Emotional Health

Anxiety
Everybody experience anxiety at some time. Anxiety is a natural response, useful in helping us to avoid dangerous situations and motivating us to solve everyday problems. Anxiety can vary in severity from mild uneasiness through to terrifying panic attack. It can vary in how
long it lasts, from a few moments to many years. An anxiety disorder differs from normal anxiety as its usually more severe, longer lasting and interferes with the persons work or relationships. Many people with anxiety disorders don’t realise there are treatments that
can make them have a better life.

General symptoms of anxiety
Physical:
 Palpitations, chest pain, rapid heartbeat, flushing (cardiovascular)
 Hyperventilation, shortness of breath (respiratory)
 Dizziness, headache, sweating, tingling and numbness (neurological)
 Choking, dry mouth, nausea, vomiting, urinary frequency, diarrhoea (gastrointestinal)
 Muscle aches and pains (especially in the neck, shoulders and lower back), restlessness, tremor and shaking (musculoskeletal)

Psychological:
 Unrealistic and/or excessive fear and worry (about past or future events)
 Mind racing or going blank
 Decreased concentration and memory
 Difficulty making decisions
 Irritability, impatience, anger
 Confusion
 Restless or feeling on edge, nervousness
 Tiredness, sleep disturbances, vivid dreams
 Unwanted unpleasant repetitive thoughts (also known as intrusive thoughts)

Behavioural:
 Avoidance of situations
 Repetitive compulsive behaviour, eg excessive checking, continual seeking of reassurance.
 Distress in social situations
 Urges to escape situations that cause discomfort (phobic behaviour)

Types of Anxiety disorder:
 Generalised Anxiety Disorder (GAD)
 Panic Disorder
 Phobias
 Acute Stress Disorder (ASD)
 Post Traumatic Stress Disorder (PTSD)
 Obsessive Compulsive Disorder (OCD)
 Mixed Anxiety and Depression

Depression
The word depression is used in many different ways. Everyone can feel sad or blue when bad things happen. However, everyday ‘Blues’ or sadness is not depression. People with the ‘Blues’ may have a short term depressed mood, but they can manage to cope and soon
recover without treatment. A clinical depression is one that lasts for at least 2 weeks and affects the persons behaviour and has physical, emotional and cognitive effects. It also interferes with the ability to work and have satisfying personal relationships.

Symptoms of depression:
 An unusually sad mood that does not go away
 Loss of enjoyment and interest in activities that used to be enjoyable
 Lack of energy and tiredness

People who are depressed can also have other symptoms, such as:
 Loss of confidence in themselves or poor self-confidence
 Feeling guilty when they are not really at fault
 Wishing they were dead / suicidal thoughts
 Difficulty in concentrating or making decisions
 Bleak and pessimistic views of the future
 Having difficulty in sleeping or sleeping too much
 Loss of interest in food or eating too much, leading to either loss of weight or putting on weight

Eating Disorders
An eating disorder is when you have an unhealthy attitude to food, which can take over your life and make you ill. It can involve eating too much or too little, or becoming obsessed with your weight and body shape. But there are treatments that can help and you can recover from an eating disorder.

Types of eating disorders
The most common eating disorders are:
 anorexia nervosa – when you try to keep your weight as low as possible by not eating enough food, exercising too much, or both
 bulimia – when you sometimes lose control and eat a lot of food in a very short amount of time (binging) and are then deliberately sick, use laxatives (medicine to help you poo), restrict what you eat, or do too much exercise to try to stop yourself gaining weight
 binge eating disorder (BED) – when you regularly lose control of your eating, eat large portions of food all at once until you feel uncomfortably full, and are then often upset or guilty

Self-harm
Self-harm is a behaviour and not an illness. People self-harm to cope with emotional distress or to communicate that they are distressed. Whilst is can be treated as a problem in its own right, self-harm can be seen as a reflection of distress, inner turmoil and despair. Self harm is a very wide ranging term, used to refer to many different actions. These may include:
 Cutting or scratching skin with knives, razor blades or other sharp implements
 Burning oneself, for example with flames, heated metal, wax or chemicals
 Hitting or banging one’s arm, legs or head on walls, or with fists or objects
 Compulsively pulling out large amounts of hair
 Interfering with healing of wounds
 Taking risks, including dangerous sexual liaisons, walking into traffic etc
 Deliberately taking overdoes of drugs, or ingesting other substances when this is NOT intended as a suicide attempt

Psychosis:
Psychosis is a general term used to describe a mental health issue in which a person experiences changes in thinking, perception, mood and behaviour which can severely disrupt their life. By definition, psychosis involves the person losing some touch with commonly accepted reality. For a person affected by psychosis, relationships, work and self care can be difficult to initiate or maintain.

Schizophrenia:
Contrary to popular belief, schizophrenia has nothing to do with a ‘split personality’. The term schizophrenia means ‘split mind’ and refers to changes in mental function whereby thoughts and perceptions become disordered. Individuals experience different combinations of symptoms, these can include:

 Delusions
Delusions are false beliefs. These can include beliefs of persecution, of guilt, of having a special mission of being of special birth or of being under outside control. Although delusions may seem bizarre to others, they are very real to the person experiencing them.

 Hallucinations
These are false perceptions. Hallucinations most commonly involve hearing voices. They can also involve seeing, feeling, tasting or smelling things. Hallucinations can be very frightening, especially if voices are making negative comments about the person or contain unpleasant ideas.

 Thinking difficulties / thought disorder
The person may have difficulties with concentration, their memory and ability to plan. This makes it more difficult to reason, communicate and complete daily tasks. These are often referred to as cognitive impairments.

 Loss of drive
The person losses motivation and this can extend to self care. This should not be interpreted as laziness.

 Inappropriate emotions
The person has a lack of emotions or inappropriate emotions. They may not react to things around them, or seem to react inappropriately.

 Social Withdrawal
Social withdrawal is a common feature of people experiencing psychosis.

Bipolar disorder (formerly known as manic depression):
People with Bipolar disorder have extreme mood swings. They experience periods of depression and mania, often with periods of ‘normal’ mood in between. Because Bipolar disorder impacts a persons mood, it is often classified alongside depression as a mood disorder. However, because mania can bring symptoms of psychosis is can also be considered part of the psychotic disorders.

Symptoms of Depression:
 Sad mood
 Loss of enjoyment and interest in activities that used be enjoyable
 Lack of energy and tiredness

Symptoms of Mania:
 Increased energy and hyperactivity
 Elated mood
 Needing less sleep than usual
 Irritability

 Rapid thinking and speech
 Grandiose delusions
 Hallucinations
 Lack of insight
 Increased risk taking

Personality Disorders
Personality disorders is the term used to describe problematic ways of coping with everyday life and dealing with self, others and the world which result from the interplay between genetic and environmental factors, in particular disrupted early development.
Personality disorders are conditions in which an individual differs significantly from commonly accepted norms, in terms of how they think, perceive, feel or relate to others. Changes in how a person feels and distorted beliefs about other people can lead to unusual
behaviour, which can be distressing and may upset others. Many countries don’t recognise personality disorders at all. In the UK there are 10 recognised forms of personality disorder. These are grouped into cluster groups:

Cluster A
 Paranoid PD
 Schizoid PD
 Schizotypal PD

Cluster B
 Antisocial PD
 Borderline / Emotionally unstable PD
 Histrionic PD
 Narcissistic PD

Cluster C
 Avoidant PD
 Dependant PD
 Obsessive compulsive PD

There are many factors that impact a persons mental health an their recovery. Experiences of stigma and discrimination are top of that list. This can include attitudes of rejection and stigma towards people with mental health issues because of their diagnoses or as a result of
inequalities within society. A diagnoses of a mental illness cannot be taken as meaning the same thing for all at all times. It is very important that we consider people as individuals, rather than making assumptions based on their diagnosis. The Equalities Act 2010 is the law that protects people from discrimination in the workplace and sets out protected characteristics “The 6 Equality stands”.

The 6 Equality stands
1. Mental Health and age
2. Mental Health and gender
3. Mental Health and disability
4. Mental Health, race and ethnicity
5. Mental Health and religion or belief
6. Mental Health and sexuality

The Mental Health Continuum
The Mental Health Continuum is a way of looking at how our Mental Health is fluid and changes over time. It can be expressed by the diagram below. With the horizontal axes being Mental Health, where everyone sits and can move up and down from good to poor
mental health. The vertical axis is where someone has been diagnosed with a Mental illness. The misconception is that people with diagnosed mental illness will always be at the poor end of the mental health axes. However, with positive coping strategies, good medication / therapy many of these people spend alot of time at the good mental health side of the scale.

Drugs and Alcohol
Not all people who use a substance will misuse it or have problematic substance use. Substance misuse occurs when a person using alcohol or other drugs at levels that are associated with short term or long term harm. Substance misuse is not just a matter of how much of a substance a person uses, but how their use affects their life and those around them. Substance abuse is more common amongst adults with mental health issues than the wider population. Substance misuse is more common in men than women, and often has its first onset during adolescence or early adulthood and often co-occurs with depression and other mood disorders, anxiety disorders and psychotic disorders.

Gambling
Being a compulsive gambler can harm your health and relationships, and leave you in serious debt. Are you a problem gambler? Try this questionnaire:
 Do you bet more than you can afford to lose?
 Do you need to gamble with larger amounts of money to get the same feeling?
 Have you tried to win back money you have lost (chasing losses)?
 Have you borrowed money or sold anything to get money to gamble?
 Have you wondered whether you have a problem with gambling?
 Has your gambling caused you any health problems, including feelings of stress or anxiety?
 Have other people criticised your betting or told you that you had a gambling problem
(regardless of whether or not you thought it was true)?
 Has your gambling caused any financial problems for you or your household?
 Have you ever felt guilty about the way you gamble or what happens when you gamble?

Score 0 for each time you answer never
Score 1 for each time you answer sometimes
Score 2 for each time you answer most of the time
Score 3 for each time you answer almost always

If your total score is 8 or higher, you may be a problem gambler.

Help for problem gamblers
There's evidence that gambling can be successfully treated in the same way as other addictions. Cognitive behavioural therapy usually has the best results. Treatment and support groups are available for people who want to stop gambling:
GamCare
GamCare offers free information, support and counselling for problem gamblers in the UK. It runs the National Gambling Helpline (0808 8020 133) and also offers face-to-face counselling.
Gamblers Anonymous UK Gamblers Anonymous UK runs local support groups that use the same 12- step approach to recovery from addiction as Alcoholics Anonymous. There are also GamAnon support groups for friends and family.

Self-help tips for problem gamblers
Do:
 pay important bills, such as your mortgage, on payday before you gamble
 spend more time with family and friends who do not gamble
 deal with your debts rather than ignoring them – visit the National Debtline for tips

Don't:
 view gambling as a way to make money – try to see it as entertainment instead
 bottle up your worries about your gambling – talk to someone
 take credit cards with you when you go gambling

Not only can we support others towards more hope and greater resilience, but we can also do this for ourselves. We can become more mindful of our own wellbeing and steps we can take to promote it. You must look after yourself if you want to look after others.

Five ways to Wellbeing
Connect
Connect with your family, friends, colleagues and neighbours. At home, work or in your local community. Think of these as cornerstones of your life and invest time in developing them. Building these connections will support and enrich you everyday.

Be Active
Step outside. Go for a run, walk or cycle. Play a game with the kids, do some weeding in the garden. Dance like no one is watching. Exercising makes you feel good.

Take Notice
Be aware of the world around you, whether you are taking a walk or eating lunch with friends, savour the moment. Catch sight of the beautiful, reflect on your experience, becoming more mindful will help you appreciate what matters to you.

Keep Learning
Try something new. Rediscover an old interest. Sign up for a course. Take on different responsibilities at work or home. Learn to play an instrument or how to cook your favourite food. Set yourself a challenge. Learning new things will make you more confident as well as being fun.

Give
Do something nice for a friend, or a stranger. Thank someone, smile, volunteer your time. Join a community group. Look out, as well as in. Seeing yourself, and your happiness, linked to the wider community can be incredibly rewarding and creates connections with the people around you.

The following list of helpful resources and organisations is intended to be a useful guide for information purposes only. There are many other voluntary organisations available and it would be impossible to list all of them. You may find it more beneficial to research local services and supports available specific to the concerns you are experiencing.

Construction Industry specific:
Construction Industry Helpline
Phone: 0345 605 1956 (24/7)
Email: info@lighthouseclub.org
Website: www.lighthouseclub.org
The lighthouse Club provide physical, mental and financial support for construction workers and their families in the UK.

Crisis and Emotional support for everyone:
Samaritans
Phone: 116 123
(Freephone, 24 hours a day, 7 days a week)
Email: jo@samaritans.org
Website: www.samaritans.org
Provide emotional support for people 24 hours a day, 365 days a year. They allow people to talk and are confidential and offer non-judgemental support.

Mind Infoline
Phone: 0300 123 3393
(Local call rates, 9am-6pm, Mon-Fri)
Text: 86463
Provides information of types of mental health issues and where to get help.

SaneLine
Phone: 0300 304 7000
(Local call rates, 6pm -11pm, 7 days a week)
Website: www.sane.org.uk
Provides out of hours mental health and emotional support and information to anyone affected by mental ill health, including family, friends and carers.

Addiction and Substance misuse (alcohol, drugs, gambling):
Addaction
Phone: 020 7251 5860
Email: info@addaction.org.uk
Website: www.addaction.org.uk
Addaction supports adults, children, young adults. And older people to make positive behavioural changes around alcohol, drugs, mental health and wellbeing.

Alcoholics Anonymous
Phone: 0800 9177 650
(freephone, national helpline)
Email: help@alcoholics-anonymous.org.uk
Website: www.alcoholics-anonymous.org.uk
Self help groups across UK for anyone affected by alcohol use, based on 12 step model of recovery.

Talk to Frank
Phone: 0300 123 6600
(24 hours a day, 7 days a week)
Text: 82111
Email: frank@talktofrank.com
Website: www.talktofrank.com
Talk to Frank is the national drug education service. It provides confidential information and live chat service on its website.

Gamblers Anonymous
Website: www.gambersanonymous.org.uk
Gamblers anonymous runs self help groups across the UK for anyone affected by addiction gambling behaviours who want to change, based on 12 step model of recovery.

Abuse (domestic violence, child, sexual abuse):
NSPCC
Phone: 0808 800 5000
(freephone, 24 hours a day, 7 days a week – for adults concerned about a child)
Email: help@nspcc.org.uk
Website: www.nspcc.org.uk
The NSPCC is a charity dedicated to ending child abuse and child cruelty.

Refuge
Phone: 0808 2000 247
(freephone, 24 hours a day, 7 days a week)
Email: helpline@refuge.org.uk (only monitored Mon-Fri 9-5pm)
Website: www.refuge.org.uk
Refuge provide help and information about domestic violence. They have a number of safe houses for women and children escaping violence.

Survivors
Phone: 0203 598 3898
Email: info@survivorsuk.org
Website: www.survivorsuk.org
Survivors UK provides help and support for men who have experienced sexual violence or abuse. Includes counselling and online and SMS chat support by professionals who specialise in male sexual violence.

Rape Crisis
Phone: 0808 802 999
(freephone helpline, see website for opening hours)
Website: www.rapecrisis.org.uk
Rape Crisis is a national charity supporting anyone who has experienced rape, child sexual abuse, or any other sexual violence.

Anxiety:
Anxiety UK
Phone: 08444 775 774
Text: 07537 416 905
Email: support@anxietyuk.org.uk
Website: www.anxietyuk.org.uk
Charity run by people with lived experience of anxiety, supporting anyone affected.

OCD-UK
Phone: 0845 390 6232
Email: support@ocduk.org
Website: www.ocd.org
OCD-UK is a national charity working with adults and children affected by obsessive compulsive disorder.

Triumph over Phobia
Phone: 01225 571 740
Email: info@topuk.org
Website: www.topuk.org
Triumph over Phobia is a UK charity which offer help to suffers of phobias, obsessive compulsive disorder and other anxiety related fears.

Depression:
Depression UK
Email: info@depressionuk.org
Website: wwwdepressionuk.org
Depression UK is a national self help organisation that offers support to everyone affected by depression.

Bipolar Disorder:
Bipolar UK
Phone: 0333 323 3880
Email: info@bipolaruk.org
Website: www.bipolaruk.org
UK based charity dedicated to supporting individuals with a diagnosis of Bipolar disorder, as well as their families and carers.

Eating Disorders:
Beat Eating Disorders
Phone: 0808 801 0677
Email: help@beateatingdisorders.org.uk
Website: www.beateatingdisorders.org.uk
Support for adults and young people who are struggling with eating disorders.

Self-Harm:
National Self-Harm Network (NSHN)
Website: www.nshn.co.uk
Survivor-led online support forum for people who self-harm, their friends and family.

Bereavement:
Bereavement Advice Centre
Phone: 0800 634 9494
(freephone helpline, 9am – 5pm, Mon- Fri)
Website: www.bereavementadvice.org
The Bereavement Advice Centre advises people after death in England and Wales.

Cruse Bereavement Care
Phone: 0808 808 1677
Email: helpline@cruse.org.uk
Website: www.cruse.org.uk
Cruse offer support, advice and information to adults and children when someone dies.
Debt:

Stepchange
Phone: 0800 138 1111
Website: www.stepchange.org
Charity Stepchange provides free advice on problem debt and debt management.

Victims of Crime:
Victim Support
Phone: 0808 1689 111
Website: www.victimsupport.org.uk
A free confidential helpline for anyone affected by crime as well as emotional and practical support.

Carers:
Carers UK
Phone: 08008 808 7777
Website: www.carersuk.org
Carers UK aim to make life better for carers, by providing advice on a range of issues, including financial and practical matters relating to careering.

Finding a Therapist:
Your GP can refer you to a therapist or you may choose to see one privately. The following organisations have searchable national lists of therapists.
British Psychological Society
Phone: 0116 254 9568
Email: enquires@bps.org.uk
Website: www.bps.org.uk
The British Psychological Society promotes excellence and ethical practice in the science, education and practical applications to psychology.

UK Council for Psychotherapy
Phone: 020 7014 9955
Email: info@ukcp.org.uk
Website: www.ukcp.org.uk
The UK Council for Psychotherapy is the leading professional body for education, training and accreditation of psychotherapists and psychotherapeutic counsellors. Their website includes a searchable register of local therapists.

IAPT
Website: www.iapt.nhs.uk
IAPT (Improving Access to Psychological Therapies) is the NHS programme which supports rolling out NICE guideline recommended talking therapies to people experiencing depression and anxiety disorders. In some areas self referral to IAPT services is possible, in others referrals need to be made via the persons GP.

Ieso Digital Health
Website: www.iesohealth.com
Provides online based one to one cognitive behavioural therapy on behalf of the NHS and for private companies. Some areas may allow self referral.