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The Mental Health Workbook




Mental He alth Is R e a l.


Table  of Contents Welcome Breaking Down Disorders

• What are they? • Personal Stories • Resources for Help

Types of Talking Therapy

• What is talking Therapy • Let’s be Mindful  • Mindful exercises

D.I.Y (Yes, That Means Actually Do It)

• Activities to try



Welcome Health Survival Guide! If Welcome to the Mental

you’re reading this that means you’ve made the¬ right choice for your mental health, and your brain will soon thank you. You may be wondering how this book came to be? Don’t worry, I was planning on telling you even if you didn’t ask! Coming from someone who’s been working with her


own mental health for the past 7 years now, I consider mental health a big part of my life, and care deeply about others who go through the kinds of things I do. I thought about those around me who perhaps weren’t as lucky as I was to have the support and help I needed, those who can’t get to therapy, don’t have the resources for help even though they need it.


Those are the ones I created this workbook for. I created this for you. It means a lot to me, as I hope it does for all of you as well. I want to also point out the fact that this book is meant to be informative, educational, relatable, fun, and interactive. At the same time, it deals with very serious issues, i.e Mental Health, so with that in mind, there is the potential for t/w or Trigger Warnings. Anytime the content in the book is of a more serious topic, I will add the tag t/w before as a warning. While my intention would never be to purposefully trigger someone, with all the different kinds of content, it is possible it may happen. With that in mind, I apologize, and hopefully you will be able to find content in the book to help soothe you.






All disorders are different and complex, and everyone reacts to them in different ways. The world of mental health is very in-depth and consists of a vast variety of different types of disorders, some with more than one in each. It’s a complex shit storm of seemingly related disorders that mix, collide, and stack on top of one another until you’re perhaps a swirling storm of mental health.



What is a mental illness? A mental illness is a disease that causes mild to severe disturbances in thought and/or behavior, resulting in an inability to cope with life’s ordinary demands and routines. There are more than 200 classified forms of mental illnesses. Some of the more common disorders are depression, bipolar disorder, dementia, schizophrenia and anxiety disorders. Symptoms may include changes in mood, personality,


personal habits and/or social withdrawal. Mental health problems may be related to excessive stress due to a particular situation or series of events. As with cancer, diabetes and heart disease, mental illnesses are often phys-

Source: Mental Health America (MHA)

ical as well as emotional and psychological. Mental illnesses may be caused by a reaction to environmental stresses, genetic factors, biochemical imbalances, or a combination of these. With proper care and treatment many individuals learn to cope or recover from a mental illness or emotional disorder.


Types of Disorders ADHD Attention deficit hyperactivity


disorder (ADHD) is a develop-

Borderline personality disorder

mental disorder where there

(BPD) is characterized by severe,

are significant problems

unstable mood swings, impulsiv-

with attention, hyperactivity

ity and instability, poor self-im-

or acting impulsively.

age and stormy relationships.



Everyone experiences anxiety

Depression is more than

sometimes, but when it be-

just feeling sad or going

comes overwhelming and re-

through a rough patch; it’s a

peatedly impacts a person’s life,

serious mental health con-

it may be an anxiety disorder.

dition that requires under-

BIPOLAR DISORDER Bipolar disorder causes dramatic highs and lows in a


standing and treatment.

DISSOCIATIVE DISORDERS Dissociative disorders are

person’s mood, energy and

spectrum of disorders that

ability to think clearly.

affect a person’s memory



and self-perception.



Psychosis is characterized as dis- PTSD is the result of trauruptions to a person’s thoughts

matic events, such as military

and perceptions that make it

combat, assault, an accident

difficult for them to recognize

or a natural disaster.

what is real and what isn’t.



SCHIZOAFFECTIVE DISORDER Schizoaffective disorder is

When you become so pre-

characterized primarily by

occupied with food and

symptoms of schizophre-

weight issues that you find it

nia, such as hallucinations or

hard to focus on other as-

delusions, and symptoms of

pects of your life, it may be a

a mood disorder, such as de-

sign of an eating disorder.

pressive or manic episodes.


SCHIZOPHRENIA Schizophrenia causes people

Obsessive-compulsive dis-

to lose touch with reality, often

order causes repetitive, un-

in the form of hallucinations,

wanted, intrusive thoughts

delusions and extremely disor-

(obsessions) and irrational,

dered thinking and behavior.

excessive urges to do certain actions (compulsions).











This is a section of the book I think is the most helpful. Yes the educational information is important to know, but the most valuable thing in my opinion? Relatability. This next section contains 7 stories from people aged 16-37 who have been dealing with mental health in different ways. These stories are all 100% honest, raw, and full of real emotion. I wanted everyone reading this to know that YOU AREN’T ALONE, there’s someone else out there going through what you are, I promise you. Let their stories inform you, and hopefully provide clarity and support, even if they are negative in subject matter. TRIGGER/CONTENT/SUICIDE WARNING: STORIES CONTAIN GRAPHIC IMAGERY, VIOLENCE, DRUG/ALCOHOL USE,ABUSE PERSONAL STORIES



I am one of those people who you wouldn’t have had known had depression. Sure I was quiet at

AGE 22 (F) times, but for the most part, I was the comic relief among my friends. They would always come to me for advice or a laugh, and I was happy to help. But, there would be days when I couldn’t muster the strength to smile, and those were the times that I suspected it might more than just “ being tired.” I started feeling numb all the time. When I went home, I would lay on my bed for hours doing nothing and feeling empty. I wasn’t getting as much joy out of life as I used to. Everything started fading to black and white. I was lucky enough to have friends that knew what I was going through. I could share my experiences among my peers and not have my feelings invalidated. When I went to college and


we went our separate ways, and I was alone, I began to retreat once more into the darkness. This continued on a downward spiral for about a year until I found myself crying in the bathroom over nothing. I was just sad, all the time. I needed help. I made an appointment with both a psychiatrist and a therapist and sought medical attention for what I learned was generalized anxiety disorder. I was prescribed medication, and things started looking up. When I had my third mental breakdown since starting college, I realized it was time for a change. I switched my major from marine biology, which although I enjoyed, couldn’t see myself pursuing a career that involved chemistry, to English literature. I had always loved to read, using it as an escape from my restricting reality and now I could get a degree in it. As I continued in my general education requirements, I ended up taking a linguistics class and found


my second love. I began to minor in teaching English as a second language and enjoyed every minute of it. These changes I was making in my life, changed it for the better and put me on a path that led me out of my depression. I was happier, more confident, and the people around me could feel it. Today, I am still here. I have a future. I am in love. I will graduate next year with a certificate from a prestigious university that I wouldn’t have even imagined attending when I was sixteen and didn’t see myself reaching the age of twenty. I moved out of my toxic home and surrounded myself with people and experiences that make me feel better, instead of wallowing in my pain. I sought help and was helped, and that was the best decision I’ve made in my life.




There are several different types of depression each one has its own unique thing. There is situational

AGE 37 (M) depression. This is when an event or situation takes place that makes you temporarily depressed. Things like a family or friends death, being fired or laid off, divorce, to name a few. Bi-polar disorder (used to be Manic Depressive disorder) has two types. Bi-polar 1, and Bi-polar 2. Bi-polar one is where you are depressed. However, you also have Manic episodes. Mania is when you feel terrific and euphoric. You feel like you are indestructible and need no sleep or food. These episodes are very dangerous. People tend to take more substantial risks, doing things they wouldn’t do otherwise. Also, it can cause you to spend beyond your means. Bi-polar 2 kicks it up a notch as far as symptoms go. This is one of the mental health Diagnosis I have. This has the Bi-Polar 1


symptoms, and Psychosis, which results in hearing and/or seeing things that are not there. It can also contribute heavily to suicidal or homicidal thoughts. This disorder is one of the leading causes of my over half dozen suicide attempts in the last two years. It triggers my anger/rage. In that state, for me, I can’t decide if I want to hurt someone or myself. Depression and Generalized anxiety disorder often go hand in hand. Depression has been a significant issue in my life since I was a kid. I was utterly reckless from 14 until I was 26. Then again in my late 20’s and early 30’s. I was an honor student who skipped school, classes, and was often suspended for fighting. I have attempted suicide nearly two dozen times in my life. It has led me to a lot of self-sabotage in my life, middle school, high school, and college I lived a reckless life using a lot of drugs and alcohol. I also in my early 20’s fought for money or drugs. The thing was I did not care at all what happened to me.


I also stopped caring about anything at all. I started being numb to any emotion, aside from despair, Sadness, and anger. Now here at 37 I pretty much feel nothing, unless I’m in a Manic state; that’s when I feel indestructible and up on a big high point where you don’t hurt so much, just waves at a time. Family and friend impact was quite significant. I tried to just work myself to death instead of accepting and dealing with it. I kept it all bottled in, which led to me snapping on people a lot. After the Doctor error killed my Dad, I went off the rails and blew through 100k on cocaine, alcohol, and pot. For four months my diet was Jack, Bud, pot, coke. I was fighting for money pretty much every other day. My sister tried to stop me by blocking my exit, and I threw her 10 feet across the room into the refrigerator. I put my dealer through my garage door when he refused to front me more coke and pot, a huge regret. I alienated all my friends. They tried being there for me, but anytime they did I swore at them and threatened them. They were afraid to be around me I’d become so dangerous. The only thing that stopped me was my blood pressure getting so high that my Doctor said he was in shock I’d not had a stroke. He told me another week doing what I was doing I would be dead and my mother and sister would bury me four months after burying my dad. When I was 15, I was on acid or mushrooms all the time. One night I was tripping hard and beat the shit out of my Father when he tried to restrain me.



These days it is a fight to even leave my house. No desire to leave my room. Yes, my room. October 2016, I had three suicide attempts. The last one I did right in front of my mother at a get-together. I took a butter knife screaming I want it to hurt as I went to town on my wrist and forearm. My family gave me a choice, go into treatment voluntarily, or have the police take me there forcefully. I went in. They said I could not work anymore nor could I live alone. I was considered a high suicide risk. They still see me as one because my mood changes are so volatile. The fact that at the job I was working, a tabletop fryers leg broke while using it and the 400-degree grease went all over my legs,


and into my left eye, sealing it shut instantly. I ripped the fryer out of the wall and threw it. I went into the back kitchen and made over two dozen fist imprints on the coolers and ripped a door off when I hit it so hard it popped open and hit me. I then went out and cooked for 300 people with one eye that burned like crazy. I could not open my eye for six days, and for the next two weeks after that, I had vision issues and a very big twitch in that eye. This disorder has taken so much from me. An engagement I ended. It contributed to my wife cheating and leaving when caught. I went nuclear that day as it was our anniversary. It made me a black sheep in my extended family. In my late 20’s early 30’s I made strong six figures as a restaurant new location opener and consultant working 70-100 hours a week. I am now unemployed and living in the manufactured home I bought her after my dad passed. This is a serious disease. I made a major mistake ignoring



“...Mania is when you feel terrific and euphoric. You feel like you are indestructible and need no sleep or food. These episodes are very dangerous. People tend to take more substantial risks, doing things they wouldn’t do otherwise...”



I’ve suffered from depression for a good portion of my life, but the worst it ever was, was when I was 17. At

AGE 21 (F) the time I was dating a very abusive guy, that coupled with my depression sent me into a tailspin. I’d always dealt with selfharm, and at this point, I had managed to stop for an extended period of my teen years, but one night I snapped. I didn’t want just to hurt myself; I wanted to end everything. I hit a point where I didn’t care about anything including myself. When you’re dating someone who’s so abusive and manipulative, that they break you down to nothing, but you can’t leave because they also say you’re their world and they’ll hurt themselves if you go. It’s a very toxic place to be. One night I tried to end it, I was sent pictures and videos of my boyfriend at the time with his ex, them being in his room and kissing


and things like that. I could tell they were current because of items in his room and what he looked like. This girl was trying to make a point, and she did. I felt so low, alone, and confused that I took a bottle and a half of hydrocodone-acetaminophen. When I tried talking to my boyfriend about it, he just said I wanted attention, and I was like his ex, so he wasn’t going to deal with me. After that, I said my goodbyes to friends and family in text form and took all the pills. The police were called to my house by my boyfriend’s ex at that time, and one of my close friends. Why the two of them were together then, I’m not sure, that part of it always bothers me. My church Minister was called and kept me on the phone until the ambulance arrived. I had to stumble out of the house and unlock the doors for the ambulance when they came.


If you’re wondering how I was alone in a house at 17 years old, well I wasn’t. My aunt and uncle were asleep on their side of the house, as was my grandma, but she was going through chemo, so I did my best not to wake her, and my mom wasn’t home. I remember in the ambulance being so angry with everyone; I was in the ambulance feeling mad that people were going to know what I did. I remember the paramedic asking me why, and telling me that no boy is worth my life, and how stupid boys are at this age. Going through this, it didn’t feel how like I imagined it would. I just felt dizzy and couldn’t stand, I felt like my brain was foggy. That was my first and only attempt at taking my life. My attempt wasn’t out of the blue, my depression and self-harm had been known, but no steps were taken.




3:00 A.M. The clock reads 3:00 A.M. The bright red numbers

AGE 16 (F) flashing on and off the dark red glow illuminating the dark room. Her mind, still groggy and not fully awake. But then sitting up now, her mind starts to clear, “Another sleepless night.” Grabbing the cool remote and turning on the TV, the air chilly causing the blankets to slide up over her arms. The screen’s flashing on hurting her eyes, waiting for them to adjust to the bright light in the dark room. The sounds from the TV drowning out the thoughts in her mind when it starts to wander off to other places as last night plays on… but the touch of the cold brick walls brings her mind


back from going too far. Reaching out for the blanket she finds tiny wet spots. Looking around the room as if the drops are falling from the ceiling, then turning her head she hears the raspy breaths and whimpers. There she sees herself, sitting on the edge of her bed in a pair of shorts and a loose shirt hiding her figure. She’s reaching up to touch her face, and the tears fall, drip drip onto her blanket. She’s moving trying to comfort herself and wrapping her arms around her waist. Grasping the blanket waiting for her to leave, she stuffs her hand in her mouth to keep sounds from being heard and startling her. She’s hunched over, and she keeps trying to calm herself down but “it’s worthless” her mouth says, and she watches her break down. The night then becomes a blur suddenly waking up to the sunrise, wondering when her body decided to sleep finally. She walks to the restroom and suddenly there she is again, the same figure from last night. Her dark brown eyes broken


and cast downward almost as if she’s afraid of herself. Her long hair falling to her waist surrounding her small figure, enveloping her in a cocoon of dark brown and black hair. Pity and sympathy are the only things that seeing the figure brings to her. She’s broken, hurt, abused, and there’s even blood running down her hands covered with dirty bandages; as if she hurried to wrap them and couldn’t finish. Looking at her, her eyes slowly go up and evaluate the figure in front of her. She keeps her gaze on it, but then she turns around and walks away.

9:00 A.M. Everyday life is now tiring her as she tries to get past each hour. Letting her mind run wild, trying to just go each day without letting anyone know the truth. She’s been hiding it for so long, it’s causing everything to fall apart, but she doesn’t care anymore she just watches it burn. The flames are consuming everything she ever knew from her past life. That girl is back...she’s the only one that can see her and her life playing like a broken record over and over again. … Her mother hits her again for not listening, her sister bullies her, her father’s gone, no one left to protect her. Seeing her on the floor crying, slumped against her bed at night, grabbing her head pulling her hair, putting her hands over her ears to shut the noises out. Her parents fighting, yelling at each other, so frustrated with each other that they don’t bother hiding the fights anymore, leaving her to pick up the mess. They make her take sides either choose mom or dad, both of them are the worse of two evils. So



she stopped paying attention to the life she has now. She hasn’t slept in so long, every night waking up before sunrise and hoping that she can fall asleep without hearing the voices, waking her up every day her nightmares neverending since the abuse began. Her once eager eyes crushed, circles under her eyes barely noticeable but if someone took the time to see them close, they’d be able to see her brown eyes full of hurt and pain, she’s tried to get help, but no one answered. Her voice tired and unable to breathe through her sentences but since she has a smile held up by clips everyone assumes she’s okay. I can see her trying to walk, but she stumbles leaning too much to one side and then the other. Her head droops down trying to catch a flitter of sleep. She keeps others happy, so maybe one day they can do the same for


her, but it’s not the same, she doesn’t have anyone anymore. They left when the rumors started, but as soon as she sees all of this, a ringing begins in her head and memories start flooding back. She grasps her head trying to take them in one by one, but she struggles to take in long deep breaths, it’s almost non-existent. Her eyes wide as the memories hit her like a truck coming back, the girls talking about her, saying the same things to her, turning everyone against her. Crying in the lunchroom bathroom to hide from everyone, running to find someone who cared, but the pain didn’t stop it kept coming never pausing. All of a sudden it stops and as soon as it does she gets up and walks away…



“...She keeps others happy, so maybe one day they can do the same for her, but it’s not the same, she doesn’t have anyone anymore. They left when the rumors started, but as soon as she sees all of this, a ringing begins in her head and memories start flooding back....”



Growing up, I used to be a very helpful and optimistic person. I was happy with life, and with the

AGE 23 (M) friends, I had made along the way. However, I noticed things began to change when I started high school. Despite the number of new friends, I have made, I still felt alone inside. I couldn’t tell why I began feeling this way or how it started, but as times went by, it only grew worse. I slowly became quieter and less patient with everything and begin to question my purpose in life. I struggled with academics and had been called out on multiple occasions about my poor decision making. My priorities weren’t centered around my academics, all I did was “waste” my time drawing in class. I was always being compared to others on how they succeed where I had failed, or how I might be the only


person in the family not to graduate. I couldn’t live up to the expectations of what my family wanted, and I slowly grew to hate my life because of how much of a failure I am. I coped using sarcasm and humor, which would only aggravate those around me, but it would distract me well enough not to focus on the negative things in my life. At the end of it all, I decided to give up and let go of my emotions, shutting out everyone one around me and let depressions overcome my life. I thought of suicide twice during high school but settled with physical and mental self-harm. This was the time I labeled myself as the “black sheep” of my family. By the time I attended college, the depression and anxiety had overcome me. Even though all the medication, all the psychiatry, I couldn’t handle the stress of college and as a result, I was expelled twice. I was beyond upset and more embarrassed about the


fact that I am the first person in my family to flunk. I felt worthless, and as if all I contribute to my family is the shame. School was starting soon, and it was time for me to face another chapter in my life that I could ruin. All I thought about was what career could I depend on to get me financially stable in the long run. I had chosen to weld, and it wasn’t until I started that major, my life would’ve changed for the better. I enjoyed my time learning about welding and the endless possibilities I could use it for. I realized that I didn’t have to give up my life because of all the mistakes I had made, and instead rise up and become a better person than I was before. I had to live my life how I wanted not what other people wanted. I started to make a change in my life and learn to accept my faults. I am currently finishing college, I am living with someone I love, and I am surrounded by people who are willing to help me when times get tough. Of course, life still has its moments, whether it’s worrying about the bills or trying to figure out what I am going to do after school, I am glad to say that I am happy with my life and living my life how I want to. I still may consider myself a “black sheep,” but I will be a black sheep with a prosperous future. I can honestly say that I love my life and I wouldn’t change anything.











reality. My mind was static. I felt outside of my

AGE 25 (F) body. My thoughts were racing, fading in and out like my awareness of where and who I was presently. My breath was labored, and I struggled to appear “normal” - pretending to drift into the dark sky, away from what happened. I smiled back at him, “be normal,” I thought. Maybe I imagined the whole thing. Maybe, it never happened. I texted my friends, my boyfriend, staggering in and out of common words, looking for their guidance. I just needed to leave, if anything was certain. Like a dying animal, I hid under the trees by the curbside and waited for the sickness to pass (it didn’t). I was whisked away within the hour, taken home to safety. The car ride was filled with my slurring


and mumbling and shouting on repeat, “I SAID NO...No, I said... no…” Cleaned up and in bed, I tried to forget. I attempted to alter my memory before passing out to sleep. I pretended that I wanted it, that it was good. But my body knew better. The nightmares began that night. And they never let me forget.


PTSD : HAIKUS two moments after -

two weeks, haven’t slept -

no breath, static of the mind

again, I am hurt each night

air was calm, not I

cold trembles, nightmares

two minutes after -

two months, want to die -

my body did not exist

was I alive before this?

he thought it was fun

too many questions

two hours after -

today, diagnosed -

pretending I was okay

you have PTSD, cry

try to forget it

a mental illness

two days, not my best flashbacks to the past, repeat I crumble, fragile fall leaves




I’ve been dealing with mental health issues since I was in high school, that’s when I started seeing my

AGE 21 (F) first therapist at least. I’m sure I was unknowingly dealing with my problems since middle school time or even earlier most likely. I always had a wide range of issues with things like anxiety, eating issues, and problems of self-confidence and self-esteem, and a lot of them I’m still working through to this day, so I know the struggle. I will talk about how a particular problem of mine that used to affect me on a daily basis has gone down significantly. I used to have extremely bad paranoia, a perk of having the level of social anxiety I had back a few years ago. It became slowly worse and worse for me, and it would get to the point where I’d be convinced that ev-


erywhere I went, people were talking about me behind my back. I would go to places and find myself being terrified, that no matter what I did, good or bad, I thought people were talking about me behind my back. It got so bad that I’d be sitting at my desk at work, and my boss would get a phone call and close her office door, and somewhere in my mind, I’d be convinced that whoever was on the phone with her, she was talking about me. I’d be sitting there utterly terrified that I wasn’t doing the job or living up to her expectations to the point of being afraid of being fired. None of these thoughts were rational or even justified on being the truth, but my mind had convinced itself that I was such a bad worker, that all my coworkers must be talking bad about me. I hated that, I hated living in the fear that I was constantly messing up, even if I knew I hadn’t done anything. It wasn’t healthy


or productive for me, and part of me knew that, but I wasn’t able to break myself from thinking this way and suffering. I didn’t like being in a group of people and assuming every time one said something quietly to the other, that it was automatically about me. Luckily for me, at that time I had been enrolled in a more intensive therapy program at the office I go to for regular therapy because of a separate event. It was I.O. P (intensive outpatient program) where I was in a group therapy setting for three nights a week, in three-hour sessions for about 12 weeks. In there I was usually the youngest in the group, most were people late 20s and older, but we took turns talking about things that happened to us during the week and working through worksheets that gave us different DBT skills to use. Being in a group therapy setting was entirely new for me, but I found that after the first few weeks being in it, the shyness started to melt away and I felt more comfortable being there. Listening to everyone’s stories and perspectives also really helped me, as I was still convinced no one my age was dealing with similar things. It helped me see that people of all ages, even ones with families, stable jobs, and good careers have problems they deal with, some similar to mine, and others different. I felt safe in that space and knew that anything I shared wouldn’t be judged in any way, everyone understood that we all are going through hard times, and the only way to get better is with support and uplifting, not negativity. That group helped me be less shy and nervous, helped me speak up, and showed me other perspectives and stories, and it gave me tools to be able to deal with some of my problems I use to this day. One that stuck with me the most was a mindful breathing exercise that I use whenever I feel overly anxious, and it helps me to relax. I’m very thankful for being a part of I.O.P, and I worry to think of where I would have been without it, as I was going down a dark path before-hand, this helped me.






For those of us who are reading this workbook, and don’t have access to outside help, or perhaps live in an unfortunate situation where you can’t speak about your mental health freely. There are still resources out there for you to be able to find relief in a more discreet way. And while I wouldn’t say that these resources are the 100% alternative for therapy services, they definitely are a good first step towards getting the help you need. Just remember, you ARE NOT ALONE in this, and you shouldn’t ever have to feel that way. There’s help out there for anyone who seeks it.



Yes, There’s An App For That. What do you do when you can’t afford therapy but are struggling to handle your mental illness alone? You could download an app. In recent years, there’s been a proliferation of mental health apps available to smartphone users. These reasonably-priced, or most

MENTAL HEALTH APPS often free, mental health apps offer a wealth of resources that make therapeutic



techniques more accessible, portable, and

Calm App

cost-effective. Within minutes, you can


find and download a myriad of apps that

What’s Up?

incorporate proven techniques such as Cognitive Behavioral Therapy (CBT) and

Acceptance Commitment Therapy (ACT), and address everything from depression to eating disorder recovery, anxiety, bipolar disorder, obsessive-compulsive disorder, and more. While the vast majority of these apps do not have peer-reviewed Source:

research to support their claims, health experts predict that they will play an important role in the future of mental health care by providing innovative solutions for the self-management of mental health disorders.


Sometimes even just going online and doing some google searches for ‘online mental health resources’ or ‘online mental health help’ might just be the thing to find you some quick info or helpful mental exercises or answers. Now, something to remember, with all the different types of illnesses and disorders there’s just as much different types of info to go with it. It might be hard to distinguish things from each other, so just be sure to read and gather as much related information you can find about what you’re searching for. Don’t just go for the quick first answer you see, because it might not be the exact answer you needed.



Coping with a Panic Attack A panic attack is a feeling of sudden and intense anxiety. Panic attacks can also have physical symptoms, including shak-

ing, feeling disorientated, nausea, rapid, irregular heartbeats, dry mouth, breathlessness, sweating and dizziness. The symptoms of a panic attack are not dangerous, but can be very frightening. They can make you feel as though you are having a heart attack, or that you are going to collapse or even die.  Most panic attacks last somewhere from five minutes to half an hour.



Professor Paul Salkovskis, Professor of Clinical Psychology and Applied Science at the University of Bath, says it’s important not to let your fear of panic attacks control you. “Panic attacks always pass and the symptoms are not a sign of anything harmful happening,” he says. “Tell yourself that the symptoms you’re experiencing are caused by anxiety.” He says don’t look for distractions. “Ride out the attack. Try to keep doing things. If possible, don’t leave the situation until the anxiety has subsided.” “Confront your fear. If you don’t run away from it, you’re giving yourself a chance to discover that nothing’s going to happen.” As the anxiety begins to pass, start to focus on your surroundings and continue to do what you were doing before. “If you’re having a short, sudden panic attack, it can be helpful to have someone with you, reassuring you that it will pass and the symptoms are nothing to worry about,” says Salkovskis.


BREATHING EXERCISES FOR PANIC ATTACKS If you’re breathing quickly during a panic attack, doing a  breathing exercise can ease your other symptoms. Try this:

Breathe in as slowly, deeply and gently as you can, through your nose. Breathe out slowly, deeply and gently through your mouth. Some people find it helpful to count steadily from one to five on each in-breath and each out-breath. Close your eyes and focus only on your breathing for two minutes. You should start to feel better in a few minutes. You may feel tired afterwards.

WAYS TO PREVENT PANIC ATTACKS “You need to try to work out what particular  stress  you might be under that could make your symptoms worse,” says Salkovskis. “It’s important not to restrict your movements and daily activities.”

Doing breathing exercises every day will help to prevent panic attacks and relieve them when they are happening. Regular exercise, especially aerobic exercise, will help you to manage stress levels, release tension, improve your mood and boost confidence. Eat regular meals to stabilize your blood sugar levels.



Avoid caffeine, alcohol and smoking – these can make panic attacks worse. Panic support groups like No Panic have useful advice about how you can effectively manage your attacks. Knowing that other people are experiencing the same feelings can be reassuring. Cognitive behavioral therapy (CBT) can identify and change the negative thought patterns that are feeding your panic attacks.

IS IT A PANIC DISORDER? If you feel constantly stressed and anxious, particularly about when your next panic attack may be, you may have panic disorder.


People with panic disorder may avoid situations that might cause a panic attack. They may also fear and avoid public spaces (agoraphobia).



“To help ground myself and try to cope with the nigh-onset of panic, if i have something with a tactile texture I really like nearby, I close my eyes and try to memorize how it feels with my hands. Then I try holding a hot or cold beverage, or alternating them, that can also help too-- kinda weird, but, basically, whatever distracting sensory input your brain tunes into, is the best in the moment” “I focus on concrete truths and tell myself over and over, in this moment---- I am fine” “a coping method that may help is counting your fingers in the wrong order, like really focusing on it”







There are many different kinds of therapies that are available to get, talking therapies are frequently the most common types, as they are the most widely used. Talking therapies include things like psychotherapy and Cognition Behavioral Therapy, which hense the category of ‘talkning’, both include methods of using words and language to help you heal. Whereas other types of therapy like mindfulness use other kinds of techniques of being mindful with yourself to help you.



What is talking therapy? Talking therapy is a general term to describe any psychological therapy that involves talking. This includes:

Counselling Psychotherapy Cognitive behavior therapy Dialectical behavior therapy People find talking therapies useful to treat mental health or behavioral problems. Talking therapy can either be used on its own or with medication.


WHAT CAN I EXPECT FROM THERAPY? At the start of therapy, you will talk to a therapist about what your problems are. The therapist will ask you specific quetions to try and figure out your therapy needs what is blocking your recovery. These questions help your therapist come up with a treatment plan for your therapy. You and your therapist should agree: what you expect from one another, your commitment to the therapy, what you want to get out of their help, and how to end the therapy if you want to. You can go to individual one-to-one therapy or group therapy. Some therapies will be a combination of one-to-one and group sessions. The length of therapy will vary from four sessions to 18 months depending on the type of therapy.


COUNSELLING Counselling is a common therapy you can get through your GP.

Counselling is for people who are generally well but are going through a difficult time such as bereavement, relationship breakdown, redu dancy or other life changing events. Usually you can only get a cetain number of counselling sessions (6 to 12 sessions). You can expect your counsellor to help you to understand how you are feeling.

COGNITIVE BEHAVIORAL THERAPY (CBT) CBT can help you to change how you think (‘cognitive’) and what you do (‘behavior’), which are both linked to how you feel. CBT

looks at problems and difficulties in the ‘here and now’ more than your past or childhood. CBT will help you understand how you think about yourself, the world and other people and how that affects your reaction to situations. Below are some of the problems and conditions CBT is often useful for treating.

Poor Anger Control Depression Anxiety Post traumatic Stress Disorder Panic attacks Psychosis Phobias



CBT is widely available on the NHS (National Health Service). CBT should only be delivered by someone who is properly trained such as a therapist, nurse or social worker. Sessions are usually weekly and last an hour. An average number of sessions is 4 to 15 but this depends on what you need. There is more information below on the recommended number of CBT sessions.

PSYCHOTHERAPY Psychotherapy looks at how your early or past experiences

affect you now. There are different types of psychotherapy. Psychotherapy is not like counselling or CBT. Psychotherapy helps you understand you self more and is done over a longer time period. Psychotherapy can be useful for people who have a long


term or recurring problems. As you may be expected to talk about possibly difficult or u setting events you may feel psychotherapy is not suitable for you. If you are considering psychotherapy you should talk to the therapist about what to expect before you start.

DIALECTICAL BEHAVIOR THERAPY (DBT) Dialectical Behavior Therapy (DBT) is a form of talking therapy for people with borderline personality disorder and significant self-harming behavior. During DBT you learn how to control your behavior and cope with distress. You learn how to reduce harmful behaviors like

self-harm and also how to deal with relationship problems.


You would be expected to go to group sessions, one-to-one sessions, and education groups. You are offered telephone support between sessions during DBT. NICE (National Institute for Health and Care Excellence) says DBT can be helpful for people with borderline personality disorder, but your local NHS Trust may not offer it. You can contact your local PALS to find out if your local trust offers DBT.

Are There Any Risks Associated with Talking Therapy? Sometimes talking about your problems can make you feel worse before you get better. Strong feelings may come up in ther-

apy and you may feel vulnerable or angry. If you are focusing on your relationships during your therapy, this could make you feel worse about them to begin with. You may become dependent on your therapist and feel very attached to them. It is important to have a trained therapist as they will understand all of these risks. The therapist is responsible for keeping an eye on these things and making sure the therapy and you are safe. You should not feel unheard, humiliated or used during therapy se sions. It is important to remember that therapy is supposed to help you.



CAN I END THE THERAPY WHENEVER I WANT? You can choose to stop therapy if you feel that it’s not helping you or if it does’nt feel right. A good therapist will regularly check that you are getting something out of it and will suggest ending the therapy if you are not. You should trust your instincts and think about ending therapy if you continue to feel worse. It is important to tell your therapist if you want to stop therapy, so you can do this properly. If you feel a therapist has behaved inappropriately you should report them to their regulatory body. Below are some example of inappropriate behavior.


Sexual comments or behavior towards you. Offensive language or statements, can be about race, religion, gender, sexual orientation, etc. Not respecting your right to privacy. Breaking any of the rules which have been agreed at the start of therapy.








Being mindful is a great technique for those to try who enjoy using thinking and breathing methods to help you cope. It can help you become more aware of yourself, your surroundings, and your mental state, and it’s something you can do just about anywhere and by yourself.



What Is Mindfulness? Several general ideas are associated with the concept of mindfulness. Mindfulness may be fundamentally understood as the

state in which one becomes more aware of one’s physical, mental, and emotional condition in the present moment, without becoming judgmental. Individuals may be able to pay attention to a variety of experiences, such as bodily sensations, cognitions, and feelings, and accept them without being influenced by them. Mindfulness practices are believed to be able to help people better control their thoughts, rather than be controlled by them.


In addition to its increasing popularity in the physical and mental health fields, mindfulness approaches are also being utilized in several other areas: In the United States, mindfulness exercises are often employed in schools, businesses, the entertainment industry, and the military.

THE USE OF MINDFULNESS IN THERAPY In the Western world, mindfulness-based interventions are becoming widely accepted methods of addressing the symptoms associated with many commonly experienced mental health challenges and/or emotional concerns. Mindfulness approaches have their roots in ancient Buddhist traditions such as Vipassana and Zen meditations. Currently, there are four recognized therapy models that incorporate mindfulness practices


In the 1970s, Jon Kabat-Zinn, the founder of the mindfulness-based stress reduction program, was one of the first individuals to att empt to integrate Buddhist principles of mindfulness into his work in science and medicine. Also in the 1970s, Marsha Linehan developed DBT with the aid of certain Western and Eastern spiritual influences. ACT, which was introduced in the late 1980s by Steven Hayes, Kelly Wilson, and Kirk Strosahl, also incorporates Eastern ideas and techniques. At the beginning of the 21st century, Zindel Segal, Mark Williams, and John Teasdale built upon Kabat-Zinn’s work to develop MBCT.

Though these approaches all involve mindfulness techniques, there are slight differences between each modality. MBSR and MBCT actively teach mindfulness meditation, but MBCT also integrates cognitive behavioral therapy techniques as a part of treatment. DBT and ACT do not teach mindfulness mediation but instead utilize other mindfulness exercises to promote awareness and focus attention. Additionally, while MBSR and MBCT focus on the process of developing mindfulness as well as any associated thoughts, DBT and ACT focus primarily on the cognitions experienced during the state of mindfulness.



MINDFULNESS TECHNIQUES USED IN THERAPY Mindfulness-based approaches are most commonly delivered through the use of mindfulness meditation, though mindfulness may be achieved through a variety of techniques. During mind-

fulness meditation, the practitioner will typically guide the person or people in therapy to direct their focus on the present moment. The participants are trained to zone in on a particular phenomenon. If the participants become aware that their thoughts are drifting away from the present, they are encouraged to take notice of where they are and what they are doing before bringing their attention back to the present moment, without reacting or judging themselves. Therapists can help those in treatment better understand and address the emotions and


physical sensations associated with their cognitions. Many types of mindfulness mediation are practiced, in and out of clinical settings. Mindfulness meditation is a popular technique used to achieve mindfulness, but mindful-

ness can be achieved without meditation. Once the knowledge of mindfulness practices is developed, those in treatment are usually encouraged to integrate mindfulness into their daily lives, especially in non-clinical environments. Mindfulness may be especially important during emotionally overwhelming experiences, as the practice can often help individu-

als maintain a sense of control. Gentle yoga movements and sitting, walking, or mountain meditations may be used in mindfulness approaches as a way of


heightening awareness of physical sensations. Verbal cues help the person in therapy maintain awareness of movement, breathing, and sensations throughout several different exercises. Breathing

exercises, body scan meditations, and guided imagery are also often used in mindfulness approaches. Eventually, the person in therapy is encouraged to practice mindfulness in daily life. This continuation of the therapeutic process allows the individual to observe, explore, and experience mindfulness in a non-clinical environment and later examine, in session, the effects and obstacles encountered during daily life. The combined observations and examination can often become a catalyst for behavior and thought modification.

HOW CAN MINDFULNESS-BASED INTERVENTIONS HELP? Mindfulness is often incorporated into other therapeutic modalities as part of an integrated approach to treatment. Even small negative thoughts can accumulate and/or spiral out of control, leading to concerns such as depression, anxiety, and suicidal ideation. Mental health professionals have come to realize, however, that mindfulness can be of great benefit, as it can enable

people to become better able to separate themselves from negative thoughts, emotions, and bodily sensations that may be present, often before they become too overwhelming. Those who are able to achieve this state of awareness may find it easier to then implement other therapeutic strategies to address any potentially harmful cognitions in order to



ACT = Acceptance & Commitment Therapy MBCT = Mindfulness-Based


Cognitive Therapy DBT = Dialectical Behavior Therapy MBSR = Mindfulness-Based Stress Reduction


prevent negative effects. Regular mindfulness practice is believed to help further psychological insight and emotional healing, over time. Mindfulness-based interventions, generally aimed at relieving symptoms of stress, mental health concerns, and physical pain, can be used to address and treat a range of symptoms and concerns.

ACT is an approach often used in the treatment of anxiety, depression, substance dependence, chronic pain, psychosis, and cancer. MBCT often forms part of the approach to treatment of recurrent depression, anxiety, psychosis, eating and food issues, bipolar, panic attacks, attention deficit hyperactivity, and posttraumatic stress, among others. DBT is used primarily in the treatment of suicidal ideation, borderline personality, self-harm, substance dependence, eating and food issues, depression, and PTSD. Mindfulness-based stress reduction can often help people address stress, chronic pain, cancer, anxiety, depression, and other chronic issues.







10 Simple Mindful Steps Take a couple of minutes to notice your breathing. Sense the flow of the breath, the rise and fall of your belly. Notice what you are doing as you are doing it and tune into your senses. When you are eating, notice the colour, texture and taste of the food. When you are walking, tune into how your weight shifts and the sensations in the bottom of your feet. Focus less on where you are headed. Don’t feel that you need to fill up all your time with doing. Take some time to simply be.


When your mind wanders to thinking, gently bring it back to your breath. Recognize that thoughts are simply thoughts; you don’t need to believe them or react to them. Practise listening without making judgments. Notice where you tend to zone out (e.g., driving, emailing or texting, web surfing, feeding the dog, doing dishes, brushing teeth, etc.). Practise bringing more awareness to that activity. Spend time in nature. Notice how the mind likes to constantly judge. Don’t take it seriously. It’s not who you are.


last exercise 3 Minute Breathing This of Three Minute Breathing Space can be the perfect technique for those with busy lives and minds. The exercise is broken into three sections, one per minute, and works as follows: The first minute is spent on answering the question, “how am I doing right now?”, while focusing on the feelings, thoughts and sensations that arise and trying to give these words and phrases. The second minute is spent on keeping awareness on the breath. The last minute is used for an expansion of attention from solely focusing on the breath, feeling the in’s and out’s and how they affect


the rest of the body. This exercise can be rather challenging for keeping a quiet mind and often thoughts can pop up. The idea is not to block them, but rather just let them come into your mind and then disappear back out again. Try to just observe them.


Five senses Use this exercise to quickly ground yourself in the 66 present when you only have a moment. The goal is to notice something that you are currently experiencing through each of your senses.


What are 5 things you can see? Look around you and notice 5 things you hadn’t noticed before. Maybe a pattern on a wall, light reflecting from a surface, or a knick-knack in the corner of a room. What are 4 things you can feel? Maybe you can feel the pressure of your feet on the floor, your shirt resting on your shoulders, or the temperature on your skin. Pick up an object and notice its texture. What are 3 things you can hear? Notice all the background sounds you had been filtering out, such as an air-conditioning, birds chirping, or cars on a distant street. What are 2 things you can smell? Maybe you can smell flowers, coffee, or freshly cut grass. It doesn’t have to be a nice smell either: maybe there’s an overflowing trash can or sewer. What is 1 thing you can taste? Pop a piece of gum in your mouth, sip a drink, eat a snack if you have one, or simply notice how your mouth tastes. “Taste” the air to see how it feels on your tongue.

The numbers for each sense are only a guideline. Feel free to do more or less of each. Also, try this exercise while doing an activty like washing dishes, listening to music, or going for a walk.









This is the section for you to use some of the tools learned earlier in the book, and apply them for youself. Activities created to boost your self esteem and how you feel about yourself. I find it’s always good to be able to find the good in each day, even if it’s something small or not what you’d consider “worthy” it’s still worth noting. It’s always worth trying.



Even on those days when you know that nothing could have possilbly gone right for you. I’d tell you to stop, and think again, to even the smallest moment, and find the good somewhere in there.

What I Did Well DAY 1 I felt good about myself when…

Today was interesting because…

DAY 2 Something I did for someone…


Today I had fun when…

DAY 3 Something I did well today…

I was proud of someone else…

DAY 4 Today I accomplished…

A positive thing I witnessed…


DAY 5 Today I had fun when…

A positive thing I witnessed…

DAY 6 Something I did for someone…

I felt happy when...

73 DAY 7 I felt appreciated today by...

Something I did well today…

DAY 8 Something I did for someone…

I felt proud when…



Negative Thoughts

Associated Emotion When Saying Thought Aloud

Evidence That Does Not Suport The Thought

Associated Emotion When Alternative Saying Thought Thought Aloud



How Do You Feel? Through identification of negative self talk, a mind clouded with negativity can be trained to view life more obcectively, and positively. Use the worksheet to record each negative thought you have about yourself for entire day, along with how each thought made you feel. Include the trigger where you were, or what you were doing when you had


the negative thought.

Immediately challenge each thought by identifying why that thought might not be true. Armed with this evidence, record an alternative thought, say it aloud, and write down how it made you feel. Whenever you feel yourself sinking into a negative self talk mode, identify each negative thought and replace

it with a positive one right away. Continue to repeat the new thought to yourself or aloud until you begin to feel better.


Letter to your Future Self Dear




Your Future Self.


leS erutuF ruoy ot retteL As hard as it may be for you right this moment, there will honestly come a better time. You just need to try. A good first step is writing a letter to your future, happier, and healthier self about the things you hope the accomplish soon, how you hope to feel, or personal goals you want to set for yourself. Use this space to just let it all out. Go ahead, no one’s looking.



LOVE YOURSELF LISTS PART 1 A bit of a self-explanatory activity here. For someone who lives with an eating disorder, low self esteem, or body dysmorphia, you kow how hard it is to write positively about yourself. Well, now’s your chance to finally do it. Stop what you are doing and take 5 minutes to think, no writing, just think. Starting from the top of your head, moving down to your feet, pick out any/all body parts that you DON’T HATE about yourself. Not ones you love, or even like, but that you have no problem with on yourself.


Now, pick five features and write them below:


2 3




This next part I want you to continue thinking from top of the body and moving down. This time spend time time thinking about all of the genuine compliments you’ve heard in your life that made you feel good, no matter how long or brief that feeling lasted.


I could be something as little as someone complimenting your nail polish color, to someone saying you have the most beautiful eyes in the world. Take 5 minutes to think of them, without overthinking WHY it was said to you or the context. Simply take the positive words, and accept them as they were said to you.

Pick five compliments and write them below:


1 2 3 4 5


PART 3 Now that you’ve reflected on things you tolerate


about yourself and positive comments by others. It’s time to think about those two lists together. Did the lists share traits in common? For example, you listing you like your lips, and also recieving a compliment on your lips. If so, what new ideas about those body parts can you make? If you kinda like them, and someone else enjoys them, then it might be safe to assume you have nice lips. Consider these connections, or make new ones, and take 5 minutes to think, then write out a list of 10 things that you can say you enjoy about yourself.

Pick 10 features about yourself and write them to the right:


1 2 3 4 5 6


7 8 9 10








Mental Health Workbook  
Mental Health Workbook