Mental Health

It is important to understand that there is a direct impact on your mental health and wellbeing if you are using alcohol or drugs. For some people it's the dreaded comedown or hangover and for others it can become more ongoing and serious.

Using alcohol or other drugs when your mental health is not at its best or if you have a mental illness can:

  • Worsen symptoms
  • Add new ones
  • Lead to more problems

While abstinence (not using at all) is the best way to reduce the harmful effects of drugs and alcohol, many people are unwilling or feel unable to do this. If you aren't ready to stop using altogether, then carefully considering the implications of your use, identifying the harms and changing how much and how you use can also be very helpful in restoring good mental health.

The following sections provides some useful information and tips to help you look after your mental health when you might be feeling a bit shakey.

However, the information provided is brief and general and can't take the place of talking to a health professional about your particular situation.

If you don't know who to talk to, contact one of the services listed here.

Or Call Lifeline on 13 11 14.

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This content was originally published in Mind Your Head by UntingCare ReGen. Visit their websites to see other ReGen resources.

Early Warning Signs

Looking Out For Triggers and Early Warning Signs

If you want to find out what triggers a downturn, it may be useful to think of the times when your mental health was suffering. Perhaps you felt miserable, even depressed, or really anxious and panicky. Maybe you were experiencing weird thoughts or sensations which made things look, sound or feel different. Or perhaps you felt so up-beat and energetic that it was hard to keep things in check. Seemingly unrelated things like changes in your sleep patterns or appetite can also be early warning signs of mental health problems.

After going through a patch of struggling with your mental health you may be able to look back and see what triggered it off. Sometimes there are patterns. For example:

  • Something terrible happening
  • Arguments with family, friends or others
  • Not being able to sleep
  • Using a drug or mixture of drugs (e.g. at a party)
  • Taking too much of a particular drug
  • Spending time with certain people or spending a lot of time by yourself

These are what we call "triggers". By identifying your specific triggers you can look out for the early warning signs and act before things get out of hand. The key is to be prepared, learn to manage your symptoms and get help if you need it.

EARLY WARNING SIGNS

Mental health problems can happen unexpectedly, but in many situations they emerge over a much longer period (weeks or months) often accompanied by symptoms we can learn to see as warning signs.

Here are some of the more common things to look out for:

Changes in feelings

  • Feeling anxious, tense, restless, sad or depressed
  • Feeling irritable or quickly getting angry
  • Feeling unsafe or threatened
  • Feeling paranoid

Changes in thinking

  • Finding it hard to concentrate, remember things or make decisions
  • Thoughts speeding up or slowing down
  • Thoughts becoming confused and not joining up properly
  • Very negative, pessimistic thoughts
  • Hearing voices not heard by other people
  • Thinking about hurting or killing yourself
  • Dwelling on past events

Changes in behaviour

  • Not wanting to go outside or spend time with others
  • Changes to your appetite or sleep patterns
  • Emotional outbursts (crying, yelling or laughing)
  • Losing motivation or energy to get things done
  • Finding it hard to look, after yourself (i.e. keep yourself clean and neat and your environment tidy)
  • Using drugs and alcohol more frequently or taking new combinations of drugs

Because it's not always easy to work out whether you are becoming unwell, it's a good idea to talk to someone you trust, someone who is prepared to help you get the treatment and support you need.

Hearing Voices

Hearing Voices, Weird Thoughts or Seeing Things

It's natural to feel stressed if you think you're hearing voices in your head or seeing visions, but it's important you try to stay calm. Check it out with someone you trust. They may be able to help you work out what's going on. You're local health service or doctor might also put you in touch with a skilled professional who can help.

If you think you're hearing voices in your head or seeing things that might not actually be there, try to find out more. Think about where it's coming from and what's different. You could ask yourself:

  • Have I taken something that could have triggered the voices or visions (drugs such as cannabis or amphetamines)?
  • Does the volume go up or down when I walk away from the source (e.g. a television)?
  • Do I know who is talking, and do I hear their voice when that person isn't around?
  • Is what I'm looking at different from what normally happens (e.g. seeing your face change colour or shape in the mirror)?
  • Is what I'm experiencing hard to explain?

COPING WITH VOICES IN YOUR HEAD

The first thing to do is seek professional help to check out what's causing the voices.

Rather than becoming anxious, the key is to try to give yourself some mental breathing space. Remind yourself that the voices can't harm you. Many people manage to exert some control over voices.

A mental health worker can help you develop strategies to cope with the voices you hear. They may suggest that you:

Take your mind off the voices – by paying attention to something else, like where you are and what the people around you are doing. You could also try doing something else, such as watching TV, playing cards, gardening or doing the housework.

Tell the voices to stop – one way to do this is imagine you have the power to tell the voices what to do and that you can command them to stop and go away. You could do this by stomping a foot on the ground, extending one of your arms forward with an open palm and yelling "STOP". It's best to do this in a place where you feel safe and comfortable.

Talk, hum or sing – if you ignore the voices you may find they fade away.

Use your imagination – close your eyes and picture a stop sign. Every time you hear the voices concentrate on the sign and tell them to stop. You could also try bringing to mind a pleasant memory – something that made you feel really happy.

Listen to something through headphones – listening to music that you like or the radio (talk-back) can help drown out the voices, or at least distract you from what they're saying.

Use earplugs – some people find that using earplugs can reduce distressing voices. Sometimes the voices will stop only after you take the ear plugs out.

Count backwards – try counting backwards from 1000 in lots of 5 (1000, 995, 990... ). Imagine seeing the numbers in your head as you count.

Avoid certain places or situations where there is a lot of background noise, as this can make the voices louder and more intense.

It is important to find what works for you and practise. Everyone's different. The more you practise the more automatic these strategies will become. Learning to use these strategies is best done with support.

Unpleasant Emotions

COPING WITH UNPLEASANT EMOTIONS

Stress and anxiety

When we're really stressed and anxious often it's because we're worried about something, sometimes to the point where it becomes difficult to manage our lives. It may have been something we've carried around for some time, even though it appears to occur suddenly.

Stress and anxiety can make you feel on-edge and as if your mind is racing. You might become preoccupied with thoughts such as "others are out to get me" or I can't cope". This can leave you feeling overwhelmed, not wanting any social contact or even not wanting to leave the house.

Learning a range of simple relaxation techniques should help you manage the effects. We've included a few you could try.

Deep breathing – This is a technique that relaxes tense muscles and focuses your energy. Start off by breathing deeply through the nose, letting your stomach expand. Once you've breathed in as much as you can, hold it in for a few seconds and then breathe out slowly through your mouth. Repeat this five times or more.

The sigh – Breathe out with a long sigh. Drop the shoulders. Relax your face and release your jaw. Keep your breathing easy and quiet.

Active relaxation – This technique will help you get rid of the tension in your body. You do this by first tensing and then relaxing each muscle in the body. Start with the muscles in the head and progressively move down to the muscles in the feet. As you relax, imagine the tension leaving your body. You can do this exercise sitting up straight in a comfortable, firm chair or lying down.

Stretching exercises – Stretching exercises are an easy, simple way to loosen tight muscles. Stand up and lift your arms to the sky, stretching your whole body. Hold it for a few seconds and then allow your body to collapse forward from the hips, bending the knees and making a loud "WHOOSH".

Everyone finds their own way of relaxing. Try a number of different techniques to find out what works best for you. Some other things you could do include:

  • Going for a walk
  • Listening to music or a relaxation CD
  • Taking a nice, long bath
  • Losing yourself in a good book
  • Going for a swim

If you're stressed, try not to dwell on what's bothering you. Give yourself a break and take time out. Do something you enjoy.

PANIC ATTACKS AND WHAT TO DO ABOUT THEM

Panic attacks are sudden surges of intense fear or anxiety. They're triggered by what is called the "fight or flight response". This is where a person's brain goes into automatic, getting the body ready to fight or run away, because it thinks it's in danger. It's a survival mechanism. The attacks are not uncommon, with one in five people experiencing them at least once in their lifetime.

During an attack people may experience sweating, pounding heart and chest pains, shortness of breath, dry mouth, tingling in the hands and feet, trembling, nausea and diarrhoea, hot or cold flushes, faintness, and a racing mind - thinking that you're in danger and you can't escape.

Panic attacks can last from a few minutes to half an hour. After the attack, it usually takes some time for the person to feel OK again. Some people can experience a panic attack when they take certain types of drugs or too much of one particular drug.

If you experience panic attacks you might like to try the following strategies*:

Self-talk – tell yourself that it's only temporary. Distract yourself by focusing on something reassuring, like the lines to your favourite song or a time when you felt happy and relaxed.

Diet – steer away from taking anything with a lot of caffeine in it (energy drinks, coffee), and avoid drugs, alcohol and tobacco, as they can all trigger attacks.

Exercise – regular exercise will usually help get rid of the hormones (such as adrenaline) which can lead to feelings of anxiety or distress.

Relaxation – using relaxation techniques every day will help lower your stress level, which has been found to contribute to panic attack.

Slow breathing – a panic attack usually makes you breathe at a rate that is faster than normal. This can cause light headedness and shortness of breath. It will also increase your heartbeat and might lead to fainting, sore chest muscles and tingling hands and feet.

  • The key to reducing these symptoms is to slow your breathing:
  • Hold your breath and count to 10, then breathe out
  • Breathe in through your nose for the count of three, then out through your mouth for the count of three. Do this for one minute.
  • Hold your breath again for the count of 10
  • Repeat these steps any time you feel panicky. It's also a good idea to practise when you're feeling calm.

*Adapted from the Reach Out! website.

SADNESS AND DEPRESSION

Although depression is often thought of as being extreme sadness, there is a big difference between clinical depression and sadness. All of us will experience sadness at some point in our lives, it is a part of being human. Depression is much more than being sad. People experiencing depression may have no appetite, no sense of pleasure or hope, and no energy for weeks or months on end.

When you are depressed things often seem hopeless but depression is treatable and the earlier you seek treatment the sooner you will start to feel better.

In addition to professional help there are many ways in which you can help yourself cope with depression or overcome sadness. Your doctor or health professional may advise you.

Sometimes the urge to use drugs to relieve the feelings of sadness or depression can be strong. While it may seem to ease problems in the short-term by numbing the uncomfortable feelings, using drugs or alcohol can lead to problems in managing your emotions in the longer term.

Aim to achieve a small task each day

It's important to stay active and plan what you're going to do each day. It doesn't have to be anything major. It could be washing the dishes, taking the dog for a walk or shopping with a friend. If you're finding it hard to come up with ideas, ask someone. That person could also help you to put it into practice.

Try to stick with the plan, but if you don't, that's OK. What isn't helpful is beating yourself up about not getting things done. Try to be positive and find ways to reward yourself (e.g. go to a movie). Each day, aim to include something enjoyable or something that gives you a sense of achievement. This will help keep you on track.

Exercise

Regular exercise can be an effective way to treat depression as physical activity triggers the release of neurotransmitters in the brain which lead to feelings of wellbeing.

Maintain contact with family and friends

Keeping in touch with others is also really important. People who are depressed often withdraw and avoid contact with their friends, family and colleagues. This can leave you feeling disconnected and alone. Even though you might not want to, stay in contact and try to spend time with your family and friends.

Help yourself to get a good night's sleep

Sadness, depression, anxiety and alcohol or other drug use all affect our sleep patterns. Not getting the amount of sleep we need has a negative effect on our physical and mental wellbeing. It's a vicious circle but you can help yourself to sleep better by:

  • Getting up at the same time every morning, and getting up as soon after you wake as you can
  • Trying to be more active and not sleeping during the day
  • Steering away from drinks that contain caffeine (Coke and coffee). Don't have these after 4pm
  • Avoiding drinking alcohol or smoking before going to bed. Alcohol makes it harder to get into a deep sleep and smoking will increase your anxiety
  • Creating a routine before going to bed (e.g. having a shower, putting on your pyjamas and brushing your teeth)
  • Only using your bed for sleeping (or sex)
  • If you want to watch TV or read a book, do it in a room other than your bedroom
  • Not going to bed too early - it's not good for deep sleep. 10-10.30pm is ideal
  • Giving yourself 15-20 minutes to fall asleep. If you haven't fallen asleep in that time, get up and do something quiet and relaxing for a while before trying again
  • Managing your drug use - this doesn't necessarily mean not using anything at all, it just means being aware of when you're using drugs to cope or using more than you normally would, or using in a riskier way.

Self Harm

SELF HARM

Life can at times be very painful and sometimes it can be overwhelming. For some people it may even seem like it's hopeless, things are never going to get better and that the best way to end the emotional pain is to end life altogether. It isn't. While it may be hard to believe, the emotional pain will pass and things do get better.

If you feel like hurting or killing yourself, you're not the only one who has had these sorts of feelings. Many people have gone through this and it's important to know that the feelings usually subside with appropriate help and support. It's important to talk to someone.

You could talk to a doctor, or your mental health or drug and alcohol worker, or contact one of the services liste here. If you don't think you can do this on your own maybe you could talk to a friend, family member or teacher who could help you get the help and support you need.

Self Harm

Deliberately hurting yourself is not the same as wanting to kill yourself and then acting on it. Many people who self-harm don't actually want to die. However, like those who are suicidal, people who self-harm are responding to intensely painful emotions.

So if you feel like hurting yourself, this is what might be going on:

  • You might feel empty or numb. Self-harming could be an attempt to replace that sense of numbness with a feeling sensation
  • It's a way for you to express what you are going through without having to put it into words. It can be hard communicating how and what you're going through, especially if things seem chaotic
  • You might want to prove to yourself and others that you're not invisible and that you do matter
  • You might feel that self-harm gives you a sense of control (over your body and feelings) when most things in your life seem chaotic

While it may bring you an immediate sense of relief, helping you deal with pent-up emotions, self-harming is not the answer. There are other less harmful ways of coping with the pain, things you can do that won't damage your body, or your mind or cause pain to those around you.

If you feel the need to self-harm, give these a go (they won't cause you injury):

  • Eat a chilli, or something else really hot. Not only does it create a burning sensation in your mouth, eating chillies is known to release endorphins, which can promote feelings of well-being
  • Squeeze ice cubes until your fingers go numb
  • Put a frozen pack of peas on the area you want to hurt
  • Have a cold shower
  • Wear a rubber band around your wrist and flick it on to your skin when you feel the urge
  • Hit a punching bag or a pillow
  • Go for a walk and break any sticks you find along the way
  • Try to tear a thick cardboard box
  • Pop bubble wrap
  • With a washable red marker, draw on your body where you want to hurt yourself
  • Put vapour rub or deep heat under your nose (it stings and makes you cry)

If you're self-harming or thinking about it, get in contact with a mental health worker, or at least tell someone who can call on your behalf.

Call Lifeline on 13 11 14.