Anxiety is a feeling of unease, fear or worry, especially around things which are about to happen or we believe may happen in the future. Everyone experiences anxiety differently. Feeling anxious at times is a normal response to certain situations, such as exams, job interviews or going to a new place. Some people find it hard to control their worries, which can affect their daily lives. 

Anxiety may present a problem if feelings of anxiety last for a long time or cause a person to avoid taking part in everyday activities. 

Anxiety can cause physical and behaviour changes, which can result in symptoms like:

• nausea (feeling sick);
• strong, fast or irregular heartbeat;
• headaches and muscle tension;
• feeling dizzy or lightheaded;
• irritability; 
• difficulty sleeping and/or tiredness; 
• feeling restless or having difficulty concentrating; 
• feeling like your mind is really busy with thoughts;
• feeling constantly unsettled or having a sense of dread;
• dwelling on negative experiences, or thinking over a situation again and again (this is called rumination).

It’s not clear why some people experience anxiety as a mental health problem. There are some factors or a combination of factors that may affect feelings of anxiety. These are:

• an imbalance of brain chemicals (serotonin and noradrenaline), which are involved in the control and regulation of mood;
• overactivity in areas of the brain that are involved in behaviour and emotions; 
• having a long-term health condition or another mental health condition;
• previous life experiences, particularly if they were stressful or traumatic;
• drug and alcohol use (including some prescription drugs);
• everyday life, including stress and diet. 

Stress is the feeling of being under too much mental or emotional pressure. Pressure turns into stress when you feel unable to cope. People have different ways of reacting to stress, so a situation that feels stressful to one person may be motivating to someone else. 

Many things in life can cause stress, including work, relationships, money issues and much more. When you feel stressed, it can get in the way of being able to deal with the things that are causing you stress. It can also affect other things you do in your daily life.

Stress causes an increase in hormones in your body which can help deal with pressures or threats. This is known as the ‘fight or flight’ response. Once the pressure or threat has passed, stress hormones will usually return to normal. 

If you’re constantly under stress, these hormones will stay in your body, which can lead to physical and psychological symptoms of stress such as: 

• tiredness; 
• headaches and/or muscle tension;
• feeling irritable or short tempered;
• sleeping problems;
• loss of appetite;
• difficulty concentrating and/or racing thoughts;
• feeling anxious, nervous or afraid;
• low self-esteem;
• unable to enjoy things;
• drinking more alcohol or using drugs;
• eating more or less;
• issues with the digestive system;
• sexual problems;
• changes to menstrual cycle.

Everyone feels low or down from time to time. It is common to feel low after distressing events or significant life changes. People may feel tired, frustrated or worried, but a low mood will pass after a short time. If it doesn’t pass and is being experienced every day, the person may be depressed.

There are different types of depression. The impact symptoms of depression have on someone’s life may be described as low, moderate or severe. 

Depression can cause changes to how someone feels, thinks and behaves. It may include symptoms like:

• feeling sad or tearful;
• feeling hopeless;
• feeling worthless or experiencing self-guilt;
• feeling nothing, empty or numb;
• losing interest in things you usually enjoy;
• no self-esteem or confidence;
• avoiding events and activities you usually enjoy;
• losing appetite or eating too much;
• finding it difficult to think or speak clearly;
• aches and pains with no cause;
• difficulty sleeping or sleeping too much, but still feeling tired all the time.

It is also common for people with depression to have symptoms of anxiety. 

There are risks with taking alcohol or drugs. Alcohol and dugs can have short and long term effects on your body including physical, psychological and emotional impacts.

All drugs and alcohol have some effect on your mental health. You should think carefully about the risks before you take a substance, especially if you have mental or physical health problems. Using any drugs that have not been prescribed for you can put your health at greater risk.

If you would like support or treatment for your alcohol or drug use or you are a family member impacted by someone who uses alcohol or drugs, help and support is available.

To find out more about drugs and the impact they may have on your physical and mental health, visit www.talktofrank.com.

If you are impacted by a family member who uses substances such as drugs or alcohol you can get help and support even if the individual is not willing or ready to engage in support themselves.

Find out more about family support available in Northern Ireland. 

Self-harm is any non-accidental behaviour that causes or can cause harm to a person. Self-harm is when someone hurts themselves on purpose as a way of coping with difficult feelings, painful memories or overwhelming experiences and situations.

Self-harming can feel like the only way to let those feelings out. This is not unusual behaviour, but it is something that can be managed and prevented.

A person who self-harms might not know or understand why they hurt themselves. Self-harming only brings short-term relief and can become a habit that is hard to stop. It is important to know that there is help and support available to those who self-harm.

There are different forms of self-harm and they are not always easy to notice. People who self-harm usually try to keep it a secret from their family and friends. 

If you think a friend or family member is self-harming, look out for the following signs:

• unexplained cuts, bruises or burns on their body;
• keeping themselves fully covered, even in hot weather;
• signs they have been pulling out their hair; 
• changes in eating habits, and any unusual changes to weight;
• signs of alcohol or drug misuse; 
• signs of depression, low mood or loss of interest in things they usually enjoy;
• low self-esteem or self-worth.

It can be upsetting when you think that self-harm is the only way you can cope, but there are other healthy ways you can try to help you cope such as:

• exercising, dancing or listening to music; 
• being with your favourite people or pets;
• spending time in nature;
• watching tv, particularly comedies;
• keeping busy by cleaning and tidying your space;
• journaling, writing your feelings on paper and tearing them up;
• reading a book; 
• practising meditation, mindfulness or breathing techniques; 
• using apps to help you to explore alternatives to self-harm which can be effective and less harmful to practice.

Self-harm can be dangerous and is a sign that there is an underlying problem so it’s important that you recognise you need help and support.

If you have self-harmed or are thinking about it, it is important to know that there are people who can help you and will not judge you. You shouldn’t feel alone.

Getting help starts with talking to someone. Talk to someone about how you are feeling.  It could be a friend or family member you trust, or a teacher, colleague, youth worker or your doctor.

You might find it easier to talk to someone who doesn’t know you. There are confidential services that can help.

When feeling overwhelmed or in pain, some people may have thoughts about suicide or not wanting to be alive. 

If you are thinking about suicide, it is important to know you are not alone. Many people have suicidal thoughts and difficult emotions or feelings. Help and support is available.   

People experience suicidal thoughts for many reasons. Thinking about suicide is not necessarily about wanting to die. It may be about being in too much emotional pain or in too difficult a situation to think, or see, that it is possible to keep living. 

Thoughts of suicide can either come and go or they can be constant. It is important to remember that you don’t need to act on thoughts of suicide. The vast majority of people don’t act on their thoughts. If you feel that you want to act on your thoughts, remember you can choose to keep yourself safe and get help from someone else. This could be someone you trust, such as your GP or a Lifeline counsellor. Lifeline counsellors are available 24/7 to speak to anyone experiencing thoughts of suicide. 

When someone is having thoughts of suicide, you may notice changes in their behaviour or things they say.  

• They may be more irritable than normal, with the smallest thing causing them to get annoyed with themselves or others around them.
• They may be spending more time alone and not want to go out and do the things they normally enjoy doing.
• They may complain of feeling tired and having disturbed sleep patterns.
• They may be skipping meals or eating more than normal.
• They may be misusing alcohol or drugs, or taking days off work, school or college.
• They may be making arrangements, such as giving away prized possessions (for example pets or family heirlooms).
• They may talk about not wanting to be around or that people would be better off without them.

Remember, we are all different and not everyone will display all of these signs.

If you are worried or concerned about someone else, talk to them about your concerns. Ask them how they are feeling and if there is anything you can do to help them. Tell them that you have noticed that they haven’t been themselves recently. It’s okay to ask them directly if they are thinking about suicide. The worst thing that can happen is that they will tell you to mind your own business, but at least they will see that you cared enough to ask. Find out more about supporting someone.

Talking to someone you trust, such as your GP, a mental health professional or a Lifeline counsellor (call 0808 808 800), is important if you are having thoughts of suicide and essential if you are thinking about acting on your thoughts. Speaking to someone can help you stay safe and find other solutions. 

Some techniques which might help you manage your thoughts of suicide are: 

• Put off making any decision about acting on your thoughts of suicide today. Instead focus on the now and getting through the day. 
• Do physical or grounding exercises to calm your nervous system. There are apps that can help. 
• Do some breathing exercises. Gently breathe in through your nose and out through your mouth, keeping the pace slow and regular. Then, starting at your toes and working up to your head, slowly tense and then relax all the muscles in your body. Practise this for around five minutes.
• Distract yourself with something you enjoy, like reading a book, listening to your favourite music or going for a walk. 
• Be around others or go to a safe place, like a friend’s house. 
• Avoid drinking alcohol and don’t use drugs.
• Think back to some of the things that have made life meaningful in the past. It could be pets, people, music or something you’ve enjoyed doing. Remember you can have these experiences again. 
• Remember feelings of pain are very real, but it is important to know these feelings will pass. 
• If you have a safety plan, use it to help yourself keep safe. 

Lifeline is Northern Ireland’s crisis response helpline for people experiencing distress or despair. Lifeline is available 24 hours a day, 7 days a week, every day of the year. Calls to Lifeline are free. 

Lifeline will support people living in Northern Ireland of every age, gender, ethnicity, religion, disability and sexuality. 

Lifeline counsellors are skilled at supporting those experiencing thoughts of suicide. 

Call Lifeline on 0808 808 8000 and find out more on Lifeline’s website. Deaf people and those with hearing difficulties can contact Lifeline using Textphone through the Relay UK app on 18001 0808 808 8000. Interpreting support is also available.

The death of a family member, friend or someone you know is never easy, but losing someone by suicide can be even more difficult and can create a range of intense emotions. If you are struggling or need to talk to someone, call Lifeline on 0808 808 8000. 

The Help is at Hand booklet provides practical guidance and emotional support following a possible death by suicide. 

Support is available to people across Northern Ireland who have been bereaved or affected by suicide. Find out about the support available in the Minding your head service directory. 

Grief is a normal process that we all experience after a bereavement. Grief affects everyone differently and is a complex and personal issue. It’s important to remember that there is no time limit to the feelings associated with grief. The journey could take months or years.  

Grief can be made more difficult to deal with for many reasons:

• the way in which a loved one died; 
• complicated relationships before death; 
• traumatic or unexpected loss;
• losing someone to suicide; 
• not getting to say goodbye.

Grief can affect the body and mind and can change the thoughts, feelings and behaviour of those bereaved. This could include: 

• shock and numbness; 
• feelings of guilt or anger;
• feelings of sadness and depression [hyperlink to low mood depression]; 
• anxiety symptoms, like panic attacks or overthinking [hyperlink to anxiety page];
• feeling tired, exhausted or tearful; 
• feelings of longing for the deceased;
• difficulty sleeping; 
• loss of appetite or comfort eating; 
• withdrawing from people (such as friends and family members), work and activities. 

It is important to remember there is no ‘normal’ way to grieve. Even members of the same family or friendship group will grieve in very different ways, and how some people cope with their loss can be difficult for others to understand. 

It is normal to see, hear or sense someone who has died. Whilst this can be unsettling, it does not mean there is anything wrong. ‘Seeing and hearing’ a person who has died can happen because the brain is trying to process the death and accept it is final.  

When you become a parent, your life changes in lots of ways. Getting to know your baby and having a new routine will take time. Be kind to yourself and take things at your and your baby’s own pace.

There are things you can try to take care of yourself after having a baby:

• Give yourself time to heal – your body has been through a remarkable physical experience. 
• Ask and accept any help offered. This could be from your partner, friends or relatives. This includes accepting help with housework or letting someone look after your baby while you shower, go shopping or cook a meal. 
• Rest and sleep when you can. Try to sleep when the baby sleeps, even if this means having a nap throughout the day. 
• Remind yourself of the things you’re good at and remember that being a good parent doesn’t mean being perfect. 
• Spend some time outdoors – being outdoors and getting some regular exercise, even a short walk if you can, are great ways of lifting your mood.
• If you have a partner, talk to them about how to share feeding, nappy changing, bathing and playtime so you both get time with your baby and time to do other things too. 
• Remember, if you feel good, you’ll feel more able to manage and care for your baby. 

Many new mums experience a mixture of emotions after they have given birth. If these continue for more than a few days, speak to your midwife, health visitor or GP.