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Subtle Signs Someone You Love May Have An Eating Disorder

Some eating disorder signs are obvious: dramatic weight loss, a refusal to eat, retreating to the bathroom for long periods after meals. But anorexia, bulimia, and binge eating disorder also reveal themselves in more subtle ways.

We’d like them to be easy to diagnose, but eating disorders are often much more complicated than that. Any given person may suffer from more than one at a time, and one list of symptoms doesn’t necessarily equal the same verdict for everyone. It’s important to keep in mind that many of the signals are less obvious than we might think. Not everyone suffering is skin and bones, haggard, and clearly starving. Because there are so many stereotypes around mental illnesses that deal with food, people who wrestle with them will do everything they can to keep it under wraps.

Changes in mood and behaviour, increased isolation and avoidance of social events and gatherings

Changes in mood and behaviour become noticeable quite early on. In an attempt to keep the eating disorder secret, the person may become more isolated and easily irritated; especially when questioned. Anxiety and Depression are very common among those with eating disorders. The person may avoid interaction with friends, especially if gatherings involve food. Hunger can make a person irritable and tired, which drastically impacts the person’s overall mood.

Increase in exercise or exercising excessively

Over-the-top workout habits—sometimes referred to as “exercise anorexia”—can go hand in hand with disordered eating and appear to be on the rise. The person may not participate in social events but will be seen running, walking or exercising. A person with an eating disorder who did not exercise before may now start to increase physical activity. A person who did partake in exercise beforehand may spend hours exercising or talking about it. Does the person panic if they miss a day of exercise? And does he or she work out even when injured or sick? These are indicators that things are going too far.

Obsession with food, diet talk, food or weight documentaries or forums about weight

This sign in adults can be tricky to spot, because internet usage is usually private. However, the person may talk about food and diet, or be the opposite and want to avoid all talk about it. Weight loss documentaries or documentaries about food can become an obsession as the person with an eating disorder becomes fixated.  The person’s internet use will often involve forums or videos related to weight and food, so keep a watchful eye out.

Not consuming food around other people

Many people with eating disorders do not like eating around other people. The anticipation of eating with a bunch of friends can be extremely anxiety-provoking for someone dealing with anorexia, BED, or any other related illness. They may not want others to watch what they’re eating or think that they are being judged on what they are eating. Does the person go out for food with you and consume very little, or order food and take it back home with them?

Always cold

People with eating disorders, especially those who restrict intake, will often experience a lowered body temperature. Frequently complaining about being cold or wearing sweaters and other heavy clothing even in mild weather are common tip-offs in people with eating disorders. This is usually a result of malnutrition and the breakdown of fat in the body. Is the person cold whilst everyone is warm? Common signs in those with eating disorders are cold hands and blue nails, a blue discoloration to the nose (cyanosis) and pale skin.

Strange eating rituals

Compulsive behaviours similar to those seen in obsessive-compulsive disorder (OCD) can also appear with eating disorders. These so-called rituals can take the form of cutting food into tiny morsels, or arranging food in certain patterns. They are mainly associated with anorexia (which often occurs alongside OCD), but they are sometimes an early sign of binge eating disorder as well. The person may revert back to ‘child like’ cutlery and plates to organise food, and food may be sectioned off so that it is not touching. When eating disorders are starting, people will try to make it look like they are eating by cutting things up and shifting food around on the plate so as not to draw attention to how little they are eating.

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Spotting the First Signs of an Eating Disorder

This week the UK’s eating disorder charity BEAT has released a poster that educates the first signs of an eating disorder. There are a range of eating disorders and these do display different symptoms, however there are some general signs that could signal a problem.

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The TOP 3 Early Signs of an Eating Disorder:

  • Food obsessions

    – Has their attitude towards food changed? Have they started measuring foods, counting calories, or cutting out foods they used to enjoy? Do they love cooking for others but don’t eat the meals themselves? They may also begin showing secretive behaviour when it comes to food or meal times. Be aware that it may look like they’re eating but they could be being secretive (such as throwing food away when you’re not looking or taking it to their room and then not eating it).

  • Distorted body image 

    – Has the person lost weight but still say they’re too fat and that they look terrible? In the first stages of an ED the person will make these commons frequently. Later, when suspicions are raised, they will start to become more quiet and withdrawn. Realise that ED thoughts occur for some time before the person loses a significant amount of weight – step in before this physical symptom.

  • The emotional roller coaster 
  • -Are they experiencing changes in their mood? Are they becoming more irritable, over sensitive, a perfectionist, compulsive, depressed, more anxious or wanting to be alone?

Other warning signs and symptoms include:

  • Constant adherence to increasingly strict diets, regardless of weight
  • Habitual trips to the bathroom immediately after eating
  • Secretly bingeing on large amounts of food
  • Hoarding large amounts of food
  • Increase in consumption of laxatives, diuretics or diet pills
  • Exercising compulsively, often several hours per day
  • Using prescription stimulant medications and/or illicit stimulant drugs to suppress appetite
  • Withdrawal from friends and family, particularly following questions about her disease or visible physical/medical side effects
  • Avoidance of meals or situations where food may be present
  • Preoccupation with weight, body size and shape, or specific aspects of one’s appearance
  • Obsessing over calorie intake and calories burned via exercise, even as one may be losing significant amounts of weight

Physical symptoms of anorexia may include:

  • Underweight, even emaciated appearance with protruding bones or a sunken appearance to the face
  • Fatigue
  • Dizziness or fainting
  • Brittle nails
  • Hair that thins, breaks or falls out
  • Menstrual irregularities or loss of menstruation (amenorrhea)
  • Baby fine hair covering face and other areas of the body (lanugo)

Emotional and behavioural signs of anorexia nervosa may include:

  • Refusal to eat
  • Denial of hunger
  • Excessive exercise
  • Eating only a few certain “safe” foods, usually those low in fat and calories
  • Adopting rigid meal or eating rituals, such as cutting food into tiny pieces or spitting food out after chewing

Symptoms of bulimia may include:

  • Abnormal bowel functioning
  • Damaged teeth and gums
  • Sores in the throat and mouth
  • Scarring on the back of the hand/fingers used to induce purging
  • Swollen salivary glands (creating “chipmunk cheeks”)
  • Menstrual irregularities or loss of menstruation (amenorrhea)
  • Irritation and inflammation of the esophagus (heartburn)

Behavioural symptoms of bulimia may include:

  • Constant dieting
  • Hiding food or food wrappers
  • Eating in secret
  • Eating to the point of discomfort or pain
  • Self-induced vomiting
  • Laxative use
  • Excessive exercise
  • Frequent bathroom trips after eating
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Psychological Consequences of ED’s

The psychological consequences of an eating disorder are complex and difficult to overcome. An eating disorder is often a symptom of a larger problem in a person’s life. The disorder is an unhealthy way for that person to cope with the painful emotions tied to the problem. For this reason, the emotional problems that triggered the eating disorder in the first place can worsen as the disorder takes hold.

An eating disorder can also cause more problems to surface in a person’s life. Eating disorders make it difficult for people to perceive things normally because certain chemical changes take place when the body is deprived of nutrients. As a result, the body relies on adrenaline (a hormone that is normally released during times of stress and fear) instead of food for energy. Adrenaline naturally makes makes someone excited, which makes it more difficult to deal with painful emotions.

Many people suffering from an eating disorder also suffer from other psychological problems. Sometimes the eating disorder causes other problems, and sometimes the problems coexist with the eating disorder. Some of the psychological disorders that can accompany an eating disorder include depression, obsessive-compulsive disorder, and anxiety and panic disorders.

In addition to having other psychological disorders, a person with an eating disorder may also engage in destructive behaviours as a result of low self-esteem. Just as an eating disorder is a negative way to cope with emotional problems, other destructive behaviours such as self-mutilation, drug addiction, and alcoholism, are similar negative coping mechanisms.

Not everyone who has an eating disorder suffers from additional psychological disorders; however, it is very common.

DEPRESSION. Depression is one of the most common psychological problems related to an eating disorder. It is characterised by intense and prolonged feelings of sadness and hopelessness. In its most serious form, depression may lead to suicide. Considering that an eating disorder is often kept a secret, a person who is suffering feels alienated and alone. A person may feel that it is impossible to openly express her feelings. As a result, feelings of depression will worsen the effects of an eating disorder, making it difficult to break the cycle of disordered eating.

Feelings of depression will worsen the effects of an eating disorder, making it difficult to break the cycle of disordered eating.

OBSESSIVE-COMPULSIVE BEHAVIOUR. Obsessions are constant thoughts that produce anxiety and stress. Compulsions are irrational behaviours that are repeated to reduce anxiety and stress. People with eating disorders are constantly thinking about food, calories, eating, and weight. As a result, they show signs of obsessive-compulsive behaviour. If people with eating disorders also show signs of obsessive-compulsive behaviour with things not related to food, they may be diagnosed with Obsessive-Compulsive Disorder (OCD).

Some obsessive-compulsive behaviours practised by eating disorder sufferers include storing large amounts of food, collecting recipes, weighing themselves several times a day, and thinking constantly about the food they feel they should not eat. These obsessive thoughts and rituals worsen when the body is regularly deprived of food. Being in a state of starvation causes people to become so preoccupied with everything they have denied themselves that they think of little else.

FEELINGS OF ANXIETY, GUILT, AND SHAME. Everyone experiences feelings of anxiety (fear and worry), guilt, and shame at some time; however, these feelings become more intense with the onset of an eating disorder. Eating disorder sufferers fear that others will discover their illness. There is also a tremendous fear of gaining weight.

As the eating disorder progresses, body image becomes more distorted and the eating disorder becomes all-consuming. Some sufferers are often terrified of letting go of the illness, which causes many to protect their secret eating disorder even more.

Eating disorder sufferers have a strong need to control their environment and will avoid social situations where they may have to be around food in front of other people or where they may have to change their behaviour. The anxiety that results causes people with eating disorders to be inflexible and rigid with their emotions.

SYMPTOMS OF AN EATING DISORDER

  • missing meals
  • complaining of being fat, even though they have a normal weight or are underweight
  • repeatedly weighing themselves and looking at themselves in the mirror
  • making repeated claims that they’ve already eaten, or they’ll shortly be going out to eat somewhere else and avoiding eating at home
  • becoming irritable or angry when food is mentioned to them
  • missing meals, eating very little, or avoiding eating any fatty foods
  • obsessively counting calories in food
  • leaving the table immediately after eating so they can vomit
  • taking appetite suppressants, laxatives, or diuretics (a type of medication that helps remove fluid from the body)
  • physical problems, such as feeling lightheaded or dizzy, dehydration, low potassium levels and/or dry skin
  • cooking big or complicated meals for other people, but eating little or none of the food themselves
  • only eating certain low-calorie foods in your presence, such as lettuce or celery
  • feeling uncomfortable or refusing to eat in public places, such as at a restaurant
  • the use of “pro-anorexia” websites

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Inside Anorexia Nervosa

A lot of people wish that they looked different or could change something about themselves, but when a preoccupation with becoming thin takes over thoughts, life and eating habits, its a sign of an eating disorder

Anorexia Nervosa is a serious, life threatening eating disorder that affects women and men of all ages. Anorexia Nervosa has three main features; the refusal to maintain a healthy body weight, an intense fear of weight gain and a distorted body image. Eating and mealtimes can be severely stressful for someone with Anorexia but yet food occupies almost every thought. Thoughts about dieting, food, exercise, calories and your body often take up the entire day which means there is a little or no time for friends, families and other activities once enjoyed. Life becomes a relentless pursuit of thinness and perfection. In the purge sub-type of anorexia, weight loss is achieved by vomiting or using laxatives and diuretics.

Anorexia Nervosa is actually not about food or weight! At least not at the core. Eating Disorders are complicated and food and weight issues are usually symptoms of something deeper including but not excluding depression, loneliness, insecurity, pressure to be perfect and feeling out of control.

A lot of people with Anorexia feel powerless in many aspects of life but in control when it comes to food. Saying no to hunger, controlling numbers on scales and calories can make a person feel strong and successful for a short period of time. People with Anorexia often strive off hunger pains or noises.

Living with anorexia means constantly hiding habits. This makes it hard at first for friends and family to spot the warning signs. When confronted, a person with Anorexia might try to explain away disordered eating and wave away concerns. But as Anorexia progresses, people close to the person wont be able to deny their instincts that something is wrong. As anorexia develops, a person become increasingly preoccupied with the number on the scale, how they look in the mirror, and what they can and can’t eat.

Anorexic food behaviour signs and symptoms

  • Dieting despite being thin – Following a severely restricted diet. Eating only certain low-calorie foods. Banning “bad” foods such as carbohydrates and fats.
    Obsession with calories, fat grams, and nutrition – Reading food labels, measuring and weighing portions, keeping a food diary, reading diet books.
    Pretending to eat or lying about eating – Hiding, playing with, or throwing away food to avoid eating. Making excuses to get out of meals (“I had a huge lunch” or “My stomach isn’t feeling good”).
    Preoccupation with food – Constantly thinking about food. Cooking for others, collecting recipes, reading food magazines, or making meal plans while eating very little.
    Strange or secretive food rituals – Refusing to eat around others or in public places. Eating in rigid, ritualistic ways (e.g. cutting food “just so,” chewing food and spitting it out, using a specific plate).

Anorexic appearance and body image signs and symptoms

  • Dramatic weight loss – Rapid, drastic weight loss with no medical cause.
    Feeling fat, despite being underweight – may feel overweight in general or just “too fat” in certain places, such as the stomach, hips, or thighs.
    Fixation on body image – Obsessed with weight, body shape, or clothing size. Frequent weigh-ins and concern over tiny fluctuations in weight.
    Harshly critical of appearance – Spending a lot of time in front of the mirror checking for flaws. There’s always something to criticize. Never thin enough.

Purging signs and symptoms

Some people with Anorexia Nervosa often use purging as a way to get rid of calories. The difference to those with Bulimia is that when a person with Anorexia purges, they have not binged but consumed little calories.

  • Using diet pills, laxatives, or diuretics – Abusing water pills, herbal appetite suppressants, prescription stimulants, ipecac syrup, and other drugs for weight loss.
    Throwing up after eating – Frequently disappearing after meals or going to the bathroom. May run the water to disguise sounds of vomiting or reappear smelling like mouthwash or mints.
    Compulsive exercising – Following a punishing exercise regimen aimed at burning calories. Exercising through injuries, illness, and bad weather. Working out extra hard after binging or eating something “bad.”

People with anorexia are often perfectionists and overachievers. They’re the “good” daughters and sons who do what they’re told, excel in everything they do, and focus on pleasing others. But while they may appear to have it all together, inside they feel helpless, inadequate, and worthless. Through their harshly critical lens, if they’re not perfect, they’re a total failure. In addition to the cultural pressure to be thin, there are other family and social pressures that can contribute to anorexia. This includes participation in an activity that demands slenderness, such as ballet, gymnastics, or modelling. It also includes having parents who are overly controlling, put a lot of emphasis on looks, diet themselves, or criticize their children’s bodies and appearance. Stressful life events—such as the onset of puberty, a breakup, or going away to school/university, rape, abuse, family dysfunction—can also trigger anorexia. Research suggests that a genetic predisposition to anorexia may run in families. If a girl has a sibling with anorexia, she is 10 to 20 times more likely than the general population to develop anorexia herself. Brain chemistry also plays a significant role. People with anorexia tend to have high levels of cortisol, the brain hormone most related to stress, and decreased levels of serotonin and norepinephrine, which are associated with feelings of well-being.

The effects of Anorexia Nervosa

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Tips for helping a person with anorexia

Think of yourself as an “outsider.” In other words, someone not suffering from anorexia. In this position, there isn’t a lot you can do to “solve” your loved one’s anorexia. It is ultimately the individual’s choice to decide when they are ready.
Be a role model for healthy eating, exercising, and body image. Don’t make negative comments about your own body or anyone else’s.
Take care of yourself. Seek advice from a health professional, even if your friend or family member won’t. And you can bring others—from peers to parents—into the circle of support.
Don’t act like the food police. A person with anorexia needs compassion and support, not an authority figure standing over the table with a calorie counter.
Avoid threats, scare tactics, angry outbursts, and put-downs. Bear in mind that anorexia is often a symptom of extreme emotional distress and develops out of an attempt to manage emotional pain, stress, and/or self-hate. Negative communication, threats to tell, tactics meant to scare such as “you’re going to die”, or isolating the person often makes things worse.

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Suicide Awareness

I agree that suicide is complex. It usually occurs gradually, progressing from suicidal thoughts, to planning, to attempting suicide and finally dying by suicide. The attitude towards suicide however always amazes me. One person dies every 40 seconds by suicide worldwide – that is an estimate of 1440 deaths by suicide a day! By 2020, the rate of death will increase to every 20 seconds. 2880 people will be dying of suicide a day… How can there be such a negative stigma surrounding suicide when it claims so many lives in simply a day? Suicide has now become one of the three leading causes of death among those aged between 15-44.

 More than 4,000 children under the age of 14 tried to take their own lives in the UK in the year 2007.

During my first suicide attempt at the age of 11, I didn’t have any suicide ideation. I had been bullied for months, probably over a year, and although I felt quite down and isolated, I didn’t feel as though I wanted to die. It was only when I was on a ski holiday with my bullies that things started to turn bad. I was sat on a ski lift with two of the people who had bullied me, and of course there was no escape. The taunting, the physical abuse, the laughter…it was all too much. My suicide ideation happened in a blink of an eye. One minute I was feeling angry at these people for being so mean and the next minute I was lifting up the bar of the ski lift ready to jump. At 11 years old, that’s a pretty scary thing to experience. I can’t remember if I knew about suicide before this attempt…or whether my mind somehow knew what to do. All I knew is that I was trapped and that was the only way of escape.

After that first attempt, suicide ideation has never gone away. Thinking about suicide became a daily task some months, but other months I wouldn’t think about it at all. As I’ve gotten older, the suicidal thoughts have become more frequent. It’s difficult, because suicide should not be ignored. Suicide should not receive negative reaction. A child – or even an adult – should be able to approach someone confidently and tell them they are thinking about suicide. Why are suicidal thoughts downplayed? The time I told my doctor I was feeling suicidal was unreal…her response? “We haven’t got any appointments for another 3 weeks.” I know that you cannot see suicidal thoughts, but they are just as serious as a broken leg.

It can be very difficult and daunting to reach out and ask for help when it comes to suicide ideation…it can be even more difficult when a loved one or someone you know unexpectedly takes their own life. That is why I’d like to educate you on the signs and symptoms of suicide, so that help can be spread to all those suffering.


Warning signs:

A person may be at risk of attempting suicide if they:

  • complain of feelings of hopelessness
  • have episodes of sudden rage and anger
  • act recklessly and engage in risky activities with an apparent lack of concern about the consequences
  • talk about feeling trapped, such as saying they can’t see any way out of their current situation
  • Self harm – including misusing drugs or alcohol, or using more than they usually do
  • noticeably gain or lose weight due to a change in their appetite
  • become increasingly withdrawn from friends, family and society in general
  • appear anxious and agitated
  • are unable to sleep or they sleep all the time
  • have sudden mood swings – a sudden lift in mood after a period of depression could indicate they have made the decision to attempt suicide
  • talk and act in a way that suggests their life has no sense of purpose
  • lose interest in most things, including their appearance
  • put their affairs in order, such as sorting out possessions or making a will

If you notice any of these warning signs in a friend, relative or loved one, encourage them to talk about how they are feeling.

Also share your concerns with your doctor or a member of their care team, if they are being treated for a mental health condition.


Offering support to someone who’s feeling suicidal

One of the best things you can do if you think someone may be feeling suicidal is to encourage them to talk about their feelings and to listen to what they say.

Talking about someone’s problems is not always easy and it may be tempting to try to provide a solution. But often the most important thing you can do to help is listen to what they have to say.

If there is an immediate danger, make sure they are not left on their own.

Do not judge

It’s also important not to make judgements about how a person is thinking and behaving. You may feel that certain aspects of their thinking and behaviour are making their problems worse. For example, they may be drinking too much alcohol.

However, pointing this out will not be particularly helpful to them. Reassurance, respect and support can help someone during these difficult periods.

Asking questions

Asking questions can be a useful way of letting a person remain in control while allowing them to talk about how they’re feeling. Try not to influence what the person says, but give them the opportunity to talk honestly and openly.

Open ended questions such as “Where did that happen?” and “How did that feel?” will encourage them to talk. It’s best to avoid statements that could possibly end the conversation, such as “I know how you feel” and “Try not to worry about it”.

Getting professional help

Although talking to someone about their feelings can help them feel safe and secure, these feelings may not last. It will probably require long-term support to help someone overcome their suicidal thoughts.

This will most likely be easier with professional help. Not only can a professional help deal with the underlying issues behind someone’s suicidal thoughts, they can also offer advice and support for yourself.


Suicide is a permanent solution to a temporary problem.

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The warning signs of Mental Illness

There are over 200 classified forms of mental illness so its clearly very important to be aware of the warning signs. Mental Illness has no clear victim. It affects people of all ages, young and old, of all races and cultures and from all walks of life. Mental illness, like physical illnesses, is on a continuum of severity ranging from mild to moderate to severe.  More than 7 million people from the UK have a mental illness in any given year.  Mental illness affects one in four adults and one in five children. Very few people, however actually seek treatment for mental illness. Many aren’t even aware of the different types of mental health problems and struggle to spot the signs.

So what ARE the warning signs of mental illness?

In an adult:

  • Marked personality change
  • Inability to cope with problems and daily activities
  • Drop in functioning – an unusual drop in functioning, at school, work or social activities, such as quitting sports, failing in school or difficulty performing familiar tasks
  • Strange or grandiose ideas (impulsive, boastful, exaggerated, dreams and fantasies)
  • Excessive anxieties
  • Neurotic or repetitive behaviour (rocking, biting, hitting, head banging, pinching)
  • Prolonged depression and apathy
  • Marked changes in eating or sleeping patterns
  • Extreme highs and lows
  • Heightened sensitivity to sights, sounds, smells or touch; avoidance of over-stimulating situations
  • jumpy/nervous behaviour, easily startled
  • problems with concentration, memory and speech
  • disconnected from self or surroundings
  • withdrawal and a lack of interaction with others
  • Abuse of alcohol or drugs
  • Excessive anger, hostility, or violent behaviour

A person who is thinking or talking about suicide or homicide should seek help immediately.

In a child:

Having only one or two of the problems listed below is not necessarily cause for alarm. They may simply indicate that a practical solution is called for, such as more consistent discipline or a visit with the child’s teachers to see whether there is anything out of the ordinary going on at school. A combination of symptoms, however, is a signal for professional intervention.

  • The child seems overwhelmed and troubled by his or her feelings, unable to cope with them
  • The child cries a lot
  • The child frequently asks or hints for help
  • The child seems constantly preoccupied, worried, anxious, and intense. Some children develop a fear of a variety of things–rain, barking dogs, burglars, their parents’ getting killed when out of sight, and so on–while other children simply wear their anxiety on their faces.
  • The child has fears or phobias that are unreasonable or interfere with normal activities.
  • The child can’t seem to concentrate on school work and other age-appropriate tasks.
  • The child’s school performance declines and doesn’t pick up again.
  • The child loses interest in playing.
  • The child tries to stimulate himself or herself in various ways. Examples of this kind of behaviour include excessive thumb sucking or hair pulling, rocking of the body, head banging to the point of hurting himself, and masturbating often or in public.
  • The child isolates himself or herself from other people.
  • The child regularly talks about death and dying.
  • The child appears to have low self-esteem and little self-confidence. Over and over the child may make such comments as: “I can’t do anything right.” “I’m so stupid.” “I don’t see why anyone would love me.” “I know you [or someone else] hates me.” “Nobody likes me.” “I’m ugly. . . too big. . . too small. . . too fat. . . too skinny. . . too tall. . . too short, etc.”
  • Sleep difficulties don’t appear to be resolving. They include refusing to be separated from one or both parents at bedtime, inability to sleep, sleeping too much, sleeping on the parent’s or parents’ bed, nightmares, and night terrors.

If you spot any of these warning signs in yourself or in another person please speak concerns to a health professional such as a GP or a charity that can help with advice such as childline or samaritans.

For more information on mental illness:

Mind

Rethink

NHS

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