Resources

Returning to School: Academic stress + Youth sharing

While returning to school is exciting, transitioning back to on-campus classes presents another change in our daily lives, you might find yourself feeling stressed about school work. This booklet primarily aims to help young people in Hong Kong cope with academic stress it also includes youth sharing about their own experience with returning to school.

Download our booklet here:

Also check out our video with tips to handle academic stress:

Resources

Returning to School

While the improving coronavirus situation is good news, transitioning back to on-campus classes presents another change in our daily lives, which might take some time to adapt to. This booklet primarily aims to help young people in Hong Kong cope with going back to school after the class suspension due to the outbreak.

Download our booklet here:

Resources

Staying Well during the Coronavirus Outbreak

With school cancelled and lots of news coverage on the coronavirus and its effects, it’s easy to feel overwhelmed. Whether you’re feeling anxious, lost, frustrated, or lonely, know that you are not alone. Experiencing these emotions are an understandable result of the current situation, and there are many ways to cope.

Download our booklet here:

Resources

Signs of Depression

We would like to acknowledge the Charlie Waller Memorial Trust (CWMT) UK for these resources and for allowing us to adapt this. For the original version of this resource, please refer to the CWMT website: www.cwmt.org.uk

Resources

Asking for help

When it’s time to talk about your mental health

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

We would like to acknowledge the Charlie Waller Memorial Trust (CWMT) UK for these resources and for allowing us to adapt this. For the original version of this resource, please refer to the CWMT website: www.cwmt.org.uk

Find out who’s best to talk to

You might already know who you want to talk to, perhaps a parent or a teacher you get on especially well with. If you’re not sure who to talk to then it’s worth thinking about who you trust and feel comfortable talking to. Have you talked to someone who has been particularly helpful before?

Think about what you want to say

Whilst you may have made the decision to talk to someone, you still need to decide what you want to tell them. You might want to think about:

  • Is there a problem you need to talk about?
  • How much are you happy to share?
  • How do you feel each day?
  • What has prompted you to ask for help now?
  • Is there anything you are finding hard to manage?

Practise saying what you need to say

It’s alright to be nervous, so it’s a good idea to prepare. It sounds a bit strange but you’ll feel much more confident talking to a parent or teacher if you’ve worked out what you want to say and tried saying it beforehand.

You can start by writing down bullet points, writing a text or using a free online resource called Doc Ready… You could give this to someone to read if you are not yet comfortable to talk.

It’s worth writing a list of what you want to say to take with you so you don’t forget anything. You could formulate your words into a letter, both to help you work out what to say and also as a back- up. That way if you find yourself unable to talk about your issues you could give the letter to the person you’ve chosen to talk to instead.

It’s ok to start small and say ‘I’m not having a good day’.

A good next step is to call an anonymous helpline (see ‘Sources of advice’ for local helplines) and practise talking to someone you don’t know – that can be easier than talking to someone you know and care about and can help you whilst you get ready to take the next step.

Find a quiet time

Make sure you start the conversation at a time when the person you’re talking to won’t be interrupted and has time to listen to you properly. It’s important not to rush the conversation. If they can’t talk now, it doesn’t mean they don’t care about you; ask them when would be a good time to talk and come back then.

Take it slowly

Don’t feel like you have to say everything in one breath, or even in that first conversation. Take it nice and slowly and don’t be afraid to pause to think about what to say next.

Don’t over-analyse their reaction

It’s perfectly normal to try and second guess what the person you’re talking to is thinking. You might have all sorts of ideas about what is going through their mind, but don’t try to second guess. They might be surprised, and thinking of ways and routes to help. Try to ask them rather than just guessing.

Remember that there are other people to talk to if the conversation doesn’t go as well as you hoped.

It’s okay to cry

However you react, it’s ok. It’s natural to cry or feel angry. None of these feelings are a bad thing.

Know your rights about confidentiality

If you talk to someone who you know through their professional role, one of the first things they’ll do is to tell you that they can’t keep confidentiality. That’s because they’ll need to ensure you get the support you need to help you to get on top of things.

You can talk to them about who needs to know what – but try to remember it’s a good thing that people understand what’s going on so they can help you, though it might seem a bit scary at first.

Think about what you want to happen next

It’s a big step to ask for help and it usually means that on some level you’re ready for things to improve. Do you have any idea of what you might like to happen as a result of the conversation you’re planning? This might include:

  • Support telling parents or a friend
  • First aid or medical help for injuries
  • Support to help you talk through and overcome underlying issues
  • Referral for specific treatment that you’re already aware of (or learn more about possible available treatments)
  • You’re not sure, you just can’t carry on with how things are

Even if you’ve gone looking for help, it can be hard to accept it – but try. Have faith in the person you’ve confided in to help you to take the first steps to make things better. They won’t be able to fix everything all in one go, but they can work with you to start to make things change.

“When I first started talking I realised I wasn’t so alone”

“From the moment I took that brave step I felt very much less alone.”

“I thought it was weak to ask for help, but I realised eventually that it was the ultimate sign of strength.”

“You’re not alone. Reach out… let yourself be loved.”

“Although it can be hard to take a first step there is help out there”

Sources of advice (Hong Kong)

Bilingual Telephone Hotlines

Samaritans Hong Kong 24-hour hotline: 2896 0000

Samaritan Befrienders Hong Kong 24-hour hotline: 2389 2222

Suicide Prevention Services 24-hour hotline: 2382 0000

Suicide Prevention Services “Youth Link” hotline (available 2pm-2am): 2382 0777

Hospital Authority Mental Health Direct hotline: 2466 7350

Chinese-Only Telephone Hotlines

Youth Outreach 24-hour hotline service: 9088 1023

The Hong Kong Federation of Youth Groups “Youthline” hotline (available Mon-Sat, 2pm-2am): 2777 8899

Resources

Bipolar disorder symptoms

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

Thank you to the Black Dog Institute for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to the Black Dog Institute’s website: www.blackdoginstitute.org.au

What this fact sheet covers:

  • What is bipolar disorder
  • Sub-types of bipolar disorder
  • Symptoms of bipolar disorder
  • When to seek help for bipolar disorder
  • Key points to remember
  • Where to get more information

What is bipolar disorder?

  • Bipolar disorder is the name used to describe a set of ‘mood swing’ conditions, the most severe form of which used to be called ‘manic depression’.
  • The term describes the exaggerated swings of mood, cognition and energy from one extreme to the other that are characteristic of the illness.
  • People with this illness suffer:
  • Recurrent episodes of high, or elevated moods (mania or hypomania) and depression.
  • Most experience both the highs and the lows.
  • Occasionally people can experience a mixture of both highs and lows at the same time, or switch during the day, giving a ‘mixed’ picture of symptoms.
  •  A very small percentage of sufferers of bipolar disorder only experience the ‘highs’.

People with bipolar disorder experience normal moods in between their mood swings.

  • The mood swings pattern for each individual is generally quite unique, with some people only having episodes of mania once a decade, while others may have daily mood swings.
  • Bipolar disorder can commence in childhood, but onset is more common in theteens or early 20’s.
  • Some people develop ‘late onset’ bipolar disorder, experiencing their first episode in mid-to-late adulthood.

Distinguishing between bipolar I and bipolar II

  • Bipolar I disorder is the more severe disorder, in the sense that individuals are more likely to experience ‘mania’, have longer ‘highs’ and to have psychotic episodes and be more likely to be hospitalised.
  • Mania refers to a severely high mood where the individual often experiences delusions and/ or hallucinations. The severe highs which are referred to as ‘mania’ tend to last days or weeks.
  • Bipolar II disorder is defined as being less severe, in that there are no psychotic features and episodes tend to last only hours to a few days; a person experiences less severe highs which are referred to as ‘hypomania’ and depression but no manic episodes and the severity of the highs does not usually lead to hospitalisation.
  • Hypomania literally translates into ‘less than mania’. It describes a high that is less severe than a manic episode and without any delusions and/or hallucinations.
  • These highs don’t last as long. While they are officially diagnosed after a four-day duration, research has shown that they may only last a few hours to a few days.
  • Both women and men develop bipolar I disorder at equal rates, while the rate of bipolar II disorder is somewhat higher in females.

Symptoms of bipolar disorder

  • Diagnosing bipolar disorder is often not a straightforward matter.
  • Many people go for 10 years or more before their illness is accurately diagnosed.
  • It is important to note that everyone has mood swings from time to time. It is only when these moods becomeextreme and interfere with a person’s personal and professional life that bipolar disorder may be indicated and medical assessment sought.
  • There are two starting points for considering whether you might have bipolar disorder.
    • Firstly, you must have had episodes of clinical depression.
    • Secondly, you must have had ‘highs’, where your mood was more ‘up’ than usual, or where you felt more ‘wired’ and ‘hyper’.
  • If both depression and ‘highs’ have been experienced, then the next thing to consider is whether you also experienced any of the six key features of mania and hypomania outlined below.

Key features of mania & hypomania

While it can be difficult to identify what separates normal ‘happiness’ from the euphoria or elevation that is seen in mania and hypomania, researchers at the Black Dog Institute, have identified the following distinguishing features:

  • High energy levels – feeling ‘wired’ and ‘hyper’, extremely energetic, talking more and talking over people, making decisions in a flash, constantly on the go and feeling less need for sleep.
  • Positive mood – feeling confident and capable, optimistic that one can succeed in everything, more creative, happier, and feeling ‘high as a kite’.
  • Irritability – irritable mood and impatient and angry behaviours.
  • Inappropriate behaviour – becoming over involved in other peoples’ activities, engaging in increased risk taking (i.e. by over indulging in alcohol and drugs and gambling excessively) saying and doing outrageous things, spending more money, having increased libido; dressing more colourfully and with disinhibition.
  • Heightened creativity – ‘seeing things in a new light’, seeing things vividly and with crystal clarity, senses are heightened and feeling quite capable of writing the ‘next great novel’.
  • Mystical experiences – believing that there are special connections between events, that there is a higher rate of coincidence between things happening, feeling at one with nature and appreciating the beauty and the world around, and believing that things have special significance.
  • More extreme expressions of mania (but not hypomania) may have the added features of delusions and hallucinations.
  • A number of other symptoms can indicate whether there is a likely diagnosis of bipolar disorder, particularly for those under the age of 40. These include:
    • Racing thoughts (for example, feeling like you are watching a number of different TV channels at the same time, but not being able to focus on any)
    • Sleeping a lot more than usual
    • Feeling agitated, restless and/or incredibly frustrated.

When to seek help for bipolar disorder

  • If you have experienced an episode of mania or hypomania, or have taken the Black Dog Institute’s Bipolar Disorder Self-Test, linked under the resources at the end of this fact sheet, and are concerned about your results, it is advisable to seek professional assessment by a mental health practitioner.
  • The first step is to arrange a consultation with your doctor. They will provide an assessment and, where necessary, refer you to a psychiatrist for further treatment.
  • Bipolar disorder is not an illness which goes away of its own accord, but one which often needs long-term treatment. Accurately diagnosing bipolar disorder is a task for the mental health professional.
  • Some people with bipolar disorder can become suicidal. It is very important that talk of suicide be taken seriously and for such people to be treated immediately. In an emergency you can go straight to your local hospital’s emergency department for help, or dial 999.

Key points to remember

  • Bipolar disorder is an illness involving exaggerated swings of mood and energy from one extreme to the other, usually involving alternating periods of depression and mania or hypomania.
  • The pattern of mood swings for each individual is quite unique.
  • The six features of mania and hypomania are:
  1. High energy levels
  2. Positive mood
  3. Irritability
  4. Inappropriate behaviour
  5. Heightened creativity
  6. Mystical experiences
  • For people under the age of 40, other symptoms of bipolar disorder may include sleeping a lot more than usual, feeling agitated, restless and/or incredibly frustrated.
  • Accurately diagnosing bipolar disorder is a task for a skilled mental health practitioner.
  • If symptoms of bipolar disorder are suspected it’s best to first see a doctor, who will likely refer you to a psychiatrist.
  • People with bipolar disorder can become suicidal. Talk of suicide should be taken seriously and immediate help should be sought from a doctor or other mental health professional.

Contact Us

Coolminds

Email: hello@coolmindshk.com

Black Dog Institute

Email: blackdog@blackdog.org.au

Where to get more information and support

Black Dog Institute – “Bipolar Disorder Self-Test”

Mind Hong Kong – “What Is Bipolar Disorder?”

Bilingual Telephone Hotlines

Hospital Authority Mental Health 24-hour Hotline: 2466 7350

Social Welfare Department Hotline: 2343 2255

Chinese-Only Telephone Hotlines

Youth Outreach 24-hour hotline service: 90881023

The Hong Kong Federation of Youth Groups “Youthline” hotline (available Mon-Sat, 2pm-2am): 27778899

Resources

Stress and its impact on you

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

Thank you to the Black Dog Institute for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to the Black Dog Institute’s website: www.blackdoginstitute.org.au

What this fact sheet covers:

  • What is stress?
  • Physical and mental health impacts
  • Factors that impact mental health
  • Recognising and managing stress

What is stress?

Stress is our body’s response to a demand placed on it. Stress is often confused with anxiety, but stress is not a diagnosable mental illness.

Stress is a normal condition, experienced by everyone. It involves an emotional, physical or mental response to events that cause bodily or mental tension. It can be thought of as a state of readiness – the ‘fight or flight’ response.

A small amount of stress from time to time is not a problem, it can even motivate us to get things done. But when stress is intense and ongoing, it can start to impact our physical and mental health.

Experiencing stress

When stressed, you might have thoughts like “I can’t cope with this”, “this is too much pressure for me”, “I don’t have enough time” and “how am I going to get this done”. In essence, your mind has decided you have ‘more on your plate than you can chew’.

At the same time, your body goes into ‘fight or flight’ mode. Your nervous system is activated, and hormones are released that enable you to react quickly. For example, when stressed you might notice your heart rate increases, pupils dilate, breathing rate increases and muscles tense. You might also notice changes in mood or emotions. These changes enable you to deal with the situation.

Stress has also been shown to affect the body’s immune response. This change in immune response and increased inflammation is a possible link between various physical diseases and stress, including cardiovascular disease, thyroid disease, and diabetes.  

Impact of stress on daily activities

Initially increasing stress, or arousal, increases performance; this is explained by the Yerkes- Dodson Law.

The ‘comfort’ zone allows you to work under stressful conditions.  Levels of stress arousal above the ‘comfort’ zone can however lead to impaired performance, reduced concentration, and fatigue.

If not addressed, prolonged chronic stress can lead to structural and functional changes inside the brain. These changes can play a role in the development of or trigger several physical and mental illnesses, such as:

  • Depression, anxiety, schizophrenia
  • Autism spectrum illnesses
  • Hypertension
  • Cardiovascular diseases
  • Endothelial dysfunction
  • Sleeping problems

How much stress is too much?

Stress is personal. What someone thinks is stressful, you might find satisfying and fun. For example, some people may find working 10 hours a day for long periods does not cause stress; for others, it will. Some people enjoy public speaking; for others, this is too stressful. There are many things that can cause stress. When they do, we call them ‘stressors’.

Potential stressors include:

  • Relationship difficulties
  • Work issues
  • Life changes (e.g. marriage, separation, retirement, moving house, starting a new job, being retrenched or becoming unemployed)
  • Illness
  • Study demands
  • Event planning (e.g. holidays and family events)

And the list goes on. Your stressors will also change over time as your life demands change.

Recent studies have found genetic differences in the genes that direct the production of stress hormones, and that there are differences in the way stress impacts on these genes. This may be the reason why people respond differently to stress, and why some are more vulnerable to the effect of chronic exposure to stress.

Stress and mental health

There’s a common misconception that there is a direct correlation between stress levels and mental health. There has been an assumption that if we want to improve mental health, and particularly mental health at work, we need to reduce stress. However, the research shows that the factors affecting our mental health are much more complex and interlinked than this simplistic model.

Our mental health and wellbeing are impacted by:

  • Individual factors: personal resilience, genetics, early life events, personality, mental health history, lifestyle factors
  • Home/work factors: conflicting demands, significant life events
  • Workplace factors: the design of our jobs, the teams we work in and the culture of an organisation

Managing stress

It’s important to remember that stress is more than just feeling overworked. We have become accustomed to feeling high levels of stress and hence are often unaware of or may not even know what it feels like to be relaxed. You need to be able to recognise stress to deal with it. By repeating these 4 steps regularly, you may start to recognise your stressors.

  1. Event: Describe to yourself one event this week that you found stressful. Consider where you were, when it was, who was there and what you were doing.
  2. Rating: On a scale of 1-5, how stressful was this event? (1 = mildly stressful, 5 = extremely stressful)
  3. Thinking: What were you thinking about this event? For example, were you thinking of the worst possible outcomes? Were you focusing on the stress itself?
  4. Feeling: Where did you feel the stress? For example, as a physical ache, or an emotional response such as being irritable? Did it change the way you were thinking, e.g. less able to concentrate or change your behavior, such as disturbing your sleep?

It is helpful to develop a range of responses to stress. Some tried-and-true strategies for dealing effectively with the stress that shows up in our lives include:

  1. Recharge activities: When we get stressed, we often stop making time for things that are nourishing, satisfying and refreshing to do.
  2. Daily routines: The human mind likes predictability and certainty. When life gets stressful, we can restore some order to the chaos by ensuring that we continue with simple daily routines.
  3. Circles of concern and influence: The problems, issues and difficulties we face generally fall into two ‘circles’:
    • Circle of concern contains things over which you have little direct control
    • Circle of influence contains those concerns that you can actually do something about – focus on making changes in this circle

Reality check: As mentioned before, stress has a large ‘thinking’ component, and certain types of thinking are likely to trigger stress and/or make your stress worse. Thought challenging is a useful strategy to ensure the way you are thinking about a situation is more balanced, realistic and helpful.

Key messages

  • Stress is a normal condition, not a mental illness
  • Everyone experiences stress, but we experience it differently and this changes over time
  • Prolonged stress can negatively impact physical and mental health
  • Learn to recognise your stressors so you can deal with them

Contact Us

Coolminds

Email: hello@coolmindshk.com

Black Dog Institute

Email: blackdog@blackdog.org.au

Where to get more Information and Support

The following resources have been produced by the HK Department of Health:

Joyful @ HK

Student Health Service – “Stress Management”

Student Health Service – “Exam Stress Management”

Additional resources:

MyCompass: an online self-help tool to keep track of and manage your mental health (English only)

Mind Hong Kong – “What Is Stress?”

Resources

Signs & symptoms of anxiety

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

Thank you to the Black Dog Institute for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to the Black Dog Institute’s website: www.blackdoginstitute.org.au

What this fact sheet covers:

  • When anxiety is a problem
  • Types of anxiety disorders
  • Signs and symptoms of anxiety

Everyone experiences anxiety

In Hong Kong,

  • Over half of the university students show symptoms of an anxiety disorder, according to research conducted by the University of Hong Kong in 2016
  • According to a 2018 survey by Hong Kong Playground Association, over a third of young people scored moderate to extremely severe on the Anxiety scale (of the DASS21)

When does anxiety become a problem?

It’s normal to feel anxious in high pressure situations such as:

  • A job interview
  • When you’re speaking in public
  • When you’re experiencing change in your life or work environment and you’re uncertain what the future will hold.

To a degree, this anxiety can help us, making us stay focused and alert.

When we’re very anxious, we have intense feelings of worry or distress that are not easy to control. Anxiety can interfere with how we go about our everyday lives making it hard to cope with ‘normal’ challenges.

Anxiety becomes a problem when you start to feel anxious most of the time and about even minor things, to the point where your worry is out of control and interfering with your day to day life.

What are anxiety disorders?

Anxiety disorders are a mix of:

  • Psychological symptoms: frequent or excessive worry, poor concentration, specific fears or phobias e.g. fear of dying or fear of losing control
  • Physical symptoms: fatigue, irritability, sleeping difficulties, general restlessness, muscle tension, upset stomach, sweating and difficulty breathing
  • Behavioural changes: including procrastination, avoidance, difficulty making decisions and social withdrawal

Severe anxiety is a feature of a group of mental health disorders including:

  • Generalised anxiety disorder
  • Social phobia
  • Specific phobia
  • Obsessive compulsive disorder (OCD)
  • Panic disorder
  • Separation anxiety disorder
  • Agoraphobia
  • Post-traumatic stress disorder (PTSD)

Other types of anxiety disorders include:

  • Substance/medication-induced anxiety disorder
  • Anxiety disorder due to a medical condition

It’s important to seek help to manage severe anxiety. There are many effective treatments for anxiety, and you can feel better.

Factors for developing anxiety

There is a range of contributing factors for developing anxiety. The factors could be:

  • Biological – genes (family history)
  • Personality traits
  • Brain chemistry
  • Life events, such as trauma and long-term stress
  • A combination of above factors

Signs and symptoms

While there are many types of anxiety disorder, there are some common signs and symptoms.

You might be feeling:

  • Very worried or afraid most of the time
  • Tense and on edge
  • Nervous or scared
  • Panicky
  • Irritable, agitated
  • Worried you’re going crazy
  • Detached from your body
  • Feeling like you may vomit

You may be thinking:

  • ‘Everything’ is going to go wrong’
  • ‘I might die’
  • ‘I can’t handle the way I feel’
  • ‘I can’t focus on anything but my worries’
  • ‘I don’t want to go out today’
  • ‘I can’t calm myself down’

You may also be experiencing:

  • Sleep problems (can’t get to sleep, wake often)
  • Pounding heart
  • Sweating
  • ‘Pins and needles’
  • Tummy aches, churning stomach
  • Lightheadedness, dizziness
  • Twitches, trembling
  • Problems concentrating
  • Excessive thirst

When these constant repetitive thoughts and feelings take over, we can:

  • Feel overwhelmed
  • Lose sleep
  • Feel exhausted
  • Start to avoid social situations

Some of these symptoms can also be signs and symptoms of other medical conditions, so it’s always best to see a doctor so they can check them properly.

There is an online Anxiety Self-test on the Black Dog Institute website.

Diagnosis

To be diagnosed with an anxiety disorder, a combination of symptoms

  • Is present on most days for more than six months
  • Interferes with your ability to function at work or at home

It is common to experience a low mood secondary to excessive worry and the two conditions – clinical depression and anxiety disorder – can occur at the same time.

It’s important to get help to treat anxiety disorders. Left untreated, anxiety can last for a long time. It can become exhausting, debilitating and get in the way of us living our everyday lives. There are a range of effective treatments for anxiety, and you can get better. Visiting a doctor or a mental health professional is a good starting point when seeking help for anxiety.

Key points to remember

  • Anxiety is normal, everyone experiences anxiety at some time.
  • Anxiety becomes a problem when it interferes with your day to day life
  • Anxiety disorders are a combination of psychological, physical and behavioural symptoms
  • A range of factors can contribute to anxiety disorders
  • Signs and symptoms of anxiety vary

Contact Us

Coolminds

Email: hello@coolmindshk.com

Black Dog Institute

Email: blackdog@blackdog.org.au

Resources

Seeking help for anxiety

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

Thank you to the Black Dog Institute for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to the Black Dog Institute’s website: www.blackdoginstitute.org.au

What this fact sheet covers:

  • Why seek help for anxiety?
  • Who to talk to
  • Treatment available

It’s important to get treatment for anxiety

Anxiety is physically and emotionally exhausting. Getting help early means you can start to get relief and recover sooner. There are many professionals who treat all kinds of anxiety.

There is a wide range of effective treatments for anxiety, e.g.

  • Cognitive behavioural therapy (CBT)
  • E-mental health tools
  • Relaxation techniques
  • Medications

There are also lots of things you can do to help yourself.

Often, it’s a combination of things that help us get better, such as:

  • A well-informed health professional you feel comfortable talking to
  • The right psychological and medical therapies
  • Support from family and friends
  • Exercising and healthy eating
  • Learning ways to manage challenges and stress, such as structured problem solving, meditation and yoga

How do I know it’s anxiety?

Severe anxiety can appear in ways that feel like other health issues, e.g.

  • Chest pain
  • A racing heartbeat
  • Dizziness
  • Rashes

Sometimes, anxious people think they’re having a heart attack.

When we’re anxious, we can also become hyper-aware of:

  • Our body
  • Aches and pains
  • Perceived threats and danger

Sometimes, once we’re aware of a problem, we can become ‘hyper-vigilant’ in checking on all the discomforts and pains we feel. This can spiral into feeling more concern and worry, making the anxiety more severe.

You should always see a doctor, so they can make a thorough check of your symptoms and rule out any other medical condition.

Who can provide help for anxiety?

As well as your doctor, there are other health professionals who can help with anxiety, including:

  • Psychologists
  • Psychiatrists
  • Counsellors
  • School and university counsellors
  • Social workers and occupational therapists trained in mental health
  • Mental health nurses

What type of treatment is available?

There are three broad categories of treatment for anxiety:

  • Psychological treatments (talking therapies)
  • Physical treatments (medications)
  • Self-help and alternative therapies

Psychological therapies are the most effective way to treat and prevent the recurrence of most types of anxiety. Depending on the type of anxiety, self-help and alternative therapies can also be helpful. They can be used alone or combined with physical and psychological treatments.

A thorough assessment by your doctor is needed to decide on the best combination of treatments for you.

Psychological treatments

Psychological treatments can be one-on-one, group-based or online interactions. Psychological treatments are sometimes called ‘talking therapies’ as opposed to ‘chemical therapies’ (i.e. medications).

Keeping health in mind

Talking therapies can help us change habits in the way we think, and cope better with life’s challenges. They can help us address the reasons behind our anxiety, and also prevent anxiety from returning.

There are a wide range of psychological treatments for anxiety, including:

  • Cognitive behaviour therapy (CBT)
  • Exposure therapy (behaviour therapy)
  • Interpersonal therapy (IPT)
  • Mindfulness-based cognitive therapy
  • Positive psychology
  • Psychotherapies
  • Counselling
  • Narrative therapy

Some of the above treatments can be accessed online. Evidence-based online treatments can be as effective as face-to-face treatments. These online treatments are often referred to as e-mental health programs.

Physical treatments

Your doctor should undertake a thorough health check before deciding whether medication is a good option for you. Taking medication for anxiety must be supervised by a doctor. If medication is prescribed as part of your treatment, your doctor should explain the reason for choosing the medication they’ve prescribed.

Your doctor will:

  • Discuss the risks and benefits, side effects, and how regularly you need check-ups.
  • Advise what treatments can work together with the medication, such as psychotherapy, lifestyle changes (e.g. exercise) and other support options.

Anti-anxiety medications are used for very severe anxiety in anxiety types such as:

  • Panic disorder
  • Generalised anxiety disorder (GAD)
  • Social phobia

Anti-anxiety medications, such as benzodiazepines, can:

  • Be addictive
  • Become ineffective over time
  • Have other side effects such as headaches, dizziness and memory loss

Anti-anxiety medications are not recommended for long-term use.

It’s important to know that not all anxiety needs medication. Many people respond well to lifestyle changes and psychological treatments.

Self-help and alternative therapies

There are a wide range of self-help measures and therapies that can be useful for anxiety. It’s good to know that there are things you can do for yourself to feel better.

Self-help and complementary therapies that may be useful for anxiety include:

  • Exercise
  • Good nutrition
  • Omega-3
  • Meditation
  • De-arousal strategies
  • Relaxation and breathing techniques
  • Yoga
  • Alcohol and drug avoidance
  • Acupuncture

Different types of anxiety respond to different kinds of treatments. Severe anxiety may not respond to self-help and alternative therapies alone. These can be valuable adjuncts to psychological and physical treatments.

e-mental health programs

e-mental health programs can be used in conjunction with a mental health professional or as a stand-alone option. e-mental health programs (also called ‘e-therapies’ or ‘online therapies’) are online mental health treatment and support services. You can access them on the internet using your smartphone, tablet or computer. The programs can help people experiencing mild-to- moderate depression or anxiety.

Some e-mental health tools, such as myCompass developed by the Black Dog Institute, have been found to be as effective in treating mild-to- moderate depression as face-to-face therapies.

e-mental health treatments are based on face-to-face therapy, positive psychology and behavioural activation. These therapies mainly focus on reframing thoughts and changing behaviour.

Key points to remember

  • Lots of professionals can help you with anxiety
  • There are many types of treatments for anxiety, and you can get better
  • Many people who have had anxiety have been able to seek help and live active, fulfilling lives

Contact Us

Coolminds

Email: hello@coolmindshk.com

Black Dog Institute

Email: blackdog@blackdog.org.au

Where to get more Information and Support

Black Dog Institute – “myCompass”

Student Health Services – “Understanding Anxiety Disorders”

OCD & Anxiety Support Hong Kong

Mind Hong Kong – “Anxiety and Panic Attacks”

The Mental Health Association of Hong Kong:

Phone: 2528 0196
Website: www.mhahk.org.hk



Resources

Helping someone who has a mental illness: for family and friends

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

Thank you to the Black Dog Institute for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to the Black Dog Institute’s website: www.blackdoginstitute.org.au

What this fact sheet covers:

  • How to tell if someone has a mental illness
  • What to do if you are concerned about a family member or close friend
  • How to behave with someone who is depressed
  • What to do if someone is suicidal
  • Self care for carers
  • Key points to remember
  • Further information and support

Someone with a mood disorder is like anyone with any other illness – they need care and support. Family and friends can provide better care if they are informed about the illness, understand the type of treatment and are aware of the expected recovery time.

How to tell if someone has a mental illness

Even if you know someone well, you will not always notice when they have changed. You are more likely to notice big or sudden changes but gradual changes can be easy to miss. It’s also true that people will not always reveal all their thoughts and feelings to their close friends and family.

For these reasons, family and friends cannot expect to always know when someone has a depressive illness and should not feel guilty that they ‘did not know’.

The best approach is to acknowledge that mental illnesses are common and to learn how to recognise the signs and how to offer help.

What to do if you are concerned about a family member or close friend

If you are worried that a family member or close friend has a mood disorder, try talking to them about it in a supportive manner and either suggest that they consult their doctor or another mental health professional.

Sometimes they may be reluctant to seek help. You might need to explain why you’re concerned and provide specific examples of their actions or behaviour that are worrying you. Providing them some information such as a book, fact sheets or helpful pamphlets might also help.

You could offer to assist them in seeking professional help by:

  • Finding someone that they feel comfortable talking to.
  • Making an appointment for them on their behalf.
  • Taking them to the appointment on the day
  • Accompanying them during the appointment if appropriate.

This level of help may be particularly appropriate if the person has a severe mood disorder such as psychotic depression or mania.

Young people, adolescents in particular, are vulnerable to mental health problems. If you are concerned about someone, try:

  1. Gently let them know you have noticed. changes and explain why you are concerned
  2. Find a good time to talk when there are no pressures or interruptions.
  3. Listen and take things at their pace
  4. Respect their point of view.
  5. Validate what they are experiencing, but don’t offer reassurance or advice too quickly
  6. Let them know that there is help available that will make them feel better.
  7. Encourage them to talk to a doctor or other health professional, and to find a trusted friend or family member that they can confide in.

There are also a range of services (e.g. telephone counselling and online resources) that are specifically designed for young people. You can find out more about what is provided in Hong Kong on the Coolminds website.

How to behave with someone who is depressed

Patience, care and encouragement from others are vital to a person who is experiencing depression. Someone experiencing depression is very good at criticising themselves and needs support from others, not criticism.

Clear and effective communication within the household or family is also important. Partners or families might find it helpful to see a psychologist during this time for their own support.

An episode of depression can provide an opportunity for family members to re-evaluate the important things in life and resolve issues such as grief or relationship difficulties.

Some Tips:

  • Avoid suggesting to the person that they “cheer up” or “try to get over it”. This is unhelpful as it is likely to reinforce their feelings of failure or guilt.
  • Another important part of caring is to help the treatment process – if medication has been prescribed, encourage the person to persist with treatment and to discuss any side effects with their prescribing doctor.
  • The person may also need encouragement and help to get to their therapy appointments or complete any online therapy exercises they have been asked to do.
  • During a depressive illness, counselling or psychotherapy often results in the person working through their life events and relationships; while this can be difficult for all concerned, friends and family should not try to steer the person away from these issues.

What to do if someone is suicidal

If someone close to you is suicidal or unsafe, try:

  • Talking to them about it and encourage them to seek help.
  • Remembering that if someone is feeling like their life is not worth living, they are experiencing overwhelming emotional distress.
  • Helping the person to develop a safety plan involving trusted close friends or family members that can keep the person safe in times of emergency.
  • Removing risks (e.g. take away dangerous weapons or items if that person is angry or out of control and threatening to disappear).

Self care for carers

(A carer is someone who provides support to a friend, family member, or neighbor in need of help because of their age, disability, or physical or mental health.)

  • Carers are also likely to experience stress. Depression and hopelessness have a way of affecting the people around them.
  • Therapy can release difficult thoughts and emotions in carers too. So, part of caring is for carers to look after themselves to prevent becoming physically run down and to deal with their internal thoughts and emotions.
  • Treatment has a positive time as well; when the person starts to re-engage with the good things in life and carers can have their needs met as well.

Key points to remember

  • If you are worried that someone is depressed or has bipolar disorder, try talking to them about it in a supportive manner and suggest that they see a mental health professional.
  • If they don’t want to seek help, explain the reasons for concern and perhaps provide them with some relevant information.
  • Young people are particularly vulnerable to depression.
  • Patience, care and encouragement from others are all vital to the person who is depressed.
  • If a loved one talks of suicide, encourage them to seek help immediately from a mental health professional.
  • Depression can take a toll on carers and close family members – it is important for these people to take care of themselves as well.

Contact Us

Coolminds

Email: hello@coolmindshk.com

Black Dog Institute

Email: blackdog@blackdog.org.au

Where to get more help and support

Bilingual Web Resources

Mind Hong Kong – “Am I A Carer?”

Mind Hong Kong – “What Can Friends and Family Do To Help?”

Student Health Service – “Understanding Depression”

Student Health Service – “Emotional Health”

English-Only Web Resources

Reach Out: a web-based support for adolescents

Headspace online: help for young people

Bilingual Telephone Hotlines

Samaritans Hong Kong 24-hour hotline: 28960000

Samaritan Befrienders Hong Kong 24-hour hotline: 23892222

Suicide Prevention Services 24-hour hotline: 23820000

Suicide Prevention Services “Youth Link” hotline (available 2pm-2am): 2382 0777

Hospital Authority Mental Health 24-hour Hotline: 2466 7350

Social Welfare Department Hotline: 2343 2255

Chinese-Only Telephone Hotlines

Youth Outreach 24-hour hotline service: 90881023

The Hong Kong Federation of Youth Groups “Youthline” hotline (available Mon-Sat, 2pm-2am): 27778899


Resources

Causes of depression

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

Thank you to the Black Dog Institute for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to the Black Dog Institute’s website: www.blackdoginstitute.org.au

What this fact sheet covers:

  • Factors involved in developing depression
  • Key points to remember
  • Where to get more information

Introduction

Unlike other illnesses or disorders, there is no simple explanation as to what causes depression. In general, depression can be due to a number of factors including stresses which can range from mild to severe, combined with vulnerability or predisposition to depression that can result from biological, genetic or psychological factors.

Each type of depression is associated with different mixtures of causes. For psychotic or melancholic depression, physical and biological factors are relevant. In contrast, for non-melancholic depression, the role of personality and stressful life events are important.

Genetic factors

There is strong evidence that genetic factors play a significant role in a person’s predisposition towards developing depression, especially melancholic depression, psychotic depression and bipolar disorder. No single gene is likely to be responsible, but rather a combination of genes.

The predisposition to develop depression can be inherited. The genetic risk of developing clinical depression is about 40% if a biological parent has been diagnosed with the illness, with the remaining 60% being due to factors within the individual’s own environment. Depression is unlikely to occur without stressful life events, but the risk of developing depression as a result of such an event is strongly genetically determined.

Biochemical Factors

Our knowledge of the human brain is still fairly limited, therefore we do not really know what actually happens in the brain to cause depression. It is likely that with most instances of clinical depression, neurotransmitter function is disrupted. Neurotransmitters are chemicals that carry signals from one part of the brain to the next. There are many neurotransmitters serving different purposes. However, three important ones that affect a person’s mood are serotonin, noradrenaline and dopamine.

In normal brain function, neurotransmitters interact with a series of nerve cells, with the signal being as strong in the second and subsequent cells as it was in the first. However, in people who are depressed, mood regulating neurotransmitters fail to function normally, so that the signal is either depleted or disrupted before passing to the next nerve cell.

Physical Illness

In a simple sense, physical illness can lead to depression through the lowered mood that we can all experience when we are unwell, in pain or discomfort, confined and less able to do the things we enjoy.

Illness can also change the body’s functioning in a way that leads to depression. Even if the illness isn’t making us feel down we can still suffer from depression. For example:

  • It is known that certain cancers can produce a depressive illness – in these cases a person might be quite unaware that they are suffering from depression.
  • Compromised immune functioning might play a part in the emergence of depression, although further research is needed to establish this link.
The ageing brain

As we age, our brain’s general functioning can become compromised and this can affect the neurotransmitter pathways which influence mood state. Three reasons for these changes are worth mentioning in relation to depression:

  • Late onset depression: Elderly people who develop dementia may also develop a severe depression for the first time; this type of depression is commonly of a psychotic or melancholic type and reflects the disruption of circuits linking certain basal ganglia and frontal regions of the brain.
  •  These brain changes can reflect an ageing process, particularly in people who are vulnerable to this kind of ‘wear and tear’.
  • In others however, high blood pressure or mini-strokes (often unnoticed by the individual and their family) may contribute. Good blood pressure control can reduce the chance of depression in some people.
Gender

Gender is a partial but incomplete explanation of why people may develop depression. Equal numbers of men and women develop melancholic depression. However, studies have shown that there is a much greater likelihood of women developing non-melancholic depression than men. Some of the explanations for this are:

  • Women are more likely than men to ‘internalise’ stress, thereby putting them at greater risk of developing depression.
  •  Women with unsatisfactory marriages or who are caring for a number of young children are also highly over represented among samples of depressed people.
  • Hormonal factors commencing in puberty may account for the increased chance in women of developing anxiety (a precursor to depression) or depression.
Stress

It is important to recognise that nearly every individual can be stressed and depressed by certain events. Most people get over the stress or depression within days or weeks while others do not. Ways that stress can lead to depression include the following:

  • Past or long-standing stresses can increase the chances of an individual developing depression in later years e.g. growing up in an abusive or uncaring family may increase the risk of developing depression in adult life.
  • Events that affect a person’s self-esteem such as the break-up of a close relationship or marriage
  • Feelings of ‘shame’ for example, thinking they have not lived up to their own or others’ expectations.
Personality

Our research has shown that people with the following personality types are more at risk of developing depression than others. Those who are high on the first four factors are at distinctly greater risk to depression (especially non-melancholic depression):

  1. High levels of anxiety, which can be experienced as an internalised ‘anxious worrying’ style or as a more externalised ‘irritability’.
  2. Shyness expressed as ‘social avoidance’ and/or ‘personal reserve’.
  3. Self-criticism or low self-worth.
  4. High interpersonal sensitivity.
  5. Perfectionism is somewhat protective against the onset of depression but if depression occurs, it can result in longer episodes.
  6. A ‘self-focused’ style is likely to be at greater risk for brief depressive episodes only

Key points to remember

  • There is no single cause for depression; rather it’s a combination of stress and a person’s vulnerability to developing depression.
  • The predisposition to developing depression can be inherited.
  • Other biological causes for depression can include physical illness, the process of ageing and gender.
  • Stress can trigger depression but understanding its particular meaning to the person is important.
  • Certain temperament and personality styles pose risks for developing non-melancholic depression.

Contact Us

Coolminds

Email: hello@coolmindshk.com

Black Dog Institute

Email: blackdog@blackdog.org.au

Where to get more information and support

Mind Hong Kong – “What Is Depression?”

Student Health Service – “Understanding Depression”

Student Health Service – “Emotional Health”

Cheer Centre: Interpretation services for Ethnic Minorities for use of public services

Bilingual Telephone Hotlines

Samaritans Hong Kong 24-hour hotline: 28960000

Samaritan Befrienders Hong Kong 24-hour hotline: 23892222

Suicide Prevention Services 24-hour hotline: 23820000

Suicide Prevention Services “Youth Link” hotline (available 2pm-2am): 2382 0777

Hospital Authority Mental Health Direct hotline: 24667350

Chinese-Only Telephone Hotlines

Youth Outreach 24-hour hotline service: 90881023

The Hong Kong Federation of Youth Groups “Youthline” hotline (available Mon-Sat, 2pm-2am): 27778899

Resources

Obsessive compulsive & related disorders + young people

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

Thank you to Orygen for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to Orygen’s website: www.orygen.org.au

People use the word ‘obsession’ a lot in everyday conversation, and it can mean different things to different people. In terms of mental health, ‘obsessions’ are recurrent and persistent thoughts, urges, or images that are intrusive and unwanted. Obsessions become a problem when they affect a young person’s behaviour so much that they interfere with everyday life.

Obsessions often go together with compulsions – these are irresistible urges to behave in a certain way. Obsessive– compulsive (OCD) and related disorders are serious, anxiety-related conditions that affect a young person’s everyday life through things like stopping them from getting to school on time, finishing homework, or going out with friends.

What is normal and what is OCD?

Almost everybody experiences the type of thoughts that people with OCD have, such as wanting to double-check they have switched off the oven or double-checking they have locked the front door before they go out. While it’s also very common for people to repeat certain actions, most people can dismiss these thoughts or urges.

People with OCD can’t ignore unpleasant thoughts and pay undue attention to them. This means that the thoughts become more frequent and distressing. Over time, the thoughts can affect all areas of a person’s life, including their school or work activities, their family, and their social life. Young people often develop compulsive behaviours to manage their distress, but these behaviours tend to take up a lot of time – sometimes more than an hour a day.

What are the common obsessive-compulsive and related disorders?

Obsessive–compulsive disorder (OCD)

Young people living with this condition experience repetitive and upsetting thoughts and sometimes compulsive behaviours.

Body dysmorphic disorder (BDD)

A young person living with BDD has an obsession with a perceived defect in their appearance. If other people hardly notice the perceived defect, then the obsession is regarded as markedly excessive. Take a look at the Eating & body image disorders + Young People factsheet to find out more.

People with OCD can’t ignore unpleasant thoughts and pay undue attention to them.

Trichotillomania (compulsive hair pulling) and compulsive skin picking

These are two distinct but related disorders that have obsessive– compulsive features. Young people with these disorders experience a build-up of anxiety that’s relieved by either repetitive hair pulling or skin picking, which are done consciously or unconsciously. Feelings of depression or hopelessness often follow because the young person realises the damage caused by these behaviours. Even if there is no anxiety beforehand, the young person may find pulling or picking pleasurable, and this makes the behaviour difficult to stop.

If these behaviours are because a young person is concerned about their appearance, then the condition may be body dysmorphic disorder.

What are the symptoms of OCD?

Obsessions

Obsessions are unwanted, intrusive, or upsetting thoughts or images that come to mind over and over again. They are difficult to get rid of and can feel silly or unpleasant. Some examples of obsessions include:

  • fears about germs and disease
  • needing things to be in a certain order
  • ‘I must count to twenty or something bad will happen’
  • unwanted thoughts about sexual or violent acts.
Compulsions

Compulsions are the actions or rituals that a person carries out in order to get rid of, prevent or ‘neutralise’ the obsessions. People with OCD also carry out compulsions to try to relieve the anxiety caused by the obsessions. Often, people try to stop themselves from doing these things because they realise it’s illogical, but they feel frustrated or worried if they can’t finish them. Some examples of compulsions include:

  • washing hands again and again
  • repeatedly checking that the light is switched off
  • mental rituals, such as counting or repeating words in your head
  • hoarding or collecting things that are unnecessary or useless.

OCD and related disorders are treatable, and most young people can learn to stop performing their compulsive rituals and to decrease the intensity of their obsessive thoughts

Other problems

Young people living with OCD or a related disorder may also experience other mental health difficulties, such as depression, other anxiety conditions, an eating disorder, or alcohol and other substance-use problems. Young people with OCD often experience feelings of intense shame about their need to carry out compulsions. These feelings of shame often make the OCD worse. Shame and the consequent secrecy associated with OCD can lead to a delay in diagnosis and treatment. This can lead to long-term health, mental health and relationship problems. Seeking the right support for what’s going on can assist with recovery and planning for getting on with education, work and relationships.

Advice and referral

OCD and related disorders are treatable, and most young people can learn to stop performing their compulsive rituals and to decrease the intensity of their obsessive thoughts.

If you’re having difficulties with OCD

Talk about your concerns with someone you trust, such as a school counsellor, family friend, a parent or teacher. Your GP can help you sort out what is and isn’t OCD, and help with a plan for getting better if you need.

If you think a young person you know is having difficulties

Let them know you’re there to support them, and encourage them to get professional support. Try to avoid giving reassurance to a young person with OCD because as part of their recovery they’ll need to confront their fears without constant reassurance. Don’t involve yourself in the young person’s compulsions – helping them carry out compulsions only makes it more difficult for them to recover. Instead, working with a professional during treatment may give you a role in helping the young person to resist the completion of rituals.

Treatment for OCD and related disorders

OCD and related disorders are usually treated with the help of a professional using cognitive–behavioural therapy (CBT), with exposure and response prevention. CBT is based on the idea that moods and emotions are influenced by thoughts. It explores thinking patterns and how they affect our behaviour and emotions, such as fear.

Exposure and response prevention involves slowly and carefully supporting a young person to confront the feared situations without performing their compulsive behaviours. This helps the young person to learn to tolerate the immediate distress and leads to a reduction in anxiety over time. In certain instances medication may also be helpful.

Getting help

If you, or someone you care about, experiences symptoms of an obsessive– compulsive or related disorder, use these tips to seek help.

  • Talk to someone you trust help. Tell family or friends about what you’re feeling and thinking so they can support you.
  • Try to eat healthily, get some regular exercise, and find ways to relax by doing things you enjoy (e.g. listening to music, reading a book, or engaging in other hobbies).
  • Try to avoid alcohol and other drugs as they often make the anxiety associated with obsessions or compulsions worse over time, and can lead to other problems, such as dependency.
  • It can be useful to keep a diary of the frequency, intensity and types of unwelcome thoughts (obsessions). Resist completing rituals (compulsions) as much as possible.
  • Do some research to understand your treatment and recovery options – seeking professional help from a counsellor, psychologist, psychiatrist, or a doctor can be helpful.

Exposure and response prevention involves slowly and carefully supporting a young person to confront the feared situations without performing their compulsive behaviours

Further information

For further information regarding mental health, or for information in other languages, visit:

Australia / International

Hong Kong

Disclaimer: This information is not medical advice. It is generic and does not take into account your personal circumstances, physical wellbeing, mental status or mental requirements. Do not use this information to treat or diagnose your own or another person’s medical condition and never ignore medical advice or delay seeking it because of something in this information. Any medical questions should be referred to a qualified healthcare professional. If in doubt, please always seek medical advice.

Resources

Getting active + young people

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

Thank you to Orygen for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to Orygen’s website: www.orygen.org.au

Being active helps maintain your health. We tend to think that the mind and body are separate, but what you do with your body can have a powerful effect on your mental health. And it’s easier to feel good about life if your body feels good.

As well as reducing the risk of physical health problems, like heart disease and diabetes, some of the potential benefits of being active are:

  • less tension, stress and tiredness
  • a natural energy boost
  • improved sleep or sleep patterns
  • a sense of achievement
  • less anger, irritability or frustration
  • meeting other people at gyms, clubs, etc.

Physical activity leads to chemical changes in the brain, which can improve your mood and lower anxiety. Being active may also lead to changes in how you view yourself and can reduce feelings of loneliness and isolation.

Being active and mental health

Being active is important for everyone. It can be hard, though, if you or someone you know is experiencing mental health difficulties. Evidence shows that getting active isn’t only great for physical health and fitness, but also can positively influence mental health.

Symptoms

Symptoms of some mental health difficulties include lower energy, problems with motivation, loss of enjoyment in activities, and problems with sleep. These symptoms can really get in the way of staying fit and healthy.

Regular exercise can boost your self-esteem and help you concentrate, sleep, feel and look better. Physical exercise, in conjunction with psychological therapy and medications, is an established treatment for depression and is effective for anxiety.

Physical activity leads to chemical changes in the brain, which can improve your mood and lower anxiety

Treatments and medications

Some treatments for mental ill-health may effect energy levels. Exercise can help improve functioning and physical health, prevent recurrences, and manage the side effects of some of these medications or treatments. Exercise is one way to ease the symptoms of psychosis, such as blunted emotions, loss of drive and thinking difficulties – it is, though, less helpful for delusions and hallucinations.

For some mental health difficulties, exercise is actually part of the problem. Excessive exercise for someone who has an eating disorder can be harmful. And increased exercise can sometimes be an early warning sign of a manic phase for those with bipolar disorder.

Before starting to exercise, speaking to a GP about a pre-existing medical concern can help find the best kind of exercise

Some things to think about

Regardless of mental health, everyone should be aware of the other factors that play into exercise. Here are some of the key things to keep in mind

Other medical conditions

Be careful if you have another medical condition. New exercise can effect that condition, like making asthma worse. Before starting to exercise, speaking to a GP about a pre-existing medical concern can help find the best kind of exercise.

Young people who smoke will generally be more puffed out when first starting physical activity. It’s important to keep at it – in only a few weeks the puffed-out feeling will get less and less.

Be practical

Plan exercise around a budget and support system. Is travel required to a sports centre? Who could take you, or how would you get there otherwise (car, public transport)? How much does the activity cost? Can someone do it with you? Does the activity require special equipment?

Get some support

Starting a new sport, joining a new gym or trying exercise for the first time can be a little intimidating. To help with nerves, have a chat to some friends, family and other supports who can help with ideas, encouragement, and motivation.

Tips to help you get active

Start small

Some activity is better than none. It’s as simple as walking or riding somewhere instead of driving. Or, if you take public transport, getting off one stop before your usual stop and walking the rest of the way. You can even take the stairs instead of the escalator or lift.

Make a plan

Planning a routine can help you become more active. Make sure some form of exercise is included each day. Try to stick to the plan as closely as possible, but be flexible because sometimes things comes up.

Choose something you’ll enjoy

… or at least something you won’t hate! Don’t go to the gym if you’ve never liked the gym. Instead, try walking, riding a bike to a friend’s place, throwing a Frisbee, or playing football at the park with some friends.

Choose a time of the day or week that works for you

Everybody is motivated at different times – morning, afternoon or evening. Just be careful about exercising too late in the evening because you may have problems getting to sleep.

Gradually build up physical activity

Increase the amount of time you exercise in a day, or the number of days in a week that you’re exercising. Aim for 30–60 minutes a day.

Ways to help you stick with it

Getting warm, sweaty or a bit puffed out doesn’t feel that great, but it means you’re working hard and getting fitter –it will get easier as you go! Here are some ways to help you stick at exercise in the long run.

Set achievable goals

For someone who hasn’t been exercising at all, exercising once a week for 20 minutes might be a good start. If you feel like even 20 minutes is too much, then start at 5 minutes and gradually build this up.

Don’t go it alone

Find a friend, family member or local group you can exercise with. It makes it more fun and helps you to keep on track if you know that you have this commitment to others. Letting them know what you’re working towards will help them motivate you, too.

Hang in there!

If you miss a day or a week, don’t give up. Try to get yourself going again.

Notice your progress

You can time yourself walking and try to beat it, or count how many push-ups you can do. Keeping track helps you notice your improvements and work out where you can go next with your exercise routine.

Try something new

If what you’ve been doing has gotten boring, you can try a few things to reinvigorate yourself. Like getting some coaching to develop your skills, getting a friend involved, or trying something completely different.

Find something flexible that you can do when you feel like it

Exercise isn’t just lifting weights in a gym, it involves all kinds of physical activities. Try a Zumba or dance class, go skating or jogging, throw a few hoops, kick a football in the park or go for a walk with a friend.

Use technology

Why not try exercise programs on your gaming console? Or you can try using exercise apps that help you to create routines and monitor your progress.

Keeping track helps you notice your improvements and work out where you can go next with your exercise routine

Top 5 reasons for not being active

  1. It’s too hot/cold/windy/rainy.
    Why not try doing something active inside – play an exercise video, or dance along to some music.
  2. I can’t be away from social media. Instead of connecting with friends on social media, try doing something active with a friend in real life, like going to the park with a ball.
  3. My shorts are dirty. Not all activities need sportswear. You can do yoga in round-the-house clothes, as well as walking in some exercise shorts and a t-shirt.
  4. I’m too busy/tired.You don’t have to spend a long time exercising – try exercising for just 20 minutes, or breaking it down into smaller time periods that add up over the day.
  5. I’ll do it tomorrow. It’s tempting to put off being active, but exercising regularly has so many benefits! If you’re having motivation troubles, try reminding yourself of all the reasons being active benefits you.

Top 5 reasons for being active

In the tough moments when you struggle to get going, here are the top five benefits that exercising has for you:

  • Better mood and more energy.
  • Less stress.
  • Better sleep.
  • More confidence in yourself and how you look.
  • Meet new friends.
Being active on a budget

Joining a gym, taking classes or visiting the swim centre can really add up, but this doesn’t mean there aren’t other forms of activity. If you’re on a budget, or want to watch your finances because you’re saving up for something, here are some of the ways you can still be active without forking out the cash.

  • Getting off one bus or MTR station earlier and walking the rest of the way.
  • Download a free exercise app or podcast, or browse YouTube for a yoga or exercise video.
  • Go to the park with a friend and a ball or Frisbee.
  • Put on some music for a 10-minute dance party in your bedroom!
  • Ditch the lift and use the stairs for less than four floors.
  • Get skipping! Jumping rope is a cheap and quick way to get some good cardio exercise.
  • Go hard when cleaning your room or doing household chores – turn up the music and have fun!
Get online

If you want to do something closer to home, here are some ways you can utilise the internet for exercise.

  • There are some great clubs, classes and groups out there just waiting for you to sign up and get involved. These can help motivate you, and might only be round the corner.
  • Try parks in Hong Kong, leisure and cultural centres, clubs from school or university, your local council, community centre, etc. for activities you might enjoy.
  • If you’ve got a smartphone, search for videos, apps or podcasts that can help you with exercise ideas. You can find apps or websites that can record how far you’ve walked, help plan a run, show you yoga, Pilates or abs workouts, or play an exercise music mix – whatever you’re interested in.
  • You might want to have a look at couch-to-5K www.c25k.com for help with taking up running.

Disclaimer: This information is not medical advice. It is generic and does not take into account your personal circumstances, physical wellbeing, mental status or mental requirements. Do not use this information to treat or diagnose your own or another person’s medical condition and never ignore medical advice or delay seeking it because of something in this information. Any medical questions should be referred to a qualified healthcare professional. If in doubt, please always seek medical advice.

Resources

Autism Spectrum Disorder (ASD) + young people

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

Thank you to Orygen for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to Orygen’s website: www.orygen.org.au

Autism spectrum disorder (ASD) is a developmental condition that can be identified from early childhood onwards and can affect a person throughout their life. The cause is unknown, and there’s no specific medical or genetic test to diagnose it. Instead, diagnosis is based on the presence of: particular patterns of social communication and interaction, restricted interests, and rigid routines, repetitive behaviour (e.g., lining up objects) or repetitive speech.

The diagnosis of ASD has replaced three diagnoses that were previously used: autistic disorder, Asperger’s syndrome and pervasive developmental disorder – not otherwise specified. These disorders no longer exist as separate diagnoses. Instead, they are reflected in the autism spectrum by specifying whether a person has mild, moderate or severe symptoms and difficulties.

With early intervention and support, young people with ASD can begin to understand how their experience of the world is different from others, and can begin to make sense of what supports they might need to live the kind of life that they want.

Areas of difficulty

Social communication and interaction

People with ASD typically have some differences in the way that they communicate and socialise. People with ASD have difficulty understanding the feelings, thoughts and intentions of others and difficulty identifying and communicating their own feelings, thoughts and intentions to others.

While many young people with ASD speak fluently, they might have problems in the area of ‘pragmatic’ language – that is, using language appropriately in social situations. This might mean they find it difficult to hold two-way conversations. A tendency for making literal interpretations can mean figures of speech and sarcasm are misunderstood or misused. Problems with pragmatic language might also lead to people having trouble using the right language for a social situation – their language might be very formal, and their vocabulary might be very rich.

Young people with ASD might also prefer to be alone or seem uninterested in others. Difficulties in reading social cues or situations, expressing empathy and understanding others mean that they might need help to interact with others. They also might have difficulty with eye contact, facial expressions and body language and forming or maintaining social relationships.

Areas of difficulty for young people with ASD

With early intervention and support, young people with ASD can begin to understand how their experience of the world is different from others

Interests and behaviours

Young people with ASD often develop special interests that are unusual in their intensity and focus. Public transport, maps, physics and computers are all examples of the wide and varied special interests of people with ASD. Young people with ASD prefer situations to be consistent and may have special preferences with respect to routine and consistency. As a result, young people with ASD might experience difficulties managing change and transition. Activity participation, diet and clothing might be areas in which young people with ASD express unusual rigidity.

Thinking

Young people with ASD are often logical thinkers and can be good with facts, figures and details. This logical thinking may mean that they can have difficulty understanding non-concrete ideas.

ASD and the body

Young people with ASD might experience clumsiness and problems with body awareness that can lead to difficulties with sports, handwriting and other physical skills. Young people with ASD frequently have problems with sleep and can be very sensitive to different sensations – finding a particular noise disturbing, or a particular item of clothing very uncomfortable.

Young people with ASD often develop special interests that are unusual in their intensity and focus

What might not be so bad about it?

Whilst people with ASD might have difficulties in a range of areas, they might also present with admirable differences in perception, attention, memory and intelligence.

ASD, youth and mental illness

Youth is a tricky time. For young people with ASD, things like progressively more complex social demands, increasingly difficult skills to be learned at school or home and transitions, such as graduating, might all be stressful. It’s often at this time that young people with ASD and others around them might become more alert to their social differences. Young people with ASD might feel excluded, bullied and frustrated by their differences. These negative experiences can leave young people with ASD at risk of low self-esteem and at increased risk of developing mental ill-health, such as depression and anxiety.

When young people with ASD develop mental illness, diagnosis and treatment need to be tailored to account for the young person’s different personality style and their differences in the areas of socialising, communication and interests.

For some young people, it’s only during their treatment for mental health difficulties that they or their family may raise suspicions about ASD. Diagnosis of ASD is a reasonably lengthy process involving multiple health professionals. Diagnosis is important for young people because it provides effective treatment options and helps to better address their needs.

Treatment

Effective treatment will target any mental health difficulty, support the young person to adjust to the changes they have as a result of ASD and make use of the skills that they have. Many people with ASD might still find social situations, personal relationships and major life changes challenging, but with support and encouragement, many people go on to undertake further education, develop their interests through hobbies and membership of clubs, work successfully in jobs that interest them and find fulfilling friendships.

Young people with ASD are often logical thinkers and can be good with facts, figures and details

Supporting someone who lives with ASD

Here are some ways you can help someone you know who lives with ASD.

  • Any approach to support someone with ASD needs to be unique and individualised.
  • Encourage the person to talk about what’s going on for them, and any troubles or worries they have. It might be hard for them to find the right words or to express themselves, so be patient and try other preferred routes for communication (e.g. stories/drawings).
  • Help them build confidence through doing things that use their strengths.
  • Some people with ASD can find being around other young people who feel ‘different’ supportive. Groups at schools, local councils and health services might be options, and internet forums and chat rooms can also be helpful and accessible.
  • Have a routine and try to be consistent. It doesn’t need to be too rigid, but might mean that a young person with ASD can begin to take advantage of planned opportunities to talk to you about their worries or hopes.
  • Be patient. It takes a lot longer for people with ASD to get used to things and make changes in their lives.

Further information

For further information regarding mental health, or for information in other languages, visit:

Australia / International

Hong Kong

Disclaimer: This information is not medical advice. It is generic and does not take into account your personal circumstances, physical wellbeing, mental status or mental requirements. Do not use this information to treat or diagnose your own or another person’s medical condition and never ignore medical advice or delay seeking it because of something in this information. Any medical questions should be referred to a qualified healthcare professional. If in doubt, please always seek medical advice.

Resources

Self harm + young people

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

Thank you to Orygen for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to Orygen’s website: www.orygen.org.au

Self-harm is when someone deliberately hurts or mutilates their body without meaning to die, although death may still occur as a result of the self-harming behavior.

Self-harming is a behaviour and not in itself a diagnosable mental disorder. Self-harm often occurs in young people who experience depression, anxiety, behavioural problems (such as conduct disorder) and substance use.

Facts about self-harm:
  • Not all people who self-harm are suicidal, but it can be a sign that they are thinking of suicide.
  • Self-harm often begins during youth and can be a way of communicating how bad someone feels or a method of coping with intense pain or distress.
  • Around 1 in 6 young people have engaged in self-harm at some point in their lives and around 1 in 15 during a 12-month period.
  • Support and treatment can help a young person learn safer and more helpful strategies for managing their distress and increasing their coping skills.
  • Treatment for an underlying mental health problem (e.g., depression, anxiety) can also help in reducing or stopping self-harming behaviours.

What to look for?

There are many different types of behaviours that can be considered self-harming. The most common behaviours include self-cutting (e.g. cutting of upper arms/wrists/thighs) and self-poisoning (e.g. deliberately swallowing excessive amounts of prescribed or illegal drugs). Young people may also engage in self-burning (e.g. using cigarettes or lighters to burn the skin).

There are other behaviours that are not formally considered to be self-harming behaviours but are “risk-taking” behaviours that can lead to personal harm. Some examples are train-surfing, driving at high speed, illegal drug use, or repetitive unsafe sexual practices despite knowing about safe sex practices.

What causes self-harming behaviours?

People self-harm for different reasons, and sometimes it can be difficult to put the reasons into words. In many instances when someone engages in self-harming behaviour, it is an attempt to relieve, control or express distressing feelings. Some people who self-harm may not know other ways of telling people about their emotional pain, and some may feel a sense of control over pain when they self-harm.

Research suggests some people are more at risk of self-harming. This includes people who have experienced emotional, physical or sexual abuse, or stressful and highly critical family environments, or experience mental ill-health, such as depression.

People self-harm for different reasons, and sometimes it can be difficult to put the reasons into words.

What can young people do if they are engaging in self-harm?

Try to talk to someone about it. Telling a trusted adult can help to make sure the young person is safe and that medical assistance is received, if needed. If a young person repeatedly engages in self-harming behaviours, it is best to get some psychological treatment (counselling). One aim of counselling is to help the young person to feel better and find safer and more helpful ways of coping. Young people who are having suicidal thoughts should see a professional or call their local hospital or a help line, such as Suicide Prevention Services “Youth Link” hotline (available 2pm-2am): 2382 0777 or Hospital Authority Mental Health 24-hour Hotline: 2466 7350. (For more Hong Kong hotlines please refer to ‘Further information’ section at the end of this article.)

Counselling usually involves helping to increase problem-solving, communication and coping skills. Sometimes this can take time, so it’s best for young people to keep at counselling even if they think it’s not helping the first couple of times. It can be difficult to accept counselling after self-harming because of feelings of guilt, anger, or shame. Trying to be open to counselling or support can assist young people in feeling less overwhelmed and stressed in the long run.

Helping a young person who self-harms

Some people just stop self-harming, others can continue in a way that minimises physical risks, and others can place themselves at risk of dying. Even when self-harming behaviours stop, young people can experience long-term consequences associated with shame, guilt or coping with physical reminders, such as scarring. The best way to help someone you know that is self- harming is to encourage and support them to seek professional help as early as possible, to try to prevent longer-term consequences and to get the right help for any underlying mental health problems. Some things to do are:

  • Try to help the young person feel safe to discuss the self-harm.
  • Try to remain calm and maintain an open attitude recognising the young person may feel ashamed of their actions.
  • Don’t be critical or get angry when discussing these issues.
  • Ask the young person whether they feel suicidal. Call your local hospital or mental health service if you think the young person is suicidal to get professional help. Remember that someone’s risk does not always stay the same, so it is best to check in with them regularly.
  • Supporting someone who self-harms can be a stressful experience and getting support for yourself is also recommended.

Really worried?

Initial treatment involves dealing with any immediate medical complications of self-harm, if present. Call an ambulance (999) or take the person to the accident and emergency department of the nearest hospital if the person needs urgent medical attention.

The best way to help someone you know who’s self-harming is to encourage and support them to seek professional help.

The best way to help someone you know who’s self-harming is to encourage and support them to seek professional help.

Advice and referral

If you know a young person who is repeatedly self-harming and you are not sure what to do, contact someone with experience in this field and discuss the situation with them.

If a young person refuses referral for further support, you need to discuss your concerns with them. Family members may find it helpful to let the young person know that they respect the young person’s wishes, but that they also care about the young person and need to discuss their concerns with a professional.

Workers need to explain the boundaries of their relationship with the young person and the limits of confidentiality. If the young person continues to be at risk and requires more care than the worker feels capable of providing, the worker should discuss the situation with a colleague and refer to a mental health professional or service.

Further information

For further information regarding mental health, or for information in other languages, visit:

Australia / International

Hong Kong

Bilingual Telephone Hotlines 

  • Samaritans Hong Kong 24-hour hotline: 28960000 
  • Samaritan Befrienders Hong Kong 24-hour hotline: 23892222 
  • Suicide Prevention Services 24-hour hotline: 23820000 
  • Suicide Prevention Services “Youth Link” hotline (available 2pm-2am): 2382 0777 
  • Hospital Authority Mental Health 24-hour Hotline: 2466 7350 
  • Social Welfare Department Hotline: 2343 2255  
  • Chinese-Only Telephone Hotlines 
  • Youth Outreach 24-hour hotline service: 90881023 
  • The Hong Kong Federation of Youth Groups “Youthline” hotline (available Mon-Sat, 2pm-2am): 27778899 

Disclaimer: This information is not medical advice. It is generic and does not take into account your personal circumstances, physical wellbeing, mental status or mental requirements. Do not use this information to treat or diagnose your own or another person’s medical condition and never ignore medical advice or delay seeking it because of something in this information. Any medical questions should be referred to a qualified healthcare professional. If in doubt, please always seek medical advice.

Resources

Sleep + young people

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

Thank you to Orygen for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to Orygen’s website: www.orygen.org.au

Having enough quality sleep is vital to your emotional and physical wellbeing. We sleep so we can be active, focused and feel good during the day.

Not being able to get to sleep can be really distressing. If you haven’t been able to rest properly, your body and mind can start doing strange things. Poor sleep can be a vicious cycle – not enough sleep may cause the brain to become more active and an over-stimulated brain is less able to fall asleep.

Sleep and mental health

While sleep is essential for everyone, sleep problems can occur if you or someone you know is experiencing mental health difficulties. Some symptoms and treatments of mental ill-health can affect your sleep in a number of ways.

Everyone is different, and our need for sleep changes over time. What’s important is finding a balance that allows you to get the sleep you need as well as achieve your goals and have fun during the day. Having a regular sleeping routine has massive benefits to your physical and emotional health.

Sleep – what’s normal?

The sleep of 15–25-year-olds

Sleep is really important. As you enter your mid teenage years, natural hormone changes shift your body clock. Your body clock regulates many of your body’s patterns, including when you sleep and when you wake up. The shift alters this and causes changes to your sleep patterns.

It’s normal to want to go to bed later than you used to, but because of all the changes happening in your body, you actually need more sleep at this time. Sleep research suggests that young people need between 9 and 10 hours of sleep every night. Yet most young people only get about 7 or 8 hours, with the average being around 8 hours of sleep a night.

Making sure you get enough sleep can be tricky. Finding the right balance of sleep is important because it helps you be alert and energetic during the day, and to feel good about yourself.

Not sleeping well can cause you more stress or moodiness. It can tip your balance and make you feel worse about yourself and others. If you’re having trouble sleeping, this can have a dramatic effect on your life, such as:

  • Drowsiness, falling asleep during the day.
  • Not being able to focus, short attention, trouble concentrating or staying mentally alert.
  • Feeling irritable or angry, anxious and stressed, or depressed or down.
  • Memory impairment, poor decision-making, risk-taking behaviour.
  • Lack of enthusiasm, not going to school, or university.
  • Reduced physical performance, slower physical reflexes, clumsiness.
  • Reduced academic or sporting performance

What helps and what doesn’t?

You have more control over your quality of sleep than you may think. Below is a list of tips a lot of people find helpful in getting good sleep. Some may not work for everyone, but you can give them a go to figure out which ones work best for you.

  • Stick to a routine of waking at the same time every day, and going to bed at the same time each night.
  • Don’t drink alcohol or smoke cigarettes as it interferes with sleeping.
  • Try to reduce your TV or computer time in the evenings – artificial light can trick your body into staying awake.
  • Try not to nap during the day, as this’ll make it harder to sleep in the evening.
  • Exercise, but do it at least three hours before bed. Exercising outdoors first thing in the morning can be useful because it helps reset your body clock.
  • Do relaxing activities in order to wind down, like reading or listening to music softly. A warm bath or shower can also help to make you feel sleepy.
  • Learn relaxation and meditation techniques to help you switch your mind off in the evenings.
  • Create a sleep space that works for you – quiet, dark, uncluttered.
Don’t stress if you find yourself waking up in the night

It’s actually pretty normal, and worrying about getting back to sleep will probably keep you up longer. Try to relax and wait for the next wave of sleepiness to arrive, and if you find yourself staring at the clock, try turning the clock face away from you.

Sleeping in

Long sleep-ins can cause poor sleep. Getting up at a similar time every day can help avoid this, and will make it easier to fall asleep at the right time in the evening.

Coping with stress

If you’re constantly rushed and overwhelmed, you’re likely to feel tired and drained of energy. Allow yourself some unfocused time each day to refresh. Let your mind wander, daydream or simply watch the clouds go by for a while. It is okay to add ‘do nothing’ to your to-do list!

Learning to relax is an important life skill and can help to improve your sleep. It may sound simple, but learning to breathe in a calm and controlled way is an easy relaxation strategy that you can use before you go to bed, or if you wake up in the night and find it hard to fall back to sleep.

Breathing relaxation technique
  • While sitting or lying down, make yourself as comfortable as possible.
  • Take a deep breath and let it out slowly. Repeat this once.
  • Close your eyes. Focus your mind on breathing.
  • Breathe easily and gently with no effort.
  • Breathe in steadily over three seconds.
  • As you breathe out steadily over three seconds, say to yourself ‘relax’ while letting all your muscles go loose and floppy.
  • Keep repeating this in a six second cycle (three seconds in and three seconds out) over and over until you find yourself feeling calm and relaxed.

Disclaimer: This information is not medical advice. It is generic and does not take into account your personal circumstances, physical wellbeing, mental status or mental requirements. Do not use this information to treat or diagnose your own or another person’s medical condition and never ignore medical advice or delay seeking it because of something in this information. Any medical questions should be referred to a qualified healthcare professional. If in doubt, please always seek medical advice.

Resources

Eating & body image disorders + young people

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit www.coolmindshk.com

Thank you to Orygen for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to Orygen’s website: www.orygen.org.au

Eating disorders and body image disorders are serious mental illnesses in which eating, weight or dissatisfaction with one’s appearance becomes an unhealthy preoccupation in a person’s life. Adolescence is the peak period for onset of these disorders and they lead to significant interference with day to day life.

Eating and body image disorders can occur when the expectations of how a young person wants their body to look doesn’t match up to reality. Negative thoughts about body image and self-worth can lead to changes in eating and exercise behaviours or compulsive behaviours, which at their worst can be life threatening. Both males and females can become excessively concerned with body image, size, weight, fitness, shape and perceived defects, and as a result of this preoccupation, change their behaviour in unhealthy ways.

Types of eating and body image disorders

Anorexia Nervosa

Anorexia Nervosa is characterised by the restriction of energy intake (reluctance or refusal to eat) leading to significantly low body weight, intense fears and thoughts about body size (worry about becoming fat), and distorted perceptions of body weight (denial that weight is too low).

Bulimia Nervosa

Bulimia Nervosa is characterised by recurrent episodes of binge eating (overeating with a sense of no control) followed by compensatory behaviour, like self-induced vomiting (purging), misuse of laxatives, fasting or excessive exercise.

Binge Eating Disorder

Binge Eating Disorder is characterised by recurrent and rapid episodes of binge eating (overeating when not physically hungry combined with a sense of no control over what or how much is eaten). The type of food eaten can vary, but often eating occurs alone and is followed by feelings of shame, depression and guilt. The young person usually eats food quickly until they become uncomfortably full, and then will become emotionally distressed, embarrassed and fatigued.

Other Specified Feeding or Eating Disorder

An Other Specified Feeding and Eating Disorder is characterised by many of the symptoms of another eating disorder – such as Anorexia Nervosa, Bulimia Nervosa or Binge Eating Disorder – but the full criteria for diagnosis of one of those disorders isn’t quite met. This category includes Atypical Anorexia Nervosa, where weight is within or above the normal range, and Purging Disorder, which is engaging in a recurrent behaviour to influence weight or shape in the absence of binge eating.

Body Dysmorphic Disorder

Body Dysmorphic Disorder is characterised by a preoccupation (obsession) with a perceived defect in a person’s appearance. This causes significant distress or disruption in social, school or occupational life. If a slight defect is present, which others hardly notice, then the concern is regarded as markedly excessive. These obsessions are hard to resist or control and make it difficult to focus on anything but the imperfections. This can lead to low self-esteem, avoidance of social situations, and problems at work or school. Often some type of compulsive or repetitive behaviour is performed to try to hide or improve the flaws, although these behaviours usually give only temporary relief.

Other difficulties

Young people with an eating or body image disorder may also experience other mental health difficulties, including depression, anxiety or substance use. A young person with an eating or body image disorder may go to great lengths to hide, disguise or deny their behaviour, or do not recognise that there is anything wrong. This can result in a delay in getting treatment, which means that long-term health, mental health and relationship problems are more likely. Getting the right support for what’s going on now can assist with recovery and planning for getting on with education, work and relationships.

Medical teams should be involved in the treatment of eating and body image disorders because all these disorders can lead to serious physical health issues, psychological distress and emotional and relationship problems. Starvation, repeated cycles of binge-eating and purging or fasting can lead to major metabolic and other chemical changes in the body as well as damage to vital organs. If a young person has extreme weight loss, as is the case with Anorexia Nervosa, they may need to be kept safe while they restore their weight.

It’s in these cases that assessment and treatment should use a medical or a specialised team approach.

A young person with an eating or body image disorder may go to great lengths to hide, disguise or deny their behaviour, or do not recognise that there is anything wrong

Advice and referral

Talk about your concerns and difficulties. You might choose to talk with someone you trust, such as a school counsellor, family friend, a parent, teacher or other support. Your GP can help to sort out what is and isn’t an eating or body image disorder and help with a plan for getting better.

If someone you know has an eating or body image disorder, let them know you’re there to support them and, if needed, encourage them to get professional support.

There are effective treatments to help young people who experience eating and body image disorders. The type of treatment will depend on the type of disorder. One of the most commonly used treatments is cognitive behaviour therapy (CBT). CBT explores thinking patterns and how they affect our behaviour and emotions. There are other psychological treatments for eating and body image disorders, including family approaches for when adolescents or young people are experiencing an eating disorder. In certain instances medication may also be helpful. If a young person does need medical treatment, there are health professionals and treatment programs that specialise in eating disorders.

If someone you know has an eating or body image disorder, let them know you’re there to support them

Ask family and friends to support you to eat in a healthy and balanced way

Getting help

If you or someone you know experience symptoms of an eating or body image disorder, you can use these tips to start seeking help.

  • Talking to someone you trust helps. Tell family or friends about what you’re feeling and thinking so they can support you.
  • Ask family and friends to support you to eat in a healthy and balanced way.
  • Try to find ways to relax by doing things you enjoy (e.g. listening to music or reading or other hobbies).
  • Try to avoid alcohol and drugs as they often make the situation worse over time, and can lead to other problems (e.g. dependency).
  • Do some research to understand your treatment and recovery options. It may be useful to seek professional help from a counsellor, psychologist, psychiatrist or doctor.

Further information

For further information regarding mental health, or for information in other languages, visit:

Australia / International

Hong Kong

Disclaimer: This information is not medical advice. It is generic and does not take into account your personal circumstances, physical wellbeing, mental status or mental requirements. Do not use this information to treat or diagnose your own or another person’s medical condition and never ignore medical advice or delay seeking it because of something in this information. Any medical questions should be referred to a qualified healthcare professional. If in doubt, please always seek medical advice.