Mental health

Adolescence is a time of complex change.

While this can make young people vulnerable to mental health issues, it is important to recognise that most young people get through adolescence without major difficulty.

Better awareness of mental health problems in young people, understanding prevention strategies, early identification of problems and seeking appropriate help are the keys to good mental health for young people.

• Mental health and wellbeing
• Getting support
• Romantic relationships
• Depression
• Self-harm
• Psychosis
• Parents, families and carers

Mental health and wellbeing

Mental health problems are the most common health problems in young people. Between 20 and 25 per cent of Australian adolescents will experience a mental health or substance-abuse problem in any given year. Many will experience more than one problem at the same time. Anxiety, depression and substance abuse are the leading mental health problems in young people.

Mental health issues need to be taken seriously as they can lead to poor academic achievement, poor social functioning, unemployment, substance abuse, self-harm and suicide. Recognising problems and getting appropriate and timely help are very important. In the first instance this might involve finding somebody to talk to, and getting some information, support and assistance with developing coping strategies. At other times more specialist help might be needed.

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Getting support

Young people are often reluctant to seek help when dealing with problems. It is estimated that as many as 75 per cent of young people who need professional help do not access health care.

However, a range of youth-friendly services have been developed, and they continue to expand across Australia to meet the needs of young people. This extends into the online environment with a range of information and resources available, as well as online mental health counselling and support. These services have increased the opportunities for young people to seek help in a range of ways that work better for them.

Help at hand

The Butterfly Foundation for Eating Disorders and Eating Disorders Victoria provide support for people suffering from eating disorders and negative body image issues.

Headspace is the National Youth Mental Health Foundation. Go to the website to locate a Headspace center near you or to access online and telephone mental health counseling.

Reachout is an online mental health service providing information and support for young people.

beyondblue is a national organisation working to help those with depression and anxiety. Youthbeyondblue is the arm of the organisation specifically focused on young people.

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Romantic relationships

While romantic relationships are a normal and healthy part of adolescent development, they bring with them new stresses and risks. This is particularly so for young people who may be same-sex attracted or questioning their sexuality or gender. If these young people are experiencing isolation, bullying and homophobia, their risk of distress and mental health difficulties increases.

Some of the factors related to romantic relationships that that can cause distress for adolescents include:

• a first romantic relationship
• a recent break-up
• unhealthy relationships, such as those with extreme ‘highs and lows’, controlling behavior or violence.

For a small number of vulnerable young people, a recent relationship break-up (in the last 12 months) appears to be one of the triggers for developing a first episode of depression during adolescence. (See depression.) 

It can be very important to have someone to talk to about your experience and feelings, to be able to learn the difference between healthy and unhealthy relationships, and to learn how to act respectfully towards your romantic partners and their interests. Also be aware of the challenges related to social networking, media and cyberbullying.

Dealing with a ‘broken heart’

Regardless of the duration of the relationship, endings can be very difficult, distressing and messy.

It is important to find ways of managing those intense feelings of sadness, anger and loss. Things that can help when you have taken a knock to your confidence include talking with a trusted person, doing things that you enjoy, going out with friends and having the support of friends and family around you.

Watch out for negative and distorted thinking such as ‘I’m ugly, nobody loves me’. Remember to spend time with those who love and value you.

It is also important for you and your ex-partner to act respectfully towards each other, and know that sometimes things don’t work out and it’s nobody’s fault.

Also remember that your relationships in adolescence are helping you to work out who the right person for you is, and it’s unlikely to be your first romantic partner.

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Depression

People who have not suffered from depression do not understand how it can affect people. Taking symptoms seriously can help sufferers from spiraling into a depressive disorder. 

Depression is a word that is used to describe everyday feelings of sadness, as well as to describe depressive disorders. Sadness and unhappiness are things that we all experience at some point in our lives, and it can sometimes be difficult to distinguish this from the symptoms of an emerging depressive disorder, especially in adolescents.

Depression is common, often starting in adolescence and young adulthood, and will effect one in four young people between the ages of 15 and 25. It is a serious and disabling illness that can have a significant impact on your wellbeing and can be a risk to your life. Fortunately, treatment is usually very effective and safe.

Treatment for depression may involve a combination of support, education, psychological treatment, lifestyle intervention and antidepressant medication. Having support through a difficult and confusing time, having a trusted adult to talk to, and understanding the nature of depression and what is happening to you are very important factors in recovering from depression. Support and education for families and carers is also essential, as they too are often feeling worried and confused.

Your GP or a professional counselor can advise on the best treatment depending on your circumstances.

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Self-harm

Self-harm is when someone deliberately injures themselves. Some of the more common self-harming behaviours include cutting, burning and scratching.

Self-harm is most common between the ages of 11 to 25 but is not limited to this age group. People who self-harm have usually had past or current negative experiences such as relationship breakdown, abuse (physical, sexual, emotional), significant loss, long-term family problems, bullying or serious illness or disability.

It can be difficult to distinguish self-harm from suicidal behaviour; however, while young people who self-harm may be very distressed and overwhelmed, they generally don't intend to end their lives.

If you are engaging in self-harming behaviour, it is important to let someone know and not to try and manage this on your own. Talking to a trusted adult or a health professional is a good place to start.

If you are concerned that someone you know is self-harming, or you see evidence that suggests self-harm, speak to the young person about your concerns and offer your support and assistance in getting help. If you are unsure about what to do or how to broach the topic with them, speak to your GP or to a local mental-health professional, such as a school counsellor.

Remember, self-harm behaviour should always be taken seriously.

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Psychosis

People who suffer from psychosis lose touch with reality. There are various psychotic disorders and they affect about one in 100 people. They commonly begin in the teens or early 30s.

The treatment of psychosis involves a comprehensive assessment to exclude medical causes for the symptoms, as well as to identify if illicit drugs have caused or worsened the symptoms. Ensuring the safety of the person with psychosis as well as others is important. Harm to yourself or others can result from delusional beliefs (for example, the belief that someone is trying to kill you, leading you to take defensive action) or hallucinations (such as a voice telling you to harm yourself), or as a result of feelings of depression leading to suicidal thoughts or actions.

Early intervention is important because delayed treatment can affect study, work, family and other relationships, as well as interfere with normal adolescent and early adulthood development.

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Parents, families and carers

Looking after a young person who is experiencing mental health difficulties can be very stressful for other family members and carers. Often parents and carers feel worried, distressed and confused about what to do and how best to help a young person. It is important to remember that families are very important and a vital part of a young person’s recovery. Young people with supportive families do better than young people without support networks.

The following are some useful hints for parents and carers looking after someone with a mental-health difficulty:

• Talk to the young person about your concerns and your wish to support them in finding solutions for their current difficulties.
• Be calm, non-blaming and non-judgemental
• Remind the young person that they are loved and valued (even though some of their behaviours might be challenging)
• Ask the young person what they would find helpful.
• Give your unconditional support.

It is important to remember that this is a time when a young person is not functioning at their best and may not be making very good decisions, and therefore they need your support even more. At the same time this is often a stressful time for other family members who often also need support and assistance to deal with their feelings and emotions as well as practical information. Your GP can give you information and refer parents to local counsellors who can assist. Online information for parents and carers can be found on websites such at Headspace and beyondblue.

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