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Depression

Sept 20th 2017

Depression can affect children and young people just as it affects adults.

New research shows a quarter of girls (24%) and one in 10 boys (9%) are depressed at age 14.

Researchers from the UCL Institute of Education and the University of Liverpool analysed more than 10,000 children and found that 14-year-olds’ own reports of their emotional problems were different to their parents’, highlighting the importance of having open conversations about emotions with your kids.

“Worryingly there is evidence that parents may be underestimating their daughters’ mental health needs,” the authors wrote in the report published with the National Children’s Bureau.

“Conversely, parents may be picking up on symptoms in their sons, which boys don’t report themselves.”

Why might your child be depressed?

Dr Monika Parkinson, clinical psychologist and co-author of ‘Teenage Depression: A CBT Guide For Parents’, said it’s important for parents to first realise that depression is a “complicated illness”.

“There is never one reason or one cause,” she told HuffPost UK. “Depression can be down to a whole interplay of different factors.”

She said parents should never blame themselves.

“There may be a biological basis to it and they may have a sensitivity to developing depression,” she said.

“There could be a whole bunch of life events or triggers such as bullying, parental separation, bereavement, or any kind of loss.

“And also, it is down to how they cope with things and their resilience.”

Calls to the helpline run by child and adolescent mental heath charity YoungMinds, show that children face a huge range of pressures as they are growing up.

According to parents’ helpline operations manager Emma Saddleton these include: stress at school, body image issues, bullying on and offline, around-the-clock social media and uncertain job prospects.

And Sarah Blackie, head of operations at PAPYRUS (Prevention of Young Suicide) said even good news can provoke depression or suicidal thoughts in kids.

“This could be the perceived loss when an older sibling moves to a new school college or university or a significant person in the young person’s life has a major change in their life and the young person sees that as a loss to themselves,” she explained.

How can you spot if your child is depressed?

As depression is a complicated illness, children who are depressed don’t fit a set of fixed signs and symptoms. But there are things parents can look out for.

“It is hard to hide depression,” said Parkinson. “It’s all-consuming and pretty hard to put on a brave face, so most parents will start to notice changes in their child’s behaviour.

“It’s important to notice what is different to your child’s ‘normal’. What’s difficult is that it might pop up at the same time as puberty, when children already have changes going on.

“So for parents, it’s about noticing what is really different and looking to see whether a child gets better over a period of time.”

Saddleton agreed that a change in a child’s behaviour is a crucial signal for parents to look out for.

“While depression can show itself in many different ways, big changes in your child’s behaviour can be a warning sign,” she told HuffPost UK.

“If they are not wanting to do things that they previously enjoyed, not wanting to meet friends, sleeping a lot more or less than normal, eating a lot more or less than normal, or seem constantly irritable or upset, it’s important to take it seriously.”

Common symptoms and signs your child may be depressed:

Parkinson said symptoms frequently associated with a child suffering from depression

Experiencing low mood

 Having loss of interest in activities they normally enjoy

  withdrawing from seeing friends and family

irritability – feelings of anger or lashing out unnecessarily 

She added: “There are also more obvious signs including self harm and them talking about death or suicide.”

Blackie said parents should also listen out for suicidal thoughts or phrases like: “There is no point in it all”, “Why am I going on?” and “What is the point of keeping going with this?”.

Less common symptoms and signs your child may be depressed:

Other things Parkinson advises watching out for include:

Tiredness and complaints of feeling tired all the time.

Changes in weight and appetite.

A difficulty to make decisions.

Not being able to concentrate.

Not being able to keep up with lessons in school.

Feeling restless and agitated, going from one thing to the next.

Feelings of worthlessness, feeling like they’re not good at anything

Blackie added: excessive drug or alcohol use (depending on their age), risk-taking behaviour, lack of self-care and a lack of care for previously precious things.

How long should you monitor symptoms?

As a rule of thumb, if symptoms last at least two weeks or more and occur most days, then Parkinson said you should assume something is not quite right and seek professional help.

What next steps should parents take?

 “As a general recommendation to parents, just ask your child how they are, even if they tell you go to away,” said Parkinson.

“Do ask and don’t be put off to keep on asking.

“Parents need to give the message to their child that they are there to talk when they’re ready. Ask them how they are feeling and show you’ve noticed changes.”

Saddleton said if your child does open up, don’t make assumptions and make sure you listen to what they have to say.

“Make sure they know that you love them and are proud of them, and that you’re on their side,” she said.

“It can be a good idea to talk to your child about what they think would help, as they may have good ideas about solving their own problems.”

If you are worried your child has thought about suicide, Blackie advised asking them about it in a straight-forward manner.

“Asking directly – ‘Are you telling me you are thinking of killing yourself?’ is a straightforward question and likely to get a truthful answer.

“Hence it is far more preferable to a general, judgemental and negative: ‘Are you thinking of doing something silly?’”

Parkinson said parents should suggest to their child that they go along to the GP, and give their child options including offering to go along with them, offering to do all the talking, or allowing their child to go in alone to talk to themselves.

“I point parents towards self-help material and websites [see below] too,” she said. “This can help them feel a bit knowledgeable about it and talk to other parents.

“My one message to parents would be: Don’t suffer it alone. Get help.”

For more information and support:

“Hence it is far more preferable to a general, judgemental and negative: ‘Are you thinking of doing something silly?’”

Parkinson said parents should suggest to their child that they go along to the GP, and give their child options including offering to go along with them, offering to do all the talking, or allowing their child to go in alone to talk to themselves.

“I point parents towards self-help material and websites [see below] too,” she said. “This can help them feel a bit knowledgeable about it and talk to other parents.

“My one message to parents would be: Don’t suffer it alone. Get help.”

Sept 7th 2017

"Cyberchondria" is fuelling an epidemic of health anxiety, with one in five NHS appointments taken up by hypochondriacs and those with irrational fears, experts have warned.

Researchers from Imperial College London said internet searching and the use of fitness trackers is heaping pressures on busy hospital clinics.

Health anxiety is estimated to cost the NHS more than £420 million a year in outpatient appointments alone, with millions more spent on needless tests and scans, they warned.

Instead, such cases should be offered a course of counselling, psychiatrists said, following a five-year study of patients treated in five English hospitals.

Researchers said the internet was feeding a “silent epidemic” of health anxiety, where harmless ailments could be mistaken for terrifying diagnoses.

And they said the growth of fitness trackers was likely to increase levels of hypochondria, heaping pressures on cardiac clinics and neurology units.

Dr Helen Tyrer, a senior clinical research fellow at Imperial College London, said the anxiety was often triggered by an event, such as the patient suffering a health scare, somebody in their family getting ill or dying, or a celebrity their age dying or getting sick.

"They become convinced they have or are developing a serious underlying disease, or that an existing medical problem is much more serious than it is," she said.

"These beliefs are held despite all medical evidence to the contrary.”

Lead author Professor Peter Tyrer said the internet appeared to be fuelling the trend: "We suspect that it is increasing in frequency because of what is now called cyberchondria," he said.

"People now go to their GPs with a whole list of things they've looked up on the internet and say 'what do you make of this?', and the poor GP, five minutes into the consultation, has four pages of reading to do.

"Dr Google is very informative but he doesn't put things in the right proportion,” he said.

The study, funded by the National Institute for Health Research, tracked 444 patients with “severe health anxiety” seen at cardiology, gastroenterology, neurology and respiratory departments.

While some had genuine health complaints, or had suffered them the past, all had abnormal levels of anxiety. Those given cognitive behavioural therapy saw a significant drop in anxiety levels, five years on, with similar death rates to those given standard NHS care, suggesting that counselling did not lead to a failure to discover life-threatening illnesses, researchers found.

July 5th 2017

Depression is the curse of modernity, affecting more and more of us. It is the black dog that haunts us, the lethargy that makes it impossible to get out of bed. It is the vacuum of meaning which sucks out all our desire, our hope, so we are left in an empty void. Sadness is something we all experience, part of the fluctuations in moods that make up everyday experience. But depression? Depression is something else.

Depression is often as physical as psychological. It saps energy and – evidence increasingly suggests – puts bodies in a state of chronic, dulling inflammation. Gait can change, even the capacity to speak in anything but a monotone. At the same time, it is remarkably difficult to locate a biological cause to depression. The chemical imbalance theories that saturate public understandings just do not fit with the evidence.

Clinical diagnosis is based, therefore, not on any objective tests but on history taking and a patient’s present mental state. Because depression is so difficult to differentiate from everyday sadness, diagnosis is based on the functional impact of experiences such as loss of interest, low energy and lack of confidence, alongside potential risk. Psychiatric diagnosis is a bit like carving up nature by the joints. A diagnosis of depression tells us that something is wrong, but never quite what.

Psychological models often emphasise a person’s negative views of themselves, the future and the world. These often emerge as a result of early experiences – things such as chronic bullying, abuse, being put down, or being expected to be perfect all the time. But depression is also often a result of loss. This may be the loss of someone we love, but it can also be the loss of an ideal. For example, that we can completely fulfil the needs of a partner, or that a dream job will make us happy. One’s sense of self can collapse, implode, leading to a death of meaning and purpose. Health problems can also cause, or at least mimic, depression. For example, people with thyroid disturbance, liver cirrhosis or a dementia process are more likely to become depressed.

Sociologists tend to emphasise the social causes of depression. It is no coincidence that women, people living in poverty, and those who have experienced discrimination are far more likely to experience depression. This is because depression and oppression are inextricably linked. There is also clear evidence – perhaps the most robust in the field – that chronic adversity is deeply damaging to both the body and the psyche. This can become dangerously invisible when depression is viewed as a simple medical problem.

Many people are concerned that the category of depression is being expanded to encompass too wide a range of human experiences, and that this may be damaging. In 1950, depression was only estimated to affect about 0.5% of the population. When antidepressants were developed, drug companies worried that there would not be enough people to prescribe them to.

Since then, depression has been marketed relentlessly despite its fuzzy nature as a diagnostic category. This has shaped how people view and thus experience their internal worlds. People have traditionally viewed the soul as a place of conflict, divided between productive and destructive urges, passion and reason, primal instincts and excessive control. But our inner worlds are now monopolised by market values – the idea that we can and should be able to excise problematic emotions such as sadness, to fashion a more sellable Brand Me.

To trouble the ideas that breed depression, it is vital to try to hear what a symptom is trying to communicate, to unfurl the onion layers around depression and uncover its message. From an evolutionary perspective, depression is often seen as serving the function of forcing a period of reflection. Many people do not regret periods of depression, finding it forced them to leave a problematic job or relationship, or re-evaluate how to live meaningfully in rejection of ideas such as that we must always be digitally “on” and available.

However, the capacity to alter how we live our lives is only possible with adequate access to space for reflection – such as via psychotherapy – and material resources to afford choice. This is why addressing structural inequalities and poverty are as important an antidote to the current epidemic of depression as the prescription pad.

If you are feeling low, conversations are very important, as depression likes to lock us in with our internal persecutors who are not – though they will probably tell you otherwise – the most reliable authorities on your worth. These conversations may be with clinicians, but many people have also found a pathway out of the woods of depression though connecting with activist groups, the local community, nature, animals and religious organisations. If things are not so bad – if you can function OK, and have some hope – viewing your experiences as everyday sadness that will pass can help to ensure you do not start to panic when your inner world throws up its occasional burps. Tagging all our negative experiences as signs of potential mental illness can do more harm than good.

For those of you who are really low, however, I want to say something else. There are many of us who have been at death’s door as a result of mental health problems and yet have found a way back. None of us believed at the time that this could be possible. However bleak life feels right now, however hopeless, things can change. Try not to let depression trick you into believing anything different.

• If you are suffering from depression here are some services that could help: find your local GP to access medication, psychotherapies and social care support here. The gateway service for psychological therapies in the UK is a scheme called Improving Access to Psychological Therapies (IAPT).

The Samaritans are available 24 hours a day. You do not need to be suicidal to call. Telephone 116 123 in the UK or email jo@samaritans.org. Maytree is a free, non-medicalised home from home to stay for a couple of days if suicidal. They can be reached on 0207 263 7070.

June 9th 2017

Anxiety is an adrenaline-fuelled feeling that everyone will experience, to some extent, during his or her lifetime. For some, this feeling and its physical and mental manifestations will arise at naturally stressful times – before a big meeting at work, before a visit to the doctors or before embarking on a new challenge, for example. This is normal and can even be beneficial if it drives us to work harder or be more prepared.

For others, however, anxiety can be triggered by seemingly small, unimportant events or situations. They may not even be able to put a finger on what's ignited that feeling of unease and panic that, in turn, can induce headaches, feelings of exhaustion, limb discomfort, light-headedness and lack of appetite.

These are the people that don't have to accept such levels of anxiety as normal and should perhaps think about taking steps to over come them. If you recognise any of the following behavioural traits in yourself, read on to find out where you can seek advice…

6 signs your anxiety is taking over

1. Turning down social invitations

Of course it is ok to say no to dinner parties, lunch dates or social gatherings occasionally if you are feeling unwell, but if you regularly turn down opportunities to socialise because they make you feel nervous and anxious about their outcome, then your anxiety may have begun to take control.

The more you avoid the situations that cause anxiety, the tighter the anxiety will squeeze you. Although it may be hard and scary in the short term to face your fears and go to that party or weekend away, it will make you feel more empowered and in control in the long run.

2. You have trouble sleeping

Those nighttime hours, when all we long for is both mental and physical rest, are often the ones when our brains will try and conquer our worries and troubles. Our anxieties can invade our dreams, wake us up in the night and even completely stop us from drifting-off in the first place.

The more tired you feel during the day, the less likely you are to feel motivated to face your anxiety triggers.

3. Your moods are affecting your relationships

A cocktail of anxious feelings and exhaustion can make you feel grotty and grumpy. It's easy to get yourself in a state of self-pity which can feel, at times, like it will be never-ending. It's also easy to take these feelings out on those who are closest to us.

You may also find yourself feeling misunderstood and alone if your friends and family have never experienced anxiety before and can't understand your struggle.

But, a strong support network is crucial for our wellbeing so, if you feel your relationships shifting because of your anxiety, it's time to seek advice.

4. A change in your weight

Feeling anxious can often suppress appetite and cause weight loss. It can also, on the other hand, lead to comfort eating and cause weight gain. Both of these can have knock-on affects on our general health and wellbeing.

Sudden changes in weight can also signify a number of other health conditions and should always be assessed by your GP.

5. You have increasingly negative and potentially harmful thoughts

This is perhaps the most obvious but, especially if anxiety is a new sensation for you, you may need to take a step back and see if your thought processes and personality traits have changed over time.

If you are unhappy, always use negative terminology towards yourself, have feelings of worthlessness and, at the most extreme, urges to harm yourself, you should seek help immediately.

6. You no longer do the things that make you happy

Whether it's gardening, seeing friends, going to yoga, painting or simply reading a book, if you are doing less of these due to any of the above reasons, it's probably time to get back to your old self!

May 11th 2017

One in four people will experience a mental health problem each year, according to support charity Mind.

It’s important to know how to spot the symptoms if you are struggling to cope, and how to distinguish depression from other mental-health issues.

Here’s a guide to how to tell if you are suffering from depression and how to get the help you need.

I feel down at the moment, am I depressed?

Most of us feel down from time to time, but mental health experts say you may be depressed if you feel low for more than two weeks.

Head of information at mental health charity Mind, Stephen Buckley, told the M.E.N: “If you’re feeling low for a couple of weeks or more without much change in mood, or such feelings return over and over again, this could be a sign of depression. Depression is a low mood that lasts for a long time, and affects your everyday life.”

What are typical symptoms of depression?</h3>

There are a few different signs and symptoms of depression. These include persistent sadness or low mood, and/or loss of interests or pleasure. Other symptoms include fatigue or low energy, disturbed sleep, poor concentration or indecisiveness. People might also experience low self-confidence, poor or increased appetite, suicidal thoughts or acts, agitation or slowing of movements, guilt or self-blame.

A system called the ICD-10 is used as a reference point by psychologists to diagnose depression among patients. Research suggests that patients must experience at least four of the above symptoms to be categorised as mildly depressed. Anyone who experiences five or six symptoms is considered moderately depressed, and anyone with seven or more is considered severely depressed.

How do I know how bad my depression is?

How people experience depression can differ greatly. In its mildest form, depression can mean just being in low spirits. It doesn’t stop you leading your normal life but makes everything harder to do and seem less worthwhile. At its most severe, depression can be life-threatening because it can make you feel suicidal or simply give up the will to live.

Stephen added: “Symptoms of mental health problems may vary from person to person, but there are some common signs to look out for.

“For example, someone with depression might feel restless, low-spirited, numb or helpless, sleep too much or too little, not eat properly, withdraw from contact with friends or family, or even – in some cases – think about suicide.”

What shall I do if I feel depressed?

It’s important to seek help if you think you may be depressed. Reach out to people close to you, speak to a friend of family member, or go to your local GP, who can talk you through the support available. It may be they recommend therapy or medication. Stephen said: “Speaking to your GP might seem daunting, but it’s the first step to getting the help and support that’s right for you.”

You can also contact your local IAPT branch, a free talking therapy service provided by the NHS. 

May 11th 2017

People who don’t have a mental illness may not know what it feels like to have depression or anxiety, but that doesn’t mean they can’t try to understand it.

Understanding and empathy helps break down stigma, but more importantly, can help us to better support loved ones and colleagues when they are struggling.

Here on Reddit, users with a mental illness were asked to reveal what they wished non-ill people knew.

Getting angry at me doesn’t help

“If you hate me because you think I’m not trying hard enough, I can assure you that I hate me more.

“The reason getting angry at people with mental illness never works to motivate them is because you’re never saying anything they haven’t already said to themselves 1000+ times.”

- JuPasta

It may not seem like it, but I’m trying my hardest

“I’m trying really hard to appear normal and functional, so when you call me out, all you’re doing is letting me know that I’ve failed to present a passable charade, which makes me feel even more pathetic. People that are dealing with depression aren’t stupid and most are overly self-aware.”

- varicoseballs

And I’m not lazy, I can’t function

“I’m not staying in bed all day because I’m lazy, I literally can’t face leaving my room. I don’t enjoy this. I wish I could get up and go outside and do something. I wish I could be like “normal” people, but I can’t.”

- Callyopi

Depression isn’t just sadness

“The Hmong people of South East Asia have a word for depression which translates directly to ‘loss of soul’. They believe that depression is caused by your soul literally leaving your body, and that you have to get it back.

“I do not believe souls exist and that is still the best way of describing what it’s like I can think of. It’s like something vital to your existence as a human is just gone for no reason, and you have no idea how to find it again.”

- Frommerman

Practical advice almost never works

“An acquaintance of mine always says to me “you think too much” and one time he said “just stop thinking, it’s that easy” and after the couple of second it took to realise he was serious I respond with “OH PRAISE THE LORD, I’VE BEEN HEALED. ALL IT TOOK WAS YOU SAYING TO STOP THINKING. WHY DIDN’T I TRY THAT BEFORE??” I’ve already said that to myself millions of times. If it didn’t work those times, it sure as hell is not going to work now...”

- DYMO_LabelWriter330

Kindness goes a long way

“I can’t count the number of times this last year I’ve started bawling in public. I’m not ashamed to cry, but its getting ridiculous.

“Those people who attended to me when I was obviously hurting, From others on the bus to the police called about me being some kind of human disaster area. A pat on the back and some kind words go a long way.”

- alittle_extreme

It’s not something that can be ‘fixed’, but I want a life for myself

“A lot of people try to tell me that it’s a “curable” problem, like I’ll just have to un-learn my depression and then I’ll be totally well. But for a lot of people, especially those of us who started showing symptoms when we hadn’t even hit puberty, it’s a biological condition that we’ll have to learn how to manage for our entire lives.

“I’m very likely never going to be able to make my brain function as a healthy brain does and I have to live my life accordingly. The thing that keeps me going is the hope that I can still live my life and still be a person in the world, provided i have the tools I need.”

- nerdlett

Like any treatment, for any illness, it’s not perfect

“There’s a lack of understanding that medications, and even counselling and therapy comes with backlash. Side effects can be worse than the disease sometimes, and being picked apart and put under a microscope doesn’t always leave you feeling like much more than a turd society wants to scrape off its shoe.

“Getting better often means getting worse in the process. Nobody seems to have much sympathy for that. “You haven’t gone outside since your appointment, you need to get out there”. Yep. Will get right on that.”

And a final note on the most common response to mental illness...

“It’s all just in your head man.”

Well ya, and your diabetes is just in your pancreas.

- Princehanz

May 11th 2017

It can, and does, affect anyone regardless of how they look from the exterior. The continuing stigma surrounding it, which although may be starting to open up, makes it difficult for some people to feel comfortable enough to talk about it and therefore leads misconceptions to perpetuate.

On Sunday, a woman called Katelyn Todd shared what living with depression is really like by posting a photo of herself brushing her hair for the first time in four weeks on Facebook.

“It was matted and twisted together. It snapped and tore with every stroke. I cried while I washed and conditioned it, because I forgot how it felt to run my fingers through it,” Ms Todd explained in the post which has since been liked more than 150,000 times and shared more than 227,000 times. She also said she had managed to brush her teeth for the first time in a week, wash her clothes and shower.

“When I got out of the shower, I couldn't stop sniffing my hair and arms. I've avoided hugging people for a while, because I never smell good. I always smell like I've been on bedrest for a week. I have no clean clothes, because I'm too tired and sad to wash them,” she wrote.

Ms Todd said depression is “bad hygiene, dirty dishes and a sore body from sleeping too much” and described more of her symptoms including hysterical crying “until there’s no more tears”, staring into space, feeling so distant and distracted that your family worry “you don’t love them any more” as well as a general feeling of emptiness.

Depression is often described as a “black cloud” over everything a person does or a “black dog” following them around all day. While many people may feel down for a day or two, depression is a low mood that lasts for a long time affecting the person’s everyday life and their ability to function. Depression can be life-threatening because it can make sufferers feel suicidal.

Symptoms range from the psychological to the physical including feeling hopeless or helpless, irritable, having low self-esteem and an inability to make decisions. Physical symptoms include moving and speaking slowly, weight loss or weight gain and a lack of energy.

Ms Todd concluded her post by reminding people to take it easy on friends and family who may be going through a similar experience with their mental health and not judging them automatically instead taking time to listen and trying to empathise.

“Please be easy on your friends and family that have trouble getting up the energy to clean, hang out, or take care of themselves. And please, please take them seriously if they talk to you about it. We're trying. I swear we're trying. See? I brushed my hair today,” she wrote.

You can call Samaritans free, any time from any phone, on 116 123 (this number will not appear on your phone bill), email jo@samaritans.org or go to www.samaritans.org to find details of your nearest branch.

Related: This woman created a line of temporary tattoos for those coping with mental illness (Provided by Hello Giggles)

May 11th 2017

Carol Vorderman has spoken to Lorraine Kelly about battling depression caused by the menopause. The 56-year-old gave a frank interview on Wednesday in which she admitted that there were days she didn’t see "the point in carrying on". The former Countdown star said her life had been normal right up until the menopause began. "I was powering on doing this and building houses, and flying a plane, and bringing up my kids by myself and all of those different things," she explained. "And then this depression hit me.

"I don't use the word depression lightly. This was a blackness where I would wake up – nothing else in my life was going wrong, I'm a very lucky woman, no money worries or nothing like that – and I would wake up and thought, 'I don't see the point in carrying on. I just don't see the point in life. I don't see it.' And there was no reason to feel that way, and the only reason I didn't do anything, and I've not admitted it before, is because I have two children." She added: "I thought, 'I just want this feeling to stop, I'd do anything for this feeling to stop, because I can't sort it.' And this went on for a number of months."

Carol revealed she had sought treatment to help combat her depression, admitting, "I suspect we wouldn't be talking today" if she hadn't. "From the moment I took [the medication], I have never ever felt that way [depressed]," she said. "I've been fed up, and obviously at the moment my mum is not well, so I'm upset. But there is a reason for all of those things, whereas before there was no reason for it, and it was absolutely, categorically to do with hormones."

May 11th 2017

To mark Mental Health Awareness Week, we'll be highlighting different themes that relate to and impact on our mental health and wellbeing – from suicide to anxiety to body image and relationships. Today, we talk to three experts about the best ways to broach the subject of mental health with children.

Dr Fiona Pienaar is Director of Clinical Services at Place2Be, the leading national mental health charity for children in the UK, of which the Duchess of Cambridge is a patron.

Jo Laughran is director of operations at Time to Change, a social movement attempting to change the way we all think and act about mental health.

Isabelle Campbell is an advisor at wellbeing charity, CABA.

According to figures from the Office of National Statistics, 10 per cent of children in Great Britain aged five to 16 have a mental health problem. Over half of all mental ill health starts before the age of 14 years, and 75 per cent has developed by the age of 18. In addition to this, rates of depression and anxiety in teenagers have increased by 70 per cent in the past 25 years. All this means that it is it becoming more important than ever to address the issue of mental health with our children.

Put simply, "It is important to recognise that all young people have mental health and wellbeing, just like they have physical health," Time to Change's Jo Laughran tells us. But when in a child's life should this be made clear?

How early on in a child's life should you instil awareness around mental health?

"The best approach is to start having these kinds of conversations as early as possible, so that they become a natural and normal part of your family life," Isabelle Campbell explains. "It is never too early to bring that conversation into the family narrative. Children are perceptive, they know when you're tense or feeling upset. This means it is vital to talk to them as soon as they are able to understand what emotions and feelings are."

"Children as young as four or five can be deeply affected by the pressures and difficulties of life today"

Dr Fiona Pienaar agrees, stating that children much younger than you would expect can suffer. "We know from our direct experience of working in schools that children as young as four or five can be deeply affected by the pressures and difficulties of life today," she explains. "That's why supporting children with their mental health early in their lives is so important."

Laughran adds: "Even if you don't think that your child is experiencing any problems, being open about mental health means that if something does crop up further down the line, they are more likely to feel like they can talk to you about it".

What signs should you look out for to indicate that your child might need to talk about their mental health?

"The challenge for parents is that mental health problems in young people can be difficult to spot and may be put down to them acting like a 'typical teenager'," Laughran explains, but says that there are telltale signs to look out for. These include:

1. Persistent low mood and unhappiness.

2. Tearfulness and irritability.

3. Worries that stop them carrying out day-to-day tasks.

4. Sudden outbursts of anger directed at themselves or others.

5. Lack of interest in activities they were previously interested in.

6. Becoming withdrawn from friends and family.

7. Problems with eating or sleeping.

"It is all about knowing your child as an individual so you can spot when behaviour feels out of place"

Campbell suggests that it is also key to watch out for changes in behaviour, as well as a tendency to be secretive. "It is all about knowing your child as an individual so you can spot when behaviour feels out of place," she says. Pienaar warns to look out for negative thoughts and them adopting a low opinion of themselves, as well as a strong desire to avoid school and stay with you at all times.

What kind of language should you use?

"Talking about mental health doesn't need to be difficult or scary and you don't need to be an expert, simply being open to talking about the issue can make a huge difference," says Laughran.

Here are her five key tips for broaching the subject:

1. Avoid situations where you blame, lecture, accuse, judge or tell your child what they should have done. Instead listen to their story and let them know that you empathise with how they feel.

2. Don't be impatient or short-tempered with your child when they are sad or anxious. Avoid making judgemental statements such as 'Okay, so you're sad again, why?'

3. Don't make it all about them. Share a situation where you felt worried, stressed or anxious to let them know that what they are feeling is natural.

4. Don't be dismissive of their worries and fears, no matter how trivial they may seem to you. Never tell them they are just being silly.

5. Don't bottle up your own emotions; your children will learn by watching you. Encourage good coping skills by demonstrating them openly.

"For younger children, who sometimes don't have the words to describe their emotions, creative activities such as arts or crafts or physical activities such as kicking a ball around together can be a wonderful way of starting a conversation," Piernaar adds.

Are there any differences in the way the subject should be broached with girls and boys?

"It's important not to generalise when we think about genders – boys can feel just the same pressures as girls and vice versa," Campbell says. "Stereotypically, women from a young age will seek out the collaborative company of others more than boys. They'll tend to talk more about their feelings – and this means that there's a possibility that girls, by picking stuff up from their parents, will learn to talk more openly about their emotions and mental health: although it's important to note that this is a generalisation.

"Still, there's a distinction to be made between girls and boys because boys are still often taught that 'boys don't cry'. It's important to try and work towards not creating this bias in your children or other people's children, by fostering the discussion of emotions amongst all children – no matter what their gender is."

How can you ensure your child has a healthy relationship with social media?

"You need to have conversations about what social media is and how it is used: helping them to understand that what they upload is there forever, teaching them that social media is a constructed reality and that people put effort into creating an image when they use it," Campbell explains.

"One way of doing this is by giving working examples of how a picture or a video is simply a snapshot of a wider day, which could have actually held a huge number of events and emotions. It's a snapshot in time and doesn't necessarily tell the full story.

"You could use a personal or family picture and explain that, while it might look very relaxed and happy, you actually remember that you were worrying about something that day and were finding it hard to relax.

"Helping them to understand the unrealistic portrayal of appearance in the media is very important"

"It's also worth noting that you'll need to help them understand pictures that are related to body image, as this is a growing issue. Helping them to understand the unrealistic portrayal of appearance in the media is very important, especially for girls."

Another way to ensure your children have as healthy a relationship with social media as possible is to lead by example.

"Be mindful of your own use of social media," Pienaar says. "It can be helpful for your children to see you having a break from technology from time to time and this will help them to understand the importance of a healthy balance."

"You might find it helpful to suggest that certain times of the day are free from social media, for example when you are eating dinner in the evening agree not to have phones or tablets at the table," she suggests. "Many experts also recommend that families have an agreement that nobody takes any electronic devices into bedrooms at night as sleep is so critical for healthy development."

What is the best way to monitor their social media usage if you do think it is having a negative impact on their mental health?

"It is important not to try and deny where we are in the world," Campbell told us. "Social media is a big part of everyone's day-to-day life. Some parents may try to protect their children from social media entirely, but this isn't realistic as often children will find a way to do something – especially when it's so widely used by everyone around them."

So, instead of barring them from it or pretending it doesn't exist, try setting boundaries and restrictions, but always with an explanation as to why you are doing this.

"With older children, it's a tricky balance but still try and be involved"

"If you're worried about it, then start to remove rights until your children can use social media responsibly: it's about creating boundaries but adding explanations at the same time," she says. "Make sure they understand why you're concerned, and why you're removing access."

Another option when they are very young is to ensure you are able to access the devices they are using. "With older children, it's a tricky balance but try and be involved in a way that makes them understand that you respect their privacy but also want to make sure they are safe," Pienaar says. "You can do this by having an open and honest conversation about some of the risks associated with the online world. Agree some boundaries with your children about what is appropriate behaviour when using social media."

What are the best resources available to parents?

These days, there is a wealth of information online provided by mental health charities and the government that can help you to understand what is happening with your child and how best to talk to them about it. Here are some of the options, recommended by our experts.

Head over to the Place2Be website for tips if you are worried about your child's mental health or if you just want to know how to be more supportive.

If you are really worried about your child, a charity called Young Minds has a great Parent Helpline (0808 802 5544) which is open from 9.30am to 4.00pm, Monday to Friday.

Also make sure to make the most of Time To Change and NHS Choices. For younger children, the NSPCC website can be very helpful.

Related: This woman created a line of temporary tattoos for those coping with mental illness (Provided by Hello Giggles)

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