Schools

Still/Falling Study Guide

INTRODUCTION TO STUDY GUIDE

This study guide was written for Green Thumb Theatre by Cathryn McPhee (Med in Health Education and Active Living). The resources and curriculum connections were adapted by Lois Adamson to suit an Ontario context.

Green Thumb recognizes how important discussions around mental health are in order to de-stigmatize mental illness and engage youth in conversations about their own mental health and self-care. Green Thumb also recognizes and values the role that teachers play in positively influencing youth development, and how they can be front line interveners and supports to youth who may be struggling with mental health concerns. To create this educational guide, mental health professionals and teachers were consulted and information from websites providing current, credible and respected mental health and educational peer-reviewed research was used. Subject areas are explored that may inspire viewers, while furthering knowledge and facilitating dialogue about mental health after watching the production of Still/Falling.

If you wish to create your own lesson plan from the study guide copy, we have created a lesson plan template for your use. We hope you will find this guide to be a useful resource. Should you have any questions or feedback or have inquiries about the use of this guide (which is copyright protected), please feel free to contact Lois Adamson, Interim Artistic Associate, Education at ladamson@youngpeoplestheatre.org.

CURRICULUM CONNECTIONS

  • The Arts (Drama)
  • Health and Physical Education (Focus on Personal Safety and Injury Prevention)
  • Social Sciences and Humanities

CHARACTER EDUCATION CONNECTIONS

  • Perseverance
  • Honesty
  • Empathy
  • Responsibility

THEMES

  • Identifying the Need for Help
  • Healthy Management of Stress and Anxiety
  • Combating Stigmas Around Mental Health

CURRICULUM EXPECTATIONS

This study guide responds directly to the following curriculum expectations as outlined by the Ontario Ministry of Education. By participating in the pre-show and post-show discussion questions and exercises, students will:

  • explain the connection between adolescents’ developmental needs and their individual behaviour;
  • identify resources within their community that are available to support the needs of individuals and families;
  • identify strategies and resources that individuals can use to improve and/or maintain their personal health and well-being;
  • analyse how both social awareness and physical, psychological, and emotional health affect people’s relationships;
  • identify warning signs and symptoms that could be related to mental health concerns (e.g., inability to cope with stress; feelings of sadness, anxiety, hopelessness, or worthlessness; negative thoughts about oneself, others, and the future; thoughts of suicide), and describe a variety of strategies for coping with or responding to mental health concerns affecting oneself or others (e.g., stress and mood management techniques, identifying ways to seek help for oneself or a friend/ classmate, supporting others who are struggling with their emotional well-being);
  • use self-awareness and self-monitoring skills to help them understand their strengths and needs, recognize sources of stress, take responsibility for their actions, and monitor their own progress as they participate in physical activities, develop movement competence, and ac¬quire knowledge and skills related to healthy living;
  • use a range of critical and creative thinking skills and processes to assist them in making connections, planning and setting goals, analyzing and solving problems, making decisions, and evaluating their choices in connection with learning in health and physical education;
  • demonstrate an understanding of factors that enhance mental health and emotional and spiritual well-being;
  • interpret short drama works and identify and explain their personal response to the works;
  • explain how dramatic exploration can contribute to personal growth and self-understanding; and
  • identify ways in which drama can influence personal growth, relationships with others, and aesthetic judgement.

SYNOPSIS

Nina has a great life. She loves her family, she does well in school, and her friends are awesome. But suddenly Nina starts feeling… off, and she finds herself slipping into a dark reality she cannot understand, let alone articulate to the people around her. Still/Falling follows Nina as she tries to come to terms with what it means to struggle with anxiety and depression, and to rise above it with as much strength, and as few scars, as possible. A realistic, honest and bitingly funny look at the difference between ‘teen angst’ and mental illness and the ways vulnerable kids can start to find their way out of the dark.

CONTENT ADVISORY

The content of this play may prove to be an intense experience for some viewers. The main character’s portrayal is an honest, open and candid representation of a teen with anxiety, depression, and displaying non-suicidal self-harm. It is advised that all Teachers, School Counselors, School Psychologists and Administration be informed about the nature of this play, and be aware that some scenes may be emotionally triggering to some students. It is advised that students should be made aware of the play’s themes prior to viewing.

The pre and post performance discussion questions and exercises will be valuable to support students’ immediate and long-term well being and self-care. It is strongly recommended that Teachers allot some class time for the students to discuss the themes and topics of the play after viewing, either informally, or formally with the exercises and activities provided in this guide.

Schools should be ready to deal with various reactions and questions from the students. It is our hope that this play will encourage youth in crisis to reach out for help, and therefore Teachers, Counselors and in-school Mental Health Teams should be prepared to debrief and deal with possible disclosures from at-risk students in the days and weeks following the performance.

ABOUT ANXIETY AND DEPRESSION

Anxiety affects our thoughts, body, and behaviour. It is:

  • our body’s reaction to perceived danger or important events.
  • something that everyone experiences from time to time.

Too much anxiety can:

  • prevent you from engaging in age-appropriate activities.
  • prevent you from meeting expected developmental milestones.

Common examples of interference and disruption include:

  • Academic failure
  • Keeping isolated or failure to join in and make friends
  • Refusal to go on school field trips
  • Resisting participating in new activities or trying new things
  • School refusal

“It started as anxiety, it moved to full depression… I started to disengage from friends, family, society in general…”
http://www.cbc.ca/news/canada/british-columbia/age-of-anxiety-panel-1.3255344

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems.

Self-injury, or self-harm, is the deliberate and direct destruction of one’s body tissue without suicidal intent.

WHY THIS PLAY?

Green Thumb Theatre chose to produce Still/Falling to encourage conversation and awareness and to help students gain a deeper understanding of mental health, and especially how it can affect themselves and their peers.

Green Thumb Theatre creates and produces plays that explore social issues relevant to the lives of children, youth and young adults. We provide theatre that celebrates the language and stories of today’s generation and culture to stimulate empathy, debate and critical thinking.

As with all of our plays, we challenge our audiences to re-examine their beliefs and prejudices and to define their feelings and aspirations.

ABOUT THE PLAYWRIGHT

Rachel Aberle, Playwright, Still/Falling

Rachel is an actor, writer and arts administrator who lives and works in Vancouver, British Columbia. A graduate of Studio 58’s Theatre Performance program at Langara College, Rachel has performed with companies throughout British Columbia and across Western Canada. Favourite stage credits include Souvenirs with Green Thumb Theatre, in which she made her professional theatre debut playing Maggie, a teenager reconnecting with her estranged father; Chelsea Hotel with the Firehall Arts Centre, which saw her singing, dancing and playing the cello, electric bass, piano and ukulele, and toured to 13 different cities; and Old Nick and In Like A Lion for the Caravan Farm Theatre – because living and working at a theatre that feeds you incredible meals and lets you play with horses can’t be beat. Off-stage, Rachel also works as a voice-over artist and playwright, and more recently joined the team at Green Thumb Theatre as the Community Engagement and Development Coordinator. Having made her professional acting debut with the company several years ago, making her administrative debut there seems like a natural fit.

“Be patient with yourself .”

–  Rachel Aberle

A note from the Playwright

Being a teenager is hard. Your body is changing, your hormones are all over the map – and this affects your mood. It can make what could seem like a small crisis to someone else seem like the end of the world to you. It can make you angry. It can make you sad. It can make you anxious.

These are all statements that are true to a degree, and all statements I heard a number of times when I was a teenager. I heard some version of these statements from my parents, from my teachers. My friends and I repeated these phrases to each other as well in times of stress. I repeated these phrases to myself, increasingly, as my mood went from bad to worse over my grade 12 year. I blamed my age bracket for my increasing anxiety and sadness, trying to chalk up the emotional turmoil I was dealing with to being a typical teenage phase.

By the time I received help, I was at a point of crisis. It took me a long time to ask for help with my mental health, and even longer for people to really hear me when I asked. Conversations around mental health were nowhere near as common as they are today. People – including myself – were much quicker to jump to the narrative of a typical teenage fluctuation in hormones than to dig deeper and question whether what was happening to me might require more attention and more targeted help.

My intent in creating this piece was to normalize conversations around mental health, and to offer avenues for youth and young adults to connect with one another on these topics, and encourage conversation with the adults in their lives as well. I hope that teenagers who see Still/Falling will take away that drowning in emotional distress is NOT what a normal teenage experience has to look like, and that they will learn to ask for help early and often if they are feeling overwhelmed. I hope too that both the students and educators who see Still/Falling will begin to look out for the kinds of signposts that can be indicators of mental illness. As we begin to acknowledge how common mental illness is, I hope that as a community we can begin to look out for each other, and create positive space for people who are struggling.

And to anyone out there who sees this play who is suffering; who has reached, or is close to reaching a point of crisis, I hope this play can let them know that they are not alone. Ask for the help you need – it is out there, and it does make a difference. And as you embark on a path towards recovery, be patient with yourself. Be patient, and be kind.

– Rachel Aberle

GLOSSARY

ANXIETY
Anxiety is part of our internal warning system; it is the fear or worry and physical changes in our body that we feel when we feel something bad might be about to happen. Everyone feels anxious at times, but too much anxiety can interfere with school, work, home-life and relationships.

ANXIETY PROBLEM OR ANXIETY DISORDER
Anxiety is normal but it can become a problem when it becomes intense or continual, and makes it harder for you to do the things you want to do. If it causes enough problems, it may be considered within a group of mental illnesses called anxiety disorders. Anxiety disorders can take many different forms; two of the most common forms are social anxiety and panic disorder. Anxiety disorders are very treatable.

COUNSELLING
It’s useful to talk to someone about any problem – some people find that simply talking with friends or family can help them feel better. A counsellor can offer more: they have training, experience, and emotional distance (since they don’t know you). They use different theories to listen to you and support you, and they have expertise to approach different problems or patterns to manage your distress.

DEPRESSION
Feeling sad or low from time to time is a part of life, but a persistent low mood could be a sign of depression. For some people, depression makes them irritable or causes them to act out against others. Depression becomes a problem when the feelings don’t go away, as well as if they intensify or begin to interfere with school, work, family and friends, in your daily life. Depression is also a treatable disorder.

Sometimes people who develop depression may also have a history with an anxiety disorder. There is no evidence one disorder causes the other, but there is clear evidence that many people suffer from both disorders.

MENTAL HEALTH
Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.

MENTAL ILLNESS
Mental illnesses can take many forms, just as physical illnesses do. Mental illnesses are characterized by alterations in thinking, mood or behaviour associated with significant distress and impaired functioning.

PANIC ATTACK
A sudden rush of intense fear or discomfort, which includes at least 4 of the following symptoms: racing or pounding heart, sweating, shaking or trembling, shortness of breath or feelings of being smothered, feeling of choking, chest pain or discomfort, chills or hot flashes, nausea or upset stomach, dizziness or lightheadedness, a sense of things being unreal or feelingm detached from oneself, numbness or tingling sensations, fear of losing control or “going crazy”, and fear of dying. Panic attacks tend to start quickly and reach a peak within 10 minutes. The peak generally lasts for about 5 to 10 minutes before the symptoms start to settle; however, it can take quite some time for all the symptoms to subside.

PANIC DISORDER
People with panic disorder experience unexpected and repeated panic attacks. They can become terrified that they may have more attacks and fear that something bad will happen because of the panic attack (such as going crazy, losing control or dying).

SELF-CARE
Any intentional actions you take to care for your physical, mental and emotional health.

SELF HARM / INJURY
Self-injury means that someone hurts themselves on purpose but doesn’t, intend to end their life. Common acts of self-injury include cutting skin and burning skin. Self-injury itself isn’t a mental illness, but may be a sign that someone needs care and support. People who self-injure are not trying to end their lives, but they can experience those thoughts. When they self-injure, they are trying to cope with difficult or overwhelming thoughts or feelings.

SOCIAL INCLUSION
This means feeling you belong, are valued and respected and able to take part in your community and benefit equally from what your community has to offer.

STIGMA
A set of negative and often unfair beliefs that a society or group of people have about something and the shame that a person carries as a result of being associated with it.

STRESS
A state of mental or emotional strain or tension resulting from adverse or very demanding circumstances; a state of mental, emotional or physical strain when the demands placed on you are more than you can cope with.

SUICIDE
The deliberate taking of one’s own life is the second leading cause of death among young people in Canada. Suicide and motor vehicle accidents account for almost sixty percent of youth deaths. This figure is not just relevant in Canada – globally, suicide is among the top three causes of death among young people (aged 15 to 34). Suicide itself is not a mental disorder, but one of the most important causes of suicide is mental illness.

SUICIDE IDEATION
Having thoughts about how to kill oneself, which can range from a detailed plan to a fleeting consideration and does not include the final act of killing oneself. The majority of people who experience suicide ideation do not carry it through.

Sources:
http://www.anxietybc.com/parent/panic.php
http://teenmentalhealth.org
https://www.porticonetwork.ca
http://www.heretohelp.bc.ca/ask-us/whats-the-difference-between-psychotherapy-and-counselling#sthash.DN9KKRGO.dpuf
http://www.cmha.ca/mental_health/youth-and-self-injury

Pre-Show Questions

  1. How do you define mental illness?
  2. When you picture someone who’s mentally ill, what do you see?
  3. What things at school or home are sources of stress/pressure?
  4. Brainstorm some of the pressures of being a teenager.
  5. How do students typically cope with these stresses?
  6. Do you know of anyone who has experienced mental illness?

Suggested pre-performance videos:

  1. Millie – Most likely to panic
  2. The Science of Depression
  3. Mental Health Awareness

”It’s only a period which will pass and I’ll help you get out of it.”

http://depressionteenshelp.com/teenagers-and-depression/

What to Consider While Watching

  1. Is this portrayal reinforcing the myths about mental illnesses, or does it address these myths or highlight a new way of understanding mental illness?
  2. What is the difference between feeling blue and being depressed?
  3. How would you want to be treated if you developed or were struggling with mental illness?
  4. What does this mean to you: ‘There is no health without mental health.’

Post-Show Questions

  1. What kinds of support did Nina seek out for her mental health problems, if any?
  2. What do you think would have happened if Nina had let her parents or her friends know earlier how she was feeling and what she was experiencing?
  3. How did Nina’s family/friends respond to her mental health problems? Were they helpful?
  4. What if you were Nina’s friend and she told you what was going on and how she was feeling, how would you respond?
  5. Is anxiety a sign of weakness? Is Depression? Define Courage.

ACTIVITY ONE

Mental Illness – True or False

Below are some common statements about mental illness and suicide. Read them aloud to your students and have them identify if they are True or False.

Mental illnesses aren’t real illnesses.
FALSE – Mental illnesses create distress, don’t go away on their own, and are real health problems with effective treatments. When someone breaks their arm, we wouldn’t expect them to just “get over it.” Nor would we blame them if they needed a cast, sling, or other help in their daily life while they recovered.

Mental illnesses don’t affect very many people.
FALSE – All of us will be affected by mental illnesses. Researchers estimate that as many as one in five Canadians will experience a mental illness at some point in their life. You may not experience a mental illness yourself, but it’s very likely that a family member, friend, or co-worker will experience challenges.

Telling yourself to “relax” is a very effective way to deal with anxiety.
FALSE – When you struggle with anxiety, it’s not as simple as just telling yourself to “relax.” Most people have to learn some new coping strategies to help them better deal with anxiety. The good news is that there is help available.

If you have a mental illness you will never recover.
FALSE – People can and do recover from mental illnesses. Today, there are many different kinds of treatments, services, and supports that can help. No one should expect to feel unwell forever. The fact is, people who experience mental illnesses can and do lead productive, engaged lives.

Half of all lifetime cases of mental illness begin by age 14.
TRUE – Mental health illnesses are the most prevalent of all health issues amongst children, adolescents, and young adults, and are much more likely to disrupt young people’s lives than physical ailments. Early identification and linking young people with resources to strengthen their mental health is key to reducing the burden of mental illnesses. Like any health issue, we are better equipped if we are able to recognize the signs and symptoms early. Early recognition and appropriate help seeking can happen only if young people know about the early changes that may indicate a mental health issue, the types of help available and how to access this help.

Only ‘emos’ self-harm, it’s part of modern-day youth culture.
FALSE – There’s no such thing as a typical person who self-harms. It can affect anyone of any age, background or race, and regardless of whether they are an extrovert or an introvert.

People who experience mental illnesses are weak and can’t handle stress.
FALSE – Stress impacts well-being, but this is true for everyone. Sometimes people who have experienced mental illnesses may gain tools that actually aid them with managing stress. Many people who experience mental illnesses learn skills like stress management and problem-solving so they can take care of stress before it affects their well-being. Taking care of yourself and asking for help when you need it are signs of strength, not weakness.

Anxiety problems are common.
TRUE – Anxiety problems are the most common mental health problem. In fact, approximately 1 in 4 teens will experience some type of problem with anxiety at some point. If you struggle with anxiety, you are not alone!

Kids can’t have a mental illness like depression. Those are adult problems.
FALSE – Even children can experience mental illnesses. In fact, many mental illnesses first appear when a person is young. Mental illnesses may look different in children than in adults, but they are a real concern. Mental illnesses can impact the way young people learn and build skills, which can lead to challenges in the future. Unfortunately, many children don’t receive the help they need.

People who attempt suicide are just looking for attention.
FALSE – A suicide attempt is often the critical event that leads a deeply distressed person to a first contact with a helping professional such as physician or psychologist. An attempt at suicide is a desperate cry for help – this is not an action that should be classified as attention seeking behaviour.


Talking to someone about whether or not they are suicidal will make their suicidal symptoms worse.
FALSE – Asking someone if they have thoughts of suicide will not put the idea in their head if they are not suicidal. If they are having suicidal thoughts, knowing that you are concerned enough about them to ask may give them the courage to ask for help.

Sources:
https://www.cmha.ca/mental_health/myths-about-mental-illness/#.Vg7jr0udBuY
http://teenmentalhealth.org/learn/suicide/
http://www.anxietybc.com/parent/panic.php
http://www.samaritans.org/sites/default/files/kcfinder/files/deal/dealing-with-feelings/07-self-harm-myths-and-facts/Handout%20-%20myths%20and%20facts.pdf

ACTIVITY TWO

Wipe Out Stigma

It is well recognized that teens and young adults resist seeking help due in part to misinformation and stigma attached to mental illness. In this activity, have students research anxiety disorders and depression, and then identify and dispel the myths still attached to these mental illnesses.

Create public awareness posters/graphics that debunk common myths about mental illness.

Materials:

  • Markers, poster board, magazines, scissors
  • Computer with Internet access /Smart phones

Help students in your school understand depression and anxiety by getting together in small groups and create an eye-catching poster/graphic that tackles one of the myths discussed in class. To get information to back up the statements made on your poster, use the websites listed on the student resources pages (29-30) to research mental illness facts in terms of how common it is, what outcomes can come from seeking help early and the importance of creating a safe community where mental illness is not stigmatized.

ACTIVITY THREE

Know Your Rights/Make Your Rights

Create a Student Bill of Rights

The 1960 Canadian Bill of Rights and Freedoms was this country’s first federal law to protect human rights and fundamental freedom. Considered ground-breaking at the time, it was eventually superseded by the 1982 Canadian Charter of Rights and Freedoms. Section 15 – Equality Rights of the Charter, makes it clear that every individual in Canada – regardless of race, religion, national or ethnic origin, colour, sex, age, or physical or mental disability – is to be considered equal. This means that governments must not discriminate on any of these grounds in its laws or programs.

Guide to the Canadian Charter of Rights and Freedoms

With this Charter in mind, research and create a “Student Bill of Rights” for your school, making sure to include mental health. Brainstorm ideas on how to educate and promote tolerance, understanding and acceptance in your school. Research has identified social inclusion to be one of the strongest determinants of mental health. How can you ensure basic rights are afforded to all students in your school community?

A sample of the Canadian Mental Health Association’s Client Bill of Rights

EXERCISE ONE

Take Charge

Taking Care of Yourself

Using the resources at the end of this guide and the self-care guidelines on the next page, think about the following:

  1. WHO? Who in your community can you talk to and share how you are feeling?
  2. WHERE? What credible resources can you turn to?
  3. WHAT? Self-Care – 3 things you can do to be good to yourself; positive ways that you can cope or de-stress when you are having a tough time.

Classroom Discussion:

  1. Ask the students to spend a few minutes thinking about possible answers to fill in the grid below.
    Then together with the whole group have students brainstorm options to all three columns.
  2. Reflecting on Nina’s situation, have the class brainstorm together possible solutions that Nina could
    have used earlier to help her understand her emotions and reach out for help.
  3. Have each student prepare their own personal Take Charge Plan with resources, people and self-care activities.
    This would include individuals that they trust and feel would support them during times of increased stress.

Click here to download the exercise chart.

Feel free to add more resources and supports to this list. Check out the Wellness Modules at Here to Help.

Remember, if self-care isn’t working for you, and negative or anxious thoughts or emotions are starting to overwhelm you, the best way to cope with your feelings is to talk to someone.

PREVENTION

Mental health is not just the absence of mental illness. Positive mental health involves emotional and psychological
wellness, healthy self-esteem and relationships, and an ability to take control of actions and feelings on a daily
basis. By being aware, we can take positive steps toward mental health when the balance is disrupted.

Tips for Controlling Stress

TALK ABOUT IT – Sharing your troubles with a friend may help you to put things in perspective and to feel that you’re not alone. You may also learn some other ways to manage stress effectively.

HEALTHY DIET – A good diet is often the first thing to go when we’re feeling stressed. Making a meal instead of buying one ready-made may seem like a challenge, but it will be probably cheaper and certainly better for you and the simple action of doing something good for yourself can soothe stressful feelings.

SLEEP – Getting a good night’s sleep can reduce stress levels. We know that over time your body will wear
down with poor sleep habits.

VISUALIZATION – Athletes achieve results by picturing themselves crossing the finish line first. Use the same technique to practice “seeing” yourself succeed in whatever situation is uppermost in your mind. http://au.reachout.com/challenging-negative-thinking

EXERCISE – You don’t have to train for a marathon, but regular, moderate exercise helps ease tension, improves sleep and self-esteem. Making exercise a habit is key.

ENJOY YOURSELF – Taking the time for a favourite hobby is a great way of connecting with and nurturing your creative self.

SET REALISTIC GOALS – Learning to say no is essential for some people. Assess your schedule and identify tasks or activities that you can or should let go. Don’t automatically volunteer to do something until you’ve considered whether it is feasible and healthy for you to do so.

LEARN RELAXATION TECHNIQUES – Practicing meditation or breathing awareness every day can relieve chronic stress and realign your outlook in a more positive way. Good breathing habits alone can improve both your psychological and physical well-being. Additional resources at http://au.reachout.com/ways-to-relaxhttp://www.mentalhealth4kids.ca/healthlibrary_docs/
BounceBackBooklet2014.pdf

VIDEO ON SELF-CARE AND COMPASSION https://vimeo.com/groups/126256/videos/118911442
SELF-HELP EXERCISES https://www.walkalong.ca/explore/self-help-exercises

EXERCISE TWO

Character Development

What would you do, what would you say?

Imagine that you are one of the characters in the play other than Nina.
Whether you are Nina’s Mother (Little Miss Sunshine), Father (The Professor), little Brother (The Creep), or whether you are one of Nina’s friends (Kate, Ash, or Ian), step into their character and continue to think about the friendship and relationship they have with Nina. Then consider what would happen to your character if Nina had told you about how she was feeling and what she was experiencing. This could give you an opportunity to expand and develop your character.

Think about how you would do this and write a script/scenario of how you would respond.

  • What would you or wouldn’t you say?
  • What would you do?
  • Would your character change?
  • Would you shut down?
  • Would you reach out?
  • How would you listen?
  • Would you have something to share with her?

Mental illness doesn’t discriminate, and can affect both girls and boys, men and women.

Due to societal pressures to ‘stay strong’ and ‘be tough’, men often find seeking help with mental illness especially difficult.

Imagine that the main character of this play was male, not female.

  • What would you say, or not say, to this person?
  • Would it differ from the above? Explain.

Consider the following four suggestions while you are developing your character and your script.

Four key things that can help you support your friend:

  1. LOOK OUT FOR THE SIGNS
    Sometimes it can be hard to know if your friend is just going through a rough patch or whether there might be something more serious going on like anxiety or depression. You might notice that they are not hanging out with their friends as much anymore or are always tired and feeling down. They might be snappier or perhaps look a mess. When you notice these changes, check in with your friend to see if they’re OK.
  2. LISTEN TO YOUR FRIEND’S EXPERIENCES
    Sitting and quietly listening is the next step. Don’t rush to offer advice. Let them know you are there for them and that you want to help where you can. If they don’t want to talk about it, respect that. Let them know you are worried and that you are happy to listen when they want to talk, or suggest other people. By listening and responding in a non-judgmental and reassuring manner, you are helping in a major way.
  3. TALK ABOUT WHAT’S GOING ON
    Knowing what to say can sometimes be difficult. You might not be sure how to start a conversation with them, or you might be worried about saying the wrong thing. You could say things like “I’ve noticed that you seem a bit down lately”, or perhaps, “You seem like you are really down, and not yourself, I really want to help you. Is there anything I can do?” Showing that you are willing to listen to what is going on can be really supportive for your friend. You don’t need to have all the answers.
  4. SEEK HELP TOGETHER
    Encourage your friend to get some support. They might want to start by talking with their family, or a school counsellor about what has been going on or they may prefer to talk with someone that they do not know, like a doctor or health professional. You could help them to find and arrange an appointment with a health professional; you might even offer to go with them to their first appointment to help them feel more relaxed about it. If they don’t feel comfortable with the first health professional, encourage them to keep looking until they find one they do feel comfortable with. https://www.youthbeyondblue.com/help-someone-you-know/supporting-a-friend

Most importantly, if at any time you are worried for your friend’s safety, seek help. Talk to an adult you trust about your concerns and ask for help in keeping your friend safe.

Things you can say to a teenager with anxiety or depression:

  • “No matter how bad things seem, I want you to know that I’m here for you.”
  • “Even if all I can give you is a shoulder to cry on, I want you to know you can count on it.”
  • “Depression and anxiety are illnesses. They can happen to anyone, and they’re nothing to be ashamed of.”
  • “Asking for help doesn’t make you weak, and it doesn’t mean you’ve failed. It’s one of the bravest things a person can do, and you should be proud of yourself.”
  • “I might not have any advice to give, but if you ever want to talk about what you’re feeling, I promise I will listen.”
  • “I know everything feels really hard these days, so don’t be afraid to tell me what you need.”
  • “You don’t ever have to thank me for being here for you. I care about you, and it’s my choice. It’s what friends do.”
  • “Even though you don’t feel like yourself these days, I want you to know that to me, you’re still the same amazing person.”
  • “I may not be able to completely understand what’s going on for you, because I haven’t experienced it myself, but I’m here for you all the same.”
  • “I can’t tell you how long you’re going to feel this way, but I can tell you I plan on being here for you whenever you need me.”

Things to avoid saying to a teenager with anxiety or depression:

  • “Snap out of it! Go have fun!”
  • “You know, a lot of people in the world have it way worse than you do.”
  • “Stop pitying yourself so much.”
  • “Just remember, what you’re feeling isn’t really real. It’s all in your head.”
  • “You have to stop playing the victim all the time.”
  • “I don’t get it, you don’t look sick.”
  • “Just try to look on the bright side more.”
  • “Get some rest and take some vitamins. That’s what I do when I’m stressed, and it always works.”
  • “Come on, smile! Don’t look so blue!”
  • “You just need a girlfriend/boyfriend.”
  • “Whenever I feel down I have a hot bath, and I feel great again. Try that?”
  • “You know, there are other ways to get attention.”

http://depressionteenshelp.com/teenagers-and-depression/

ACTIVITY FOUR

A Note from a Friend

Responding to a Friend in Need

“I’ve been trying to figure out how to tell you, but it’s embarrassing, so I keep putting it off. I started hurting myself again a few weeks ago. It makes me feel so ashamed and like there’s something wrong with me… I don’t know why I do it. It’s like I want to scream, but I don’t want people to think I’m a freak, so instead I just do this because it’s like it can just be my secret, you know? I don’t want to do this anymore, but I don’t know how to stop. Can we talk? All I know for sure is that something has to change.”

When somebody has the courage to tell you that they self-harm it is incredibly important to show them that you take them seriously, regardless of how severe, or not, the injury is. Your reaction may have a tremendous impact on them. Being available, whenever possible, to talk to a friend who self-harms can make all the difference, as feelings of isolation are often part of the problem. Let the person self-harming know that self-harm is very common and that individuals who do it are by no means alone.

In pairs, look at ‘A Note from a Friend’. Consider what advice you would give to this person as a friend

  • What can you do that is helpful?
  • What do you think would not be helpful?

Make sure that your friend knows who they can go to for expert help. Encourage your friend to seek help. If they are reluctant to tell other people, it’s important to acknowledge that you aren’t able to help them all on your own. If your friend is under 18 years old, help should be from a trusted adult or mental health professional.

Be sure to take care of your own emotional well-being. Supporting a friend who self-injures can be difficult, so make sure that you also have some good supports in place and that your friend who self-injures knows who you may be talking to (e.g., do not gossip or talk to other peers about your firend’s self-injury without his/her permission). You may want to talk to a mental health professional to help you with your own emotions. This is a difficult time for your friend, and also a difficult time for you.

FOR TEACHERS:
After the student pairs have completed “A Note from a Friend” exercise, provide an opportunity to discuss their responses and ensure the following feedback is highlighted:

  • DO NOT tell the person what to do – allow them to have control over what they want to happen.
  • DO NOT tell them to stop. Although this seems counter intuitive, it is very difficult and takes time and support to stop – the person will need to find other safer ways of coping first.
  • DO offer to support them in seeking help if that is what they want.
  • DO continue to be their friend.
  • Seek help for yourself if you need support.
  • Offer to listen to them and give them time and space to talk.
  • Offer to help if they need it.

Do not allow students to share detailed information regarding Self-Harming. When educating youth about Self Harming behaviour, discuss the behavior in its broader context; that is, as a maladaptive coping strategy among several others (such as substance abuse, or risk-taking). Educating students about signs of distress in themselves and others, as well as teaching the use of positive coping skills, is appropriate and recommended.

As a follow up exercise, have each student brainstorm things that they do when they are feeling low that help them feel better, then meet as a group and list each students’ activities on a whiteboard for all students to see.

Additional educational supports for teachers can be found at:
http://www.cmha.ca/mental_health/youth-and-self-injury
http://www.heretohelp.bc.ca/factsheet/self-harm

When talking about the subject of self-harm it is important to acknowledge that this could be a trigger for young peopple who are currently self-harming or have self-harmed in the past. Be aware of any students that may be affected and make sure support is outlined and highlighted.

Sources:
http://www.samaritans.org/sites/default/files/kcfinder/files/deal/dealing-with-feelings/07-self-harm-myths-and-facts/Selfharm%20myths%20and%20facts.pdf
http://sioutreach.org/learn-self-injury/

ACTIVITY FIVE

Channeling Emotion: Making Poems out of Feelings

Writing poems can be a cathartic emotional release and through a writing process students may tap into their emotions and express them in powerful, beneficial ways. Often times the writer may be unintentionally burying such feelings, and through this suggested activity students may become more open to the idea of poetry.

Have students reread ‘Normal Girl’, one of Nina’s poems in the play, as an example of how poetry can illustrate emotion. Then have students write their own emotion-based poem, using some of the writing strategies found below.

Normal girl
Normal heart
Normal brain
Then it starts
A creeping feeling: sorrow, dread
A tiny voice inside my head
Stay inside, keep out of sight
Something in you isn’t right
Darkness in you, black as night
Ugly, shameful, full of spite
Frightened girl
Jagged heart
Crooked mind
Tears you apart
Horrid girl
Broken brain
Ugly heart
Am I insane?
(Rachel Aberle – Still/Falling)

Make a list of emotions that you noticed within the play.

  • Choose one of the emotions, and, without naming the emotion, describe in detail, using concrete images, and think of a specific time when you may have experienced that emotion. “What happened? What did it look like? Sound like? Taste like?”.
  • How does this emotion help people?
  • How does it hurt people? Or hurt you?
  • Personify this emotion. If it were a person, what would it do?
  • Incorporate a simile or a metaphor to further gain understanding of the emotion.

Source:
http://www.nwp.org/cs/public/print/resource/402

EXERCISE THREE

Rename This Play

A title is a story’s first impression. People make a first impression with appearance, wardrobe and
body language. Stories and plays do it with a title. A title creates anticipation and expectation or,
perhaps, disinterest. Often the title is what will determine whether or not someone reads a story or
attends a play.

  • What did you think of the title of this play?
  • Did it make you want to attend the play, or not?
  • Did the title match the content of the play?
  • Does the title represent what was to follow and was it appropriate? Give reasons for your answer.
  • If you could, would you give this play an alternate title?
  • If so, what would it be? Defend the “Alternate Title” that you would choose for this play.

Sources:
https://www.writingclasses.com/toolbox/ask-writer/how-important-is-the-title-of-a-story

TORONTO-BASED RESOURCES

CMHA: Canadian Mental Health Association
The Canadian Mental Health Association promotes mental health awareness and supports the recovery of those dealing with mental illness. It provides a variety of information and resources, both local and nationwide.

East Metro Youth Services: what’s up walk-in
416.438.3697
Located in East Toronto, what’s up walk-in, a part of East Metro Youth Services, is a no fee, no appointment service for young people dealing with mental health issues, including addiction, depression, identity and bullying.

Family Outreach and Response
Downtown: 416.535.8501 x7853 Scarborough: 416.439.2253
With offices Downtown and in Scarborough, Family Outreach and Response provides recovery-oriented mental health educational and support services to families during the recovery process. Family Outreach and Response works with a diverse group of families.

The Hincks-Dellcrest Centre
416.633.0515
With centres located in north Toronto and downtown, the Hincks-Dellcrest Centre is a non-profit children’s mental health organization which offers a wide range of mental health support services to children, youth and their families. In addition to its treatment programs, the Hincks-Dellcrest Centre is also committed to education and research in the field of young people’s mental health.

Kids Help Phone
1.800.668.6868
Operating 24/7, 365 days a year, it is an anonymous, non-judgmental and confidential phone and online professional counselling service provided for children and young people free of charge.

Mind Your Mind
Mind Your Mind is an online teen mental health program. It is a place for youth and young adults to find and share information, resources and tools to help one another through difficult times.

Mood Disorders Association of Ontario
The Mood Disorders Association of Ontario provides free support to people, and their families, across the province who are dealing with depression, anxiety or bipolar disorders.

Ontario Mental Health Helpline
1.866.531.2600
The Ontario Mental Health Helpline provides free information and referral health services 24/7, 365 days a year.

Toronto Distress Centre
416.408.4357
The Toronto Distress Centre provides confidential and accessible emotional support, crisis intervention and suicide prevention 24/7, 365 days a year.

Youthdale
416.363.9990
Youthdale provides comprehensive, integrated mental health services to children and young people, regardless of race, creed, ethnicity or financial circumstances.

Online Resources

Dealing with Depression

Self-Injury Outreach and Support

Youthrive
The Canadian Association For Suicide Prevention – Crisis Centres Across Canada

Canadian Education Association

Talking About Mental Illness, Teacher’s Guide

Wellness Apps – Available on iTunes and Google Play for free

BoosterBuddy – A free app designed to help teens and young adults improve their mental health.

Guided Mind – Relax and get guided through meditations on a variety of topics dealing with the stresses and challenges of day-to-day life.

MindShift – MindShift is an Anxiety App and is the work of a joint collaboration between Anxiety BC and BC Mental Health & Addiction Services.

Mind Your Mood – Co-created with youth and MindYourMind, this is an easy-to-use app that allows youth and young adults to track their moods securely on their phone.

Thinkfull – For iPhones only and aimed and older youth and young adults.

DISCLAIMER

The materials contained within this study guide are provided for general information purposes only and do not constitute professional advice on the subject matter.

The information provided is not intended to replace the specialized training and professional judgment of a health care, mental health, or school counselling professional.

Every effort has been made to cite the owners of the copyrighted materials and to make due acknowledgment. If situations are identified where this has not been achieved, please notify Green Thumb Theatre so appropriate corrective action can be taken and appropriate credit given.