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

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

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

Depression in adolescents & 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 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:

  • Signs of depression in adolescence
  • Where to get help for an adolescent
  • Key points to remember
  • Where to get more information

Introduction

  • A 2017 study by the Hong Kong Federation of Youth Groups found that of the 3,441 secondary school and university students surveyed, 51% displayed symptoms of depression and close to 40% experienced high levels of stress (7 on a scale of 10).
  • According to research done by the University of Hong Kong, more than two-thirds of Hong Kong’s university students experience symptoms of mild to severe depression.
  • The HKJC Centre for Suicide Research and Prevention observed that suicide rates for full-time students increased by 76% between 2012 and 2016.
  • Onset of depression is typically around mid-to-late adolescence, and it is important to recognise the early warning signs and symptoms. Early intervention can often prevent the development of severe depressive illness.

Developmental Impact

  • The teenage years are a time when individuals develop their identity and sense of self.
  • If depression is left to develop, it can lead to isolation from family and friends, risk-taking behaviours such as inappropriate sexual involvements and drug and alcohol abuse.
  • It can also impact on school performance and study, which can have downstream effects on later career or study options.
  • Both biological and developmental factors contribute to depression in adolescence. If bipolar disorder or psychosis is suspected, an assessment by a health professional is recommended. See our Fact Sheet “Symptoms of Bipolar Disorder” for more information.

Signs of depression in an adolescent

  • An adolescent who is depressed may not show obvious signs of depression.
  • It is often hard to distinguish adolescent turmoil from depressive illness, especially when the young person is forging new roles within the family and struggling with independence, and having to make academic and career decisions.
Signs of a depressed mood include:
  • Lowered self-esteem (or self-worth)
  • Changes in sleep patterns, that is, insomnia (inability to sleep), hypersomnia (excessive sleep) or broken sleep
  • Changes in appetite or weight
  • Inability to control emotions such as pessimism, anger, guilt, irritability and anxiety
  • Varying emotions throughout the day. For example, feeling worse in the morning and better as the day progresses.
  • Reduced capacity to experience pleasure: inability to enjoy what’s happening now, not looking forward to anything with pleasure such as hobbies or activities.
  • Reduced pain tolerance: decreased tolerance for minor aches and pains
  • Poor concentration and memory
  • Reduced motivation to carry out usual tasks
  • Lowered energy levels

Where to get help for an adolescent

  • If you think someone you are close to might be depressed, you should encourage them to seek advice from a professional. (At school – school counsellor, social worker. Outside school – doctor, counsellor, psychologist)
  • The first step is to speak to a professional who can conduct an assessment, provide options and discuss the next steps to take.
  • Other initial sources of help are school counsellors and trusted close family members to whom the young person feels comfortable talking.
  • If the young person does not want to seek help, it is best to explain your concerns and to provide them with some information to read about depression.
  • There are also some excellent websites designed for young people, as well as confidential online and telephone counselling services in both English and Chinese. Please see our list of services at the end of this fact sheet.
  • It’s important for young people to know that depression is a common problem and that there are people who can help.
  • If there is any mention of suicide this should be taken seriously, and immediate assistance is available by calling 999 or going directly to the nearest hospital.

Key points to remember

  • A 2017 study by the Hong Kong Federation of Youth Groups found that of the 3,441 secondary school and university students surveyed, 51% displayed symptoms of depression and close to 40% experienced high levels of stress (7 on a scale of 10).
  • Depression in young people is associated with social withdrawal, drops in performance at school, drug or alcohol use and engaging in risky behaviours.
  • It can be hard to distinguish depression from adolescent turmoil; if depression is suspected, an assessment should be sought from a doctor or other mental health professional.
  • Immediate help should be sought if a young person talks of suicide.

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”

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

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

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

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.

Resources

Mental health problems in children and young people: guidance for parents and carers

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

Looking after a child or young person who has emotional or mental health problems can be very hard. You may feel challenged, isolated, scared and deeply upset and wish you knew where to turn for help.

What is this leaflet for?

This leaflet offers guidance on how best to support your child and where to find further advice and help with their mental health.

Be assured, things can improve for your child. Mental health, like physical health, is relevant to all of us, including children and young people. Problems are often temporary and, with support, can change for the better.

Seeking help

You are not alone. Many parents and carers have similar concerns and stresses, although they may not feel able to discuss them openly. There is good support and guidance, through national and local organisations. On the back of this leaflet is a list of reliable organisations that offer information based on sound evidence. Do have a look to find out which sources of support might be best for you.

The sooner you seek help, the better. Every local area is different but the three places listed below are a good place to start.

Talk to your GP

Your GP will listen, begin to understand your child’s needs and suggest the most appropriate course of action or support for your child, including referral to mental health specialists, if necessary.

So, make an appointment for your child and explain your concerns when you do so. You might also find it helpful to make a second appointment with the GP, for yourself, to discuss the “ripple effects” of your child’s difficulties on the rest of the family.

“[I spoke] about my hopelessness and sadness to a teacher, who called my Mum, and arranged for us to see my GP. A year later, I have just turned 16 and am in a completely different place to where I was a year ago.”

Help at school

School is an important part of the picture when it comes to children’s mental health. It’s a good idea to stay in communication with the school about the issues your child is experiencing. There may well be sources of help and support within the school, so do encourage your child to talk to a trusted teacher or member of support staff.

“The younger generation will hopefully grow up where mental health is not something that is ignored but something that should have everyone’s attention.” Teacher

Integrated Family Service Centre

Funded by the Social Welfare Department, IFSC’s are located all across Hong Kong. You can approach to receive support for your child, young person of family. Their social workers can provide counselling services or refer you out to a psychologist if necessary. You can call 23432555 to locate the IFSC for your family.

What you can do to help your child

As a parent you can have a crucial role in your child’s recovery. The more you can understand about mental health and your child’s difficulties, the more confident you will be in supporting them. Getting professional help can be important but there is a great deal you can do as a parent too. Every case is individual, but these general tips might help you to help your child:

Encourage them to talk

Try ‘open-ended’ questions like, “How are things for you?” “What’s happening with you?” “What do you think or feel about…?” or “What’s on your mind?”, rather than questions that have “yes/no” answers.

When discussing their problem, don’t try to ‘fix’ it. For the most part, young people simply need to know you are there to support them.

Listen and be understanding

Listen calmly and try not to judge your child. Let them know you are happy to listen while they chat about anything and everything, whenever they want to. Never underestimate the importance of being an attentive, non-judgmental listener.

Remember, you don’t need to know all the answers, listening without responding is often enough.

Give your child reliable self-help information from trusted sources, based on sound evidence

They can read and use this at their own pace, allowing them some privacy, but at the same time you are showing you are there to help and they are not alone. Peer-to-peer support can be really useful. Self-help links include:

Tell them, and show them, how much you care and how important they are in the family

It is not easy when stress levels are high, but a peaceful, loving home life can really help recovery. Keep family routines as normal

as possible and do simple things together – maybe watching a film, or having a meal, going for a walk or playing a game. Just doing simple everyday things together (like grocery shopping or cooking) can provide a really helpful distraction. This can bring everyone in the family closer.

Enjoy the time you spend together but understand that it might be a while before your child starts enjoying activities again. Try not to pressurise them and, if they need a little space, support them with that while not leaving them isolated.

Understand the problems

As with physical health, there are many different ways of experiencing mental health issues. Try to read up on your child’s specific problems. This will help you understand their experiences and what helps recovery, building their confidence for the future.

Encourage social contact with friends and family

Encourage your child to go out (if only for short periods) and to keep in touch with friends.

Simple physical activity

Taking regular exercise, such as going for walks, can help improve mood and reduce anxiety.

Know that recovery will not happen overnight

As a parent or carer, you want to make your child feel better immediately but, like physical health problems, mental health problems can sometimes take time to improve and some, such as eating disorders, may be complex and seem illogical. There will often be ups and downs in recovery.

Don’t be afraid to seek further advice from mental health professionals

Many of them have a great deal of experience and are generally an excellent source of guidance and support.

Don’t blame yourself

Parents or carers often feel guilty, thinking they have caused the problems, perhaps through genetics or the home life they have created. Usually, this is not the case.

Look after yourself

In order to support your child, you need to stay strong and well yourself. Often it helps to talk to someone, so don’t be scared about doing this, with friends, family or a parent helpline. For further resources and support for parents please visit the online helplines and resources on www.coolmindshk.com

Hong Kong organisations which help parents

Mind Hong Kong provides information and advice on a range of mental health topics, as well as a community directory of available resources.

New Life Psychiatric Rehabilitation Association provides a Family Support Service. They aim to build a holistic support network among carers to support them to face challenges with a positive mindset and to maintain family functions.

Caritas Family Crisis Support Center (in Chinese only) aims to manage family crisis at an early stage by providing integrated and easily accessible services to assist individuals or families in crisis or distress. Services provided include 24-hour hotline service (18288) and short-term emergency accommodation.

Youth Outreach (in Chinese only) has a 24-hour hotline for young people from ages 8 to 18. The organisation also provides support through emergency accommodation, individual and family counselling, academic and career advice, among others.

Hong Kong Eating Disorders Association
In addition to patient support groups and members gatherings, they host small group gatherings for caregivers to share and de-stress.

Baptist Oi Kwan Social Service has a family resource and service centre providing support and counselling for families of those recovering from mental illnesses.

Christian Family Service Centre provides education, counselling, groups, shelter and other services to children and families. They aim to help overcome family problems, provide quality learning environment, and build up their mutual support networks.

International organisations which help parents

Young Minds is an excellent source of information about all aspects of child mental health, including a Parent Helpline.

Minded for Families provides free, quality- assured advice which is easy to understand. It is helpful for any adults caring for children or teenagers with mental health problems.

Beat gives clear advice on all aspects of dealing with eating disorders, including helpful guidance to parents, carers and families.

Anna Freud Centre – a leaflet about mental health for parents of young children.