Mental Health and Illness

Symptoms and Signs of Depression

When people are depressed, they may often show symptoms through:

• Negative feelings about themselves;
• Sadness, irritable moods, lack of interest or concern;
• Loss or increase of appetite (significant changes in weight/diet);
• Changes in sleep patterns (less or more);
• Feeling tired or fatigued a lot of the time;
• Chronic but unexplained aches and pains;
• Loss of interest in life;
• Withdrawal from friends/family and/or interests;
• Changes to hygiene;
• Changes to attendance at work/school or other activities;
• An inability to make decisions;
• An inability to analyze and solve problems;
• Increasing alcohol or other drug use;
• Showing major changes in school or work performance/attendance;
• Becoming involved with many sexual partners or other risky behaviours;
• Fighting with friends, family and teachers;
• Changing their level of activity e.g. restlessness to boredom;
• Rejecting past friends, family;
• Running away from home; and
• A tendency to blame themselves.

Bipolar Disorder

Bipolar disorder, also known as “manic depression”, is a medical condition that causes a person to cycle through periods of depression and elevated mood known as mania. Approximately 1% of Canadians live with bipolar disorder, and many are able to maintain a high quality of life.

Bipolar disorder typically consists of three states:

• A high state, known as mania;
• A low state, known as depression; and
• A well state, where the person functions well/without many symptoms.

All people experience emotional ups and downs, but the mood swings for people with bipolar disorder are often more extreme and go in a cyclical nature.

Signs and Symptoms of Bipolar Disorder

Manic phase

• Exaggerated self-esteem or feelings of grandeur;
• Decreased need for sleep;
• More talkative than usual;
• Racing thoughts;
• Easily distracted;
• Excessive energy for activities; and
• Engaging in risky behaviour or exhibiting poor judgement.

Depressive phase

• Depressed mood;
• Loss of interest or pleasure in activities that used to be enjoyable;
• Weight loss or gain;
• Difficulty sleeping or sleeping too much;
• Apathy or agitation;
• Loss of energy;
• Feelings of worthlessness and guilt;
• Inability to concentrate; and
• Thoughts of suicide.

Psychotic symptoms

People with bipolar disorder may also experience psychotic symptoms, such as delusional/disordered thinking, hearing voices or having ideas that are not based in reality. Typically a person who experiences psychotic symptoms with bipolar disorder may meet the criteria to be diagnosed with schizoaffective disorder. Less than 1% of Canadians live with schizoaffective disorder. 

For more information, visit Mood Disorders Society of Canada and CAMH.

Schizophrenia is a serious mental illness that affects approximately 1% of the Canadian population. Other psychotic disorders may affect up to 4% of the population. Schizophrenia generally presents in men in their late teens or early twenties, while it presents in women in their late twenties or early thirties.

Early Psychosis is defined as the experience of loss of contact with reality and usually involves hallucinations and delusions. Early psychosis is a common symptom of schizophrenia, but not all forms of psychosis will be diagnosed as schizophrenia.

Symptoms of Schizophrenia and Psychosis

• Hallucinations cause a person to hear voices inside or outside their heads (auditory hallucinations) or to see things that do not exist (visual hallucinations).
• Delusions occur when someone believes ideas that are clearly false, such as that people are reading their thoughts or that they can control other people’s minds.
• Emotional flatness or lack of expressiveness;
• An inability to start and follow through with activities;
• Speech that is brief and lacks content;
• Lack of pleasure or interest in life;
• Problems with memory and executive functioning; and
• Lack of insight into illness.

Medications are crucial to control symptoms of schizophrenia and psychosis.

For more information on schizophrenia and psychosis, visit the Schizophrenia Society of Canada and the Schizophrenia Society of Saskatchewan.

Although individual motives for suicide vary, there are some common warning signs. Suicide seldom happens without some warning. These signs may indicate that someone is at risk of suicide:

Physical Signs

• Neglect of personal appearance or not taking care of oneself (change from normal);
• Disturbed sleep or changes to sleep patterns;
• Chronic or unexplained illness, aches and pains or health complaints;
• Sudden weight gain or loss; and/or
• Sudden change in appetite/diet.

Emotional Clues

• Sense of hopelessness or helplessness;
• Feelings of loss (relationship, job, financial, etc.);
• Inability to enjoy or appreciate friendships;
• Extreme mood changes and sudden outbursts;
• Anxiousness, extreme tension and agitation;
• Feeling tired or fatigued;
• Changes in personality: from outgoing to withdrawn, from polite to rude, from compliant to rebellious, from well-behaved to acting out;
• Loss of the ability to concentrate, daydreaming;
• Depression, sadness;
• Loss of rational thought;
• Feelings of guilt and failure;
• Self-destructive thoughts or expressions of self-harm;
• Feelings of worthlessness or of being a burden; and/or
• Loss of enjoyment from activities enjoyed before.

Behavioural Signs

• Decreased activity. Sudden drop in achievement and interest in school subjects, hobbies or work;
• Unexplained and/or increased use of alcohol or other drugs;
• Withdrawal from family and friends, sometimes acting in a manner which forces others away;
• Spending a lot of time alone;
• Changes in eating and/or sleeping habits;
• Changes in friendship;
• Running away from home, skipping school or other erratic decisions;
• Increase in risk-taking behaviour such as careless driving, dangerous use of firearms or impaired driving;
• Becoming involved with many sexual partners;
• Statements that involve suicide or their problems ending/not being around any longer, being a burden, being done, saying goodbye, thanking you as if they won’t see you again, etc.;
• A sudden positive or euphoric shift in mood;
• Giving away prized possessions or making plans for loved ones or pets to be looked after;
• Preoccupation with thoughts of death or suicide/self-harm; and/or
• Sudden changes in personality.

The following behavioural signs are especially significant, because these signs indicate that a decision to die by suicide may have been made. A previous attempt is a particularly important sign. If a person has experienced a suicide attempt, it increases their risk of death by suicide.

• Making a will, writing poetry, or stories about suicide or death;
• Putting affairs in order, "taking care of business";
• Threatening to die by suicide;
• Intoxication by alcohol or drugs;
• Recent events of loss or trauma and expressions of pain as noted in the symptoms above;
• Hopelessness;
• Hoarding pills, hiding weapons, describing methods; and
• Previous suicide attempts.

Suicide Intervention – You Can Help

Here are ways you can help if someone wants to talk to you about his or her feelings of depression or about suicide.

9-8-8: National Suicide Prevention and Mental Health Crisis Hotline

Dial or text 9-8-8; 24/7 voice or text support for mental health crisis and suicide prevention. Visit 988.ca for more information.

• If the person mentions suicide or you suspect they are thinking of suicide, it is important to directly and clearly ask them if they are thinking about suicide. A common misconception or myth exists that people believe that if they ask a person if they are suicidal it will put the idea in their head. This is scientifically proven to not be true. It is very important to ask the person and let them know there are ways you can get them help.
• Refrain from using the phrase “commit or committed suicide” as this language is stigmatizing and has negative connotations. For more information on language, visit Language Matters.
• Always treat such talk or behaviour seriously; don't believe that "it's just attention-seeking."
• Do not promise to keep such talk or behaviour a secret; it is one secret you should not keep. It's too risky. Reach out to mental health or crisis services immediately.
• Do not give quick advice or say that "everything will be alright."
• Be an active listener. Do a lot of listening; little talking. Let the person know you are hearing what they are saying. Try paraphrasing to check whether you are accurately hearing what is being said.
• Help the person explore his or her own feelings. Do not add to possible guilt by saying things such as "think how your friends and family will feel."
• Don't "discount" the individual's feelings of crisis by saying things like "things aren't that bad," or "that's not true, you have lots of friends."
• Show and describe your concern and caring to the person.
• Try to determine whether or not the person has a plan or has attempted suicide. If they have attempted suicide, call 9-1-1 or take them to the closest emergency room.
• Do not debate whether or not suicide is right or wrong. To do so may add to guilt or feelings of worthlessness.
• Discussions of this nature do not always progress in a straight forward manner. It may be necessary to check on some point or other. If you miss something or it becomes obvious that you "should" have said something else, don't worry. Apologize and return to what was missed or say what you think needs saying.
• Remember: You can often be a help by just being there to talk to. Many crises are immediate and short term. Talk and listen.
• Encourage the person to go to a counsellor, minister or family member for additional help. If they won't and the risk remains, contact someone for them. You might consider:
  • contacting the person's family;
  • accompanying the person to a walk-in clinic;
  • phoning the family doctor;
  • staying with him or her until help arrives;
  • call the Saskatchewan Health Authority intake number in your area;
  • contact emergency or crisis support services; and
  • taking him or her to the closest emergency department.
• If the risk seems high or immediate, do not leave the person alone and do not send them on their own to an agency or other resource person.
• Continue to be involved. Let the person know you care beyond the immediate crisis. Remember, the person may continue to need assistance – yours, as well as that of a professional.

Suicide Intervention – Resources

You are not alone. There are individuals and agencies willing and able to assist you, or someone else, in dealing with depression or thoughts of suicide. These same individuals and agencies can provide information and support to assist you in working with others.

Each person's support network is unique. Generally, the following might provide initial and/or long-term support:

• Family physicians
• Family and community support services counsellors
• Local health clinics
• Employers
• Coaches
• Social workers
• Police
• Ministers, priests, rabbis and other religious leaders
• Medical personnel
• Psychologists
• Emergency response personnel
• Crisis/Suicide line
• Kids Help Phone

Find services and supports in your area.

Eating disorders are complex mental health conditions affecting people of every age, race, size, gender identity, sexual orientation and background. They manifest in various forms of disordered eating and different diagnoses. Eating disorders affect at least 9% of the population worldwide, making them a global concern. Notably, eating disorders have one of the highest mortality rates of any mental health disorder; and only one in 10 individuals seek treatment.

Symptoms of Eating Disorders:

• Distorted body image
• Restrictive eating
• Binge eating
• Purging behaviours
• Over-exercising
• Social withdrawal

Full recovery is possible. However, recovery requires genuine, safe, and caring support throughout the treatment process. Eating disorders are not solely about body image and food; they also involve self-worth, personal effectiveness, and feelings of control. Early detection, preliminary evaluation and appropriate treatment are crucial.

Effective treatment for eating disorders typically involves a multidisciplinary approach, including working with your primary care team, therapy and nutritional counselling. Early intervention is essential for recovery and preventing further physical and psychological harm. You don't have to wait for a diagnosis to start conversations about disordered eating. If you or someone you know is struggling with an eating disorder, please seek help from a qualified healthcare professional or reach out to BridgePoint.

About BridgePoint
BridgePoint Center for Eating Disorder Recovery provides onsite and virtual program options to Saskatchewan residents free of charge. Participants can self-refer, and no diagnosis is required. BridgePoint is not a medical program and requires participants to be physically and psychiatrically stable for admission. For more information, please visit the BridgePoint Center website or call 306-935-2240.

The word trauma is used to describe many feelings and circumstances. People can be traumatized by divorce, workplace harassment, the death of someone close to us, being sexually assaulted, experiencing a fire, or natural disaster, as examples. It is also possible that something traumatic may affect one person much differently than another.

• "True" trauma occurs when the body reacts by turning on its "fight, flight or freeze" automatic pilot in response to situations involving intense fear, helplessness or horror.
• "True" trauma is not the same as severe distress. It occurs when a person is exposed to real or perceived danger, directly (for self) or indirectly (for other) that results in an extreme set of physiological and psychological responses.

Traumatic events are characterized by:

• Threat to life and limb;
• Severe harm and/or injury;
• Being intentionally harmed or injured by someone;
• Exposure to grotesque, violent or sudden loss of a loved one;
• Witnessing or learning of violence to a loved one;
• Exposure to disaster, devastation or critical incidents; and/or
• Causing death or severe injury to another.

Common Causes of Post-Traumatic Stress

There are certain factors that can increase vulnerability to post-traumatic stress:

• Witnessing domestic violence.
• Fear and fundamental lack of safety in children living with chronic parental addiction or other situations causing anxiety, fear and insecurity.
• Losing access to an absent parent or to a primary caregiver whoever that person may have been e.g. grandparent, aunt, etc.
• Being arrested or being kept in isolation in a custodial facility.
• Being the victim of violence, emotional, mental, sexual or physical.
• Witnessing or having knowledge of the suicide or suicide attempt of a family member or friend.

General Reactions to Trauma and Loss

Reactions to trauma are not solely determined by events. There are a number of other factors including the nature and magnitude of previous losses and trauma (especially childhood trauma) and coping strategies.

• Trauma experiences can affect how we function in all areas of our lives.
• There is no one "standard" pattern of reactions to the extreme stress of traumatic experiences. Some people respond immediately, others have delayed reactions over a period of weeks, months and even years, and some may not have any reaction or lasting effect from the event.
• Some people experience adverse effects for a long period of time while others recover quite quickly. Serious life events such as deaths, suicide, murder, sexual assault, war, etc., are experiences that we do not generally just "get over." They may leave long-lasting scars.
• All loss involves some degree of trauma, and all traumas involve a substantial amount of loss and grief.
• Self-blame is a common response to a traumatic experience. It may cause a person to self-sabotage and is a factor in symptoms of depression, anxiety and other mental health illnesses.

Anxiety disorders are the most common of all mental health disorders. It is estimated that 10% of Canadians lives with an anxiety disorder. These disorders can be successfully treated through therapy and/or medication so it is important to recognize the difference between being anxious in response to a real event, and an anxiety disorder which produces fear or distress that is out of proportion to the situation.

For more information, visit Anxiety Canada.

If you or a loved one are experiencing any mental health concerns, it is important to reach out for help. Start by contacting your family physician or Saskatchewan Health Authority Mental Health and Addictions Services in your area.

Rapid access counselling is available throughout Saskatchewan through Family Service Saskatchewan.

Free online cognitive behavioural therapy (CBT) is available through the University of Regina Online Therapy Clinic and the Saskatchewan Health Authority.

If it is an emergency, more options available provincially and nationally.

Find more detailed mental health information at Saskatchewan HealthLine on the following topics:

• Anxiety
• Bipolar Disorder
• Depression
• Mental and Behavioural Health
• Mind-Body Wellness
• Post-Traumatic Stress Disorder
• Schizophrenia
• Suicidal Thoughts