause clinically significant distress in social, occupational, or other areas of functioning. Evidence of the PD must have been present in at least adolescence or early adulthood, with a stable pattern of long duration. The pattern cannot be due to another mental disorder, or due to the physiological effects of a substance or a general medical condition.7 Specific (types of) PDs require their own criteria, which are presented in the DSM-IV manual.7PD diagnoses apply only to the completely formed personality, thus, they are rarely made before age 18 and are therefore not usually assessed in children and adolescents.69

The causes of developing a PD are unknown. Researchers believe that a specific situation or event (e.g., loss of a parent or friend) can trigger the behaviours common in PDs, particularly events in early childhood that have the potential to influence behaviour in later life. A genetic vulnerability to developing a PD has also been suggested.127,128,129 Social factors, such as parental neglect, overprotection, or abuse may contribute to personality or other psychiatric problems in children. Because onset of PDs is usually in adolescence, a time when the personality stabilizes and matures, individuals with PDs are prone to developing maladaptive coping mechanisms and low self-esteem.127,128,129

Overall, there is no cure for a PD, but treatments are available to improve prognosis. Depending on the PD, pharmacological interventions can be targeted at reducing impulsivity (e.g., olanzapine, neuroleptics) and depression (e.g., serotonin reuptake inhibitors); antipsychotics may be used in cases of distorted thinking. Psychotherapy (individual, group, or family) is directed towards management of the disorder, including education about the illness, support, and social skills training. Psychotherapy, however, may be difficult for an individual with a PD because they may be reluctant to build a trusting relationship with the therapist. Character modification may be necessary to improve mood instability and impulsive behaviours, or for the individual to learn ways to cope with rejection and abandonment fears, self-destructive behaviours, or other traits associated with the particular PD being treated. Inpatient care is rarely required.

Due to the generally low rate of compliance with treatment, the following health state describes the functional limitations associated with an individual diagnosed with a PD who is not undergoing treatment.

Individuals with a PD exhibit the whole spectrum of personality features that do not allow for adequate social functioning. Some tend to be extremely unstable emotionally – feelings range from intense and inappropriate anger, to feelings of guilt and shame and depression, to feelings of inadequacy and inferiority. Others may show impulsive behaviour, sexual promiscuity or reckless driving, and possibly suicide attempts, particularly at times of crisis (i.e., a change in job or relationships, a therapist’s or family member’s vacation). Mentally, individuals with a PDmay have an unstable self image and identity confusion, or may be hypersensitive to rejection and feel hurt by criticism or disapproval. Interpersonal relationships are extremely unstable as well; attitudes towards family members or friends may suddenly shift from great admiration and love to disappointment, dislike and anger. A major characteristic of a PD is social withdrawal or rejection. Individuals with a PD tend to have an impaired capacity for attachment. Family life is often disrupted, and occupational and social functioning are limited. Anxiety is experienced. Occasionally, individuals with a PD may perform self-harmful behaviours.

Suicide

This section is a reproduction of “Suicide Prevention,” a Government of Canada webpage.

Defining Suicide

Suicide is the intentional action of ending one’s life.

A suicide attempt is when someone tries to end their life. An attempt often means that a person needs help and may be at high risk for suicide.

Suicide-Related Behaviours

Suicide-related behaviours can include the following:

  • thinking about or considering suicide
  • planning suicide
  • attempting suicide

Suicide Survivors

Survivors are those who have

  • lost someone through suicide and/or
  • survived a suicide attempt and may continue to experience thoughts of suicide or suicide-related behaviours.

Suffering and Suicide

People who die by suicide don’t necessarily want to end their lives. They often want to stop significant or unbearable mental, emotional or physical pain. They want to end their suffering or put an end to a situation that seems overwhelming to them.

If you or someone you know is struggling with thoughts of suicide or suicide-related behaviours, you’re not alone. Learn more about the warning signs and how to ask for help.

How To Talk About Suicide

We use the terms “attempt” and “died by suicide” because they help break the stigma around suicide and mental illness. Stigma is the negative associations made about certain:

  • people
  • qualities
  • activities
  • behaviours
  • circumstances

To use the term “commit suicide” is like saying it’s a criminal offence. Suicide isn’t a crime. These types of negative associations can make it harder for

  • someone to ask for help when they need it and
  • survivors to heal after being affected by suicide.

Those Affected by Suicide

Suicide affects more than just one person. It’s a tragedy that affects many people in society, including

  • peers,
  • friends,
  • coworkers,
  • communities, and
  • family members.

It also affects

  • coaches,
  • teachers,
  • spiritual leaders,
  • recreational staff,
  • community workers,
  • mental health professionals, and
  • health and social service providers.

It can also affect first responders who contribute to suicide prevention. They may experience increased risk of suicide because of their exposure to trauma on the job. First responders can include

  • firefighters,
  • paramedics,
  • police officers,
  • military personnel,
  • correctional officers, and
  • other emergency personnel.

If you’re struggling with your mental health or are worried about someone, you’re not alone. Get help now.

Warning Signs of Suicide

Warning signs that might suggest someone is at risk of suicide include

Other signs and behaviours that might suggest that someone is at risk of suicide include the following:

  • withdrawal from family, friends or activities
  • feeling like you have no purpose in life or reason for living
  • increasing substance use, like drugs, alcohol and inhalants
  • feeling trapped or that there’s no other way out of a situation
  • feeling hopeless about the future or feeling like life will never get better
  • talking about being a burden to someone or about being in unbearable pain
  • anxiety or significant mood changes, such as anger, sadness or helplessness

Factors That Increase the Risk of Suicide

No single cause can explain or predict suicide. Thoughts of suicide or suicide-related behaviours are a result of a combination of personal, social and cultural factors. The presence of these factors is different from person to person over their lifetime.

Factors that may increase the risk of suicide include the following:

  • a prior suicide attempt
  • mental illness like depression
  • a sense of hopelessness or helplessness
    • this means that you believe your life or current situation won’t improve
  • misuse of alcohol or substances
  • chronic (long-term) physical pain or illness
  • trauma, for example:
    • violence
    • victimization, like bullying
    • childhood abuse or neglect
    • suicide by a family member or friend
    • events that affect multiple generations of your family

Other factors that can increase the risk of suicide include the following:

  • significant loss, including:
    • personal (relationships)
    • social
    • cultural
    • financial (job loss)
  • major life changes or stressors, such as:
    • unemployment
    • homelessness
    • poor physical health or physical illness
    • the death of a loved one
    • harassment
    • discrimination
  • lack of access to or availability of mental health services
  • personal identity struggles (sexual, cultural)
  • lack of support from family, friends or your community
  • sense of isolation

What Helps To Prevent Suicide

There are a number of things that can help to guard against suicide, including the following:

  • positive mental health and well-being
  • a sense of hope, purpose, belonging and meaning
  • social support
  • healthy self-esteem and confidence in yourself
  • asking for help if you’re having thoughts of suicide
  • a sense of belonging and connectedness with your:
    • family
    • friends
    • culture
    • community

Other ways to help protect against risk of suicide include the following:

  • a strong identity (personal, sexual, cultural)
  • access to appropriate mental health services and support
  • good coping and problems-solving skills, and the ability to adapt to change and new situations
  • supportive environments where you’re accepted and valued (school, workplace, community)
  • positive relationships (peers, family, partner)

If you’re struggling with your mental health or are worried about someone, you’re not alone. Get help now.

Get Help

If you need to talk and you

  • are not feeling yourself,
  • are experiencing a crisis,
  • have emotional pain, or
  • know someone who needs help.

Crisis Services Canada

Available to all Canadians seeking support. Visit Crisis Services Canada for the distress centres and crisis organizations nearest you.

If you or someone you know is thinking about suicide, call the Canada Suicide Prevention Service at 1-833-456-4566 (24/7) or text 45645 (4 PM – 12 AM ET).

Kids Help Phone

Call 1-800-668-6868 (toll-free) or text CONNECT to 686868.

Available 24 hours a day to Canadians aged 5 to 29 who want confidential and anonymous care from professional counsellors.

Download the Always There app for additional support or access the Kids Help Phone website.

Hope for Wellness Help Line

Call 1-855-242-3310 (toll-free) or connect to the online Hope for Wellness chat.

Available to all Indigenous peoples across Canada who need immediate crisis intervention. Experienced and culturally sensitive help line counsellors can help if you want to talk or are distressed.

Telephone and online counselling are available in English and French. On request, telephone counselling is also available in Cree, Ojibway and Inuktitut.

How To Help Someone in Crisis

Talking honestly, responsibly and safely about suicide can help you determine if someone needs help. If you want to help someone in crisis, try:

  • listening and showing concern
    • showing concern can be an immediate way to help someone
    • listening won’t increase the risk of suicide and it may save a life
  • talking with them and reassuring them that they’re not alone
  • letting them know you care
  • connecting them with a:
    • crisis line
    • counsellor
    • trusted person (neighbour, friend, family member or Elder)

License

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Fundamentals of Health and Physical Activity by Kerri Z. Delaney and Leslie Barker is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.