Q: How can I deal most effectively with stress?

Q: How does employment affect mental health?

Q: What is mental illness?

Q: How many people are affected by mental illness?

Q: What are the most common serious mental illnesses?  How do I recognize them?

Q: What causes mental illness and what are some ways to deal with it?

Q: How can I deal with mental illness in my family?

Q: Is mental illness related to poverty?

Q: Why do people kill themselves?

Q: How would I know if someone is feeling suicidal?

Q: What can I do about my friend who told me he/she was suicidal and made me
    promise not to tell anyone?

Q: Is it true that most suicides leave notes?

Q: How many people complete suicide in the world each year?

Q: What is a "consumer"?

Q: What is the role of the CMHA?

Q: How is CMHA funded?

Q: Where can I get more information about mental health and mental illness?

What is mental health?

Mental health means striking a balance in all aspects of one’s life: social, physical, spiritual, economic and mental. At times, the balance may be tipped too much in one direction and one’s footing has to found again. Everyone’s personal balance is unique and the challenge is to stay mentally healthy by keeping the right balance.

Mental health is as important as physical health. The World Health Organization (WHO) has always considered mental well-being as an integral part of the general definition of health. WHO defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. CMHA believes that everyone must have good mental health, including people living with mental illness on a daily basis.

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How can I deal most effectively with stress?

Major events in our lives can bring on stress: events like new jobs, getting married or becoming a parent. Ongoing worries about finances or your children's future can cause stress. So can day-to-day irritations, like the car not starting or being late for work.

Not all events that provoke stress have to be negative. We can either welcome them as challenges enriching our lives, or we can view them as "stressful," taking away from our enjoyment of life. How we approach these events greatly affects our physical, mental and social well-being.

You can enhance your life by taking stress under control. Using some or all of these approaches should help you to deal better with stress in your life:

• Balance your work and leisure time. Arrange your life so that you are not feeling guilty when you rest, and not "goofing off" when you should be working.
• Set aside some time for laughter.
• Learn to delegate tasks to other people. You don’t have to do it all yourself.
• Learn to use relaxation techniques like yoga or meditation. Expand your spiritual life.
• Get plenty of exercise. If you have to, combine it with physical tasks that need to be done (gardening, house cleaning).
• Learn how to manage your time. Set up priority lists.
• Eat healthy. Some things you put in your body like alcohol, caffeine, and fats make it harder to deal well with stress. Other foods like fruit, vegetables and whole grains make it easier.
• Get the amount of rest and sleep your body needs.
• Discuss your problems openly with friends, relatives, or counsellors.
• Get away once in a while. Take a complete break. Have some fun!
• Know you don’t need to ‘win’ every argument. Let up on being competitive.
• Don’t try to be perfect, and don’t expect others to be either.

Heart disease and stress

Researchers are still studying the link between stress and heart disease. But so far we do know that people under stress will sometimes have higher blood pressure and cholesterol, and a higher chance of blood clots. Someone under stress is also likely to smoke more, over eat or skip physical activity.

We can’t avoid stress, and it seems today’s lifestyles are even more stressful than ever. So it’s important to learn to cope with it so it affects our bodies as little as possible.

More resources

For details on how to get healthy amounts of physical activity, see Canada’s Physical Activity Guide to Healthy Active Living.

For advice on what makes up a healthy balanced diet, take a look at Canada’s Food Guide. Dietitians of Canada’s site can also help you achieve your healthy eating and active living goals.
For more information on stress click here.

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How does employment affect mental health?

In our society, the work you do says a lot about who you are. To be out of work can be very hard on a person. It can also lead to a number of physical and mental health problems, including:

• fatigue
• weight changes
• fainting spells
• sleeplessness
• shorter attention span

Also, when unemployment goes up, rates of spousal abuse, sexual assault, and child abuse rise as well. At these times the mental health of those affected is under a lot of pressure.

People with mental illness have an even harder time, since they are more likely to be unemployed. A new approach to this problem has recently emerged. People who have had mental illnesses are fully managing and staffing employment projects. These people find that their mental health is greatly improved. What’s more, the work experience has given them something meaningful to focus on.

Workplace health

Recent studies of Canadians in general show that working is linked with good mental health. But the benefits of work can be offset by workplace stress. Since stressful workplaces can have a serious impact on both physical and mental health, it is critical to take steps towards making workplaces healthier.

One way to do this is to focus on individual worker’s mental health needs. For example, employers can offer Employee Assistance Programs or stress reduction workshops. It is even more important to make the entire workplace a healthier environment. Here are some proven ways to create more mentally healthy workplaces:

• Give employees opportunities to have control over the organization.
• Give them more control over the design of their work.
• Make the job more flexible.
• Communicate clearly.

Contact your local CMHA office to find out how you can improve mental health in your workplace.

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What is mental illness?

Mental illness is the term used to refer to a variety of mental disorders that can be diagnosed. Mental disorders are health conditions that are characterized by alternations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning.

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How many people are affected by mental illness?

Mental illness is increasingly recognized as a serious and growing problem. It is estimated that 1 in 5 Canadians, close to six million, will develop a mental illness at some time in their lives. Many more individuals such as family, friends and colleagues are also affected.

We can say for sure that at least one percent of a population is likely to have a serious and persistent mental illness at any given time. This is equal to about 300,000 Canadians at any given time.

The rates of mental illness vary from one illness to another. For example, it is estimated that

• schizophrenia affects about 1% of Canadians,
• mood disorders affect about 10%, and
• anxiety disorders affect about 12%.

Factors affecting mental illness rates

A number of factors affect how many people will have a mental illness. One of these is the support of family and friends. For example, people who are divorced or separated are more likely to go through a depression than those who are married. Another factor is gender. Twice as many females report depression as males.

There is also a link between physical and mental health. It is reported that 25% of people with serious physical health conditions will develop a major depressive disorder along with their condition. These other health conditions include diabetes, heart attack, cancer and stroke.

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What are the most common serious mental illnesses?
How do I recognize them?

The most common serious mental illnesses are schizophrenia, depression and manic depression. In general, the major mental illnesses tend to be "episodic". This means the symptoms come and go, leaving periods in between when people can lead fairly normal lives.

Schizophrenia

People with schizophrenia can have:

• confused thoughts,
• hallucinations (seeing or hearing things that others don't),
• extreme anxiety,
• delusions (irrational beliefs),
• passivity,
• depression, and
• lack of motivation.

Schizophrenia is rarely a constant state. People generally go through periods of illness, followed by periods where they are at least partly recovered.

What happens over the long term is mixed as well. Ten years after schizophrenia first appears, most people probably will improve to some extent. Some of these people will still need a lot of support, while others will be living quite independently. About 25% will recover completely. Unfortunately, around 15% of people will not improve, and around 10% will die, mostly by suicide.

Depression and manic depression

Depression and manic depression are also called mood disorders or affective disorders. Depression is the most common of the two.

People with depression may:

• suffer from anxiety
• feel helpless and hopeless
• lose interest in activities they used to enjoy
• feel guilty
• think of suicide

Physically, they may gain or lose a lot of weight, and their appetites may change. Their sleeping patterns may be different, and they may have less energy as well.

People with manic depression (also called bipolar disorder) go through mood swings between depression and mania. The most obvious sign of mania is an outgoing "feeling up" kind of mood.
People in manic phases appear sociable, talkative, very energetic and full of self-confidence.

On the other hand, they may also become:

• very irritable,
• unpredictable,
• overly self-important, or
• reckless. For example, they may go on spending sprees, even to the point of financial ruin or trouble with the law.

Other illnesses

Other common mental illnesses fall into the category of anxiety disorders. These include:

• phobias (unreasonable fears)
• panic disorders (intense episodes of sudden fear)
• obsessive compulsive disorder (unwanted thoughts or actions that keep repeating)

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What causes mental illness and what are some ways to deal with it?

Mental illness has no single cause. In the past, people often blamed parents unfairly if a child in the family developed a mental illness. However, it is most likely several factors together that lead to mental illness. For example, recent evidence has shown that many of the major mental illnesses involve chemical imbalances in the body.

Mental illnesses are:

• biological, linked with disturbances in the brain or other body-system chemistry,
• psychological, linked with disturbances in thought or emotion, and
• social, linked with life events and stresses.

Mental health professionals account for all three areas of a person’s life when they design a plan for dealing with the illness.

Biological factors that may affect whether someone becomes seriously mentally ill include:

• pre-natal damage
• birth trauma
• viral infection
• faulty brain chemistry

Genetics may play a part, too. Studies show that close relatives of someone with schizophrenia or an affective disorder are much more likely to have the same illness. However, people don’t inherit the illness itself. They just inherit the tendency to get it.

Psychological and social factors could include:

• lack of support from relationships
• child abuse
• family violence
• unemployment
• major changes in life

Dealing with mental illness

Just as there are different causes, there are also many different ways to deal with mental illness.

Professional methods usually include medication or psychotherapy (or both at the same time). One approach that is becoming more popular is cognitive behavioural therapy. In this type of therapy, the therapist helps the person to view their situation in a more positive light. There are also community support services to help people manage their lives. The areas these services can help with include:

• housing
• employment
• income
• recreation

Non-professional methods are just as important. For example, the support of family and friends is critical for someone coping with mental illness. Another valuable resource is a self-help group. In these groups, people in similar situations can share advice, help, and support.

Many people find that a combination of strategies is what helps most. This can include:

• medication,
• talk therapy, and
• alternative approaches (like a balanced diet, exercise, yoga and meditation).

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How can I deal with mental illness in my family?

It can be very stressful to have a family member with a mental illness. A common response is to try to deal with the problem alone. People may isolate themselves so they can avoid the stigma that may come about when friends and neighbours find out about ‘our secret’.

However, keeping the problem in the family is not the best approach. The best way to deal with mental illness in the family is to link up with other families who are in a similar situation. In Canada, the two best known family organizations are the Mood Disorders Association and the Schizophrenia Society. They can connect you to other families in your area, and give you information about the illness.

Care for each other, and for yourself

Within the family itself it is best to talk openly about concerns. You will want to be supportive of your family member, but remember that this is not your fault, and you cannot make it go away. Try to stay positive, and approach problems directly.

Make sure everyone in the family knows they are loved and included in discussions about the situation. If the family member who has mental health problems is an adult, it helps to treat them like an adult rather than a helpless child.

Families carry huge burdens, with little support for the role they play. Although your family member is the one with the illness, it is all right to admit that you may need help too. For example, you may need help with housework or child care, or you may just need someone to talk to. Give your friends concrete suggestions of how they can help you. For example, they can spend an evening out with you, or help with a home-cooked meal.

You can also join a self-help group of other families. These groups help you get peace of mind by giving you:

• tips
• information
• emotional support
• practical help

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Is mental illness related to poverty?

We can look at this question in two different ways:

1. Whether being poor causes mental illness, and
2. Whether having a mental illness can lead to poverty.

Does poverty cause mental illness?

Poverty increases the level of stress in someone’s life. The constant struggle to survive can take a great toll on their mental health, and bring about mental health problems. Clearly, it is easier to have good mental health if you have material comfort than if you live in poverty.

However, the causes of mental illness are varied and complex. It’s hard to say that poverty alone directly causes mental illness. Mental illness occurs in all classes of society, and the great majority of people who live in poverty do not have mental illness.

Does mental illness cause poverty?

Having a mental illness can make it very hard to find a steady job. The chances of becoming poor are greater if someone is mentally ill. For instance, recent Canadian studies show that the numbers of homeless people with a mental illness are rising. Still, many people with mental illness hold down well-paid jobs. A key factor for many of these people is a strong support network of family and friends.

So we can say that poverty may contribute to mental health problems, and that mental illness can make it difficult to live above the poverty line. After that, the connections are not simple. Again, the support of family and friends is key. Poor people who don’t have support networks are at higher risk of becoming mentally ill. Likewise, people with mental illness and no solid support networks are more likely to become and stay poor.

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Why do people kill themselves?

Experts in the field suggest that a suicidal person is feeling so much pain that they can see no other option. They feel that they are a burden to others, and in desperation see death as a way to escape their overwhelming pain and anguish. The suicidal state of mind has been described as constricted, filled with a sense of self-hatred, rejection, and hopelessness.

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How would I know if someone is feeling suicidal?

Most people who consider suicide are not determined to die. They are undecided about whether to live or die. Warning signs may be their way of asking for help or revealing the seriousness of their situation.

Signs to watch for:

• a previous suicide attempt
• general talk of death or suicide
• talking about a specific suicide plan, including the method, date, location
• making a plan (e.g. drawing up a will, talking about final wishes)
• signs of depression or other mental illness
• writing or drawing about suicide
• giving away valued possessions
• sudden change in behaviour (for better or worse)
• withdrawal from friends and activities
• increased use of alcohol or other drugs
• recent loss (such as death, loss of a job, or loss of a relationship)
• feelings of hopelessness or helplessness.

Remember, there is no ultimate list of warning signs. Any one of these signs by itself does not necessarily mean a person is suicidal, but the more of these signs that are present, the greater the risk of suicidal behaviour. On the other hand, a suicidal person may not display the signs on this list. It may be right to be concerned simply because someone's behaviour is out of character. Sudden shifts in actions or attitude may alert friends to potential problems.

How you can help

• Ask directly if the person is thinking about suicide. Talking openly about suicide does not increase the risk. In fact, it can bring relief to someone who has been afraid to confide their suicidal thoughts.
   
• Talk to the person in a non-judgmental way, and listen to them without becoming upset. Let the person know you care and want to help.
   
• Believe what the person says, and take all threats seriously.
   
• Look into community resources, such as crisis lines and counselling services that you can suggest to the person.
   
• Never keep someone's suicidal feelings a secret. Tell someone who can help.
   
• Take action if you feel someone is at immediate risk. If necessary, make contact with the police, emergency services or a hospital to ensure the person's safety.

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What can I do about my friend who told me he/she was suicidal and made me promise not to tell anyone?

A young person who makes a promise to keep this type of secret is stuck in an awful position. They are afraid their friend is going to kill themselves, yet at the same time they have sworn to secrecy. This is a huge burden for a young person to carry. On one hand, they are afraid that their friend will die, or be seriously hurt. On the other hand, they worry that their friend will be angry with them if they tell anyone.

How adults can help

A promise like this is just too much responsibility for a young person to handle. Adults need to help them see the reality of the situation. If they do not tell someone, they may end up with a dead friend. They need to ask themselves if they prefer to have a friend who is alive and angry, or one who is dead. Also, if the friend succeeds and commits suicide, the surviving friend will go through severe trauma.

Encourage the young person to let you contact a parent or other trusted adult. This person can then contact a trained mental health professional, who may be able to help their friend.
You can receive more help and information by e-mailing the Centre for Suicide Prevention at info@suicideinfo.ca

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Is it true that most suicides leave notes?

No, in fact a surprising number of people who complete suicide do not leave suicide notes. According to Canadian researcher Dr. A. Leenaars, who has extensively studied suicide notes, the percentage of those who leave notes varies from 12 to 37% percent.

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How many people complete suicide in the world each year?

The World Health Organization projects that one million people will die from suicide this year - a global mortality rate of 16 per 100,000, or one death every 40 seconds. For a world map of suicide rates, and data for more than 100 countries, visit the World Health Organization website.

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What is a “consumer”?

The term “consumer” refers to a person who has used or is using services provided by the mental health system. There is some debate within our community about the most appropriate term. While some organizations prefer the term “client”, CMHA has listened to and heard individuals who have used or are using the mental health system and many of them prefer the term “consumer”. This is the word employed throughout our communications.

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What is the role of the CMHA?

At the community level, CMHA Branches/Regions provide multi-faceted services directly to consumers, their families and other stakeholders. Each Branch/Region structures its programs to meet the needs of its community. For example, links with ethno-cultural groups have been invaluable in providing service to diverse populations. And links with the private sector have been invaluable in helping to improve employment prospects for consumers. Provincially and territorially, CMHA Divisions provide public education materials, develop policy, conduct research, studies and demonstration projects and advocate at the provincial level. CMHA National works to assist the members of the Association, through the 135 CMHA Divisions, Regions and Branches in promoting the mental health of all people. CMHA National reaches out to the federal government at political and bureaucratic levels to drive policy and advocate on issues relating to mental health. We also develop national educational materials for the organization as a whole, work in partnership with other national organizations on common issues of concern, provide leadership on national/pan-Canadian issues and conduct research and programs to support policy development.

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How is CMHA funded?

CMHA is a charity – in fact we are one of Canada’s oldest charitable organizations. We rely on the financial support of corporations, foundations, individuals and other groups who believe in our work. At CMHA/Peel we are funded by various levels of government -- federal, provincial and regional.  Three of our programs receive funding from United Way of Peel Region. Visit the How we are funded pages to find out more.

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Where can I get more information about mental health and mental illness?

To find out more about mental health and mental illness, click on the Mental Health, Mental Illness menu items or contact our Resource Centre at 905-451-2123 or info@cmhapeel.ca to find out what resources are at our Resource Centre, click on Lending Library.

For medical information on any form of mental illness or mental health problem, please contact your doctor or other healthcare professional.

Excerpts reprinted with permission from Canadian National Mental Health Association National web site.