• At any given time in Canada, as many as 1.6%-2.7% of the population may meet the diagnostic criteria for an eating disorder. (Parliament of Canada)
• Eating disorders typically begin in adolescence or young adulthood and affect women 10 times more than men. (Statistics Canada)
• One study suggests that unhealthy dieting behaviours are reported in girls as young as 10 years of age. (McVey et al., 2004)
• Anorexia nervosa has the highest mortality rate of any mental illness – it is estimated that 10% of individuals with it will die within 10 years of the onset of the disorder. (National Eating Disorder Information Centre)

Eating disorders are very common today, but frequently go undetected due to their secretive nature. It is important to be aware of the signs and symptoms so you can recognize if you or someone you know may be struggling.

ANOREXIA NERVOSA:

A severely distorted perception of one’s physical appearance. This mindset leads to actions including: self-starvation and excessive exercise rooted in an intense fear of gaining weight.

Possible signs and symptoms of anorexia

• Physical: Continual weight loss; irregular periods; dizziness; fainting spells; low body temperature (complaining of being cold); pale complexion and dry skin; dry brittle hair or hair that is falling out; growth of facial and body hair; easy bruising; exhaustion and fatigue
• Emotional: Intense fear of weight gain; excessive need for control; distorted body image; and dramatic mood swings
• Behavioural: Wearing loose clothing; deception (hiding food in napkins or clothes); abuse of laxatives, diet pills, or diuretics; obsession with caloric and fat content of food; compulsive exercise; making excuses not to eat; isolating or avoiding social events; consuming a lot of non-caloric foods (diet soda, gum, or coffee); avoiding restaurants and eating in front of others; ritualistic behaviours at meals (cutting food into small pieces, eating food in a particular order); discomfort with or avoiding being touched; defensiveness when questioned about weight; hyperactivity; and depression

BULIMIA NERVOSA:

Identified by compulsive overeating leading to self-induced vomiting, as well as intentional vomiting after any/all food intake. Laxatives and diuretics are commonly used in an attempt to purge the body of food.

Possible signs and symptoms of bulimia

• Physical: Binging and purging; constant sore throat; broken blood vessels in eyes; dramatic weight fluctuation; digestive problems; swollen neck glands and puffy cheeks; scrape wounds on knuckles (due to contact between knuckles and teeth to induce vomiting); and eroding of tooth enamel and increased cavities
• Emotional: Self-criticism and poor body image; poor impulse control (drugs, alcohol, spending, moods); and promiscuity
• Behavioural: Expressing guilt after eating; avoiding restaurants and eating in front of others; abusing laxatives, diet pills, ipecac, diuretics and/or enemas; frequently going into the bathroom right after meals; showering after meals; hiding food throughout the house; and alternating between eating large amounts of food and self-starvation

BINGE-EATING DISORDER:

Identified by consuming large quantities of food in an uncontrolled manner.

Possible signs and symptoms of binge-eating disorder

• Physical: Rapid weight gain
• Emotional: Poor body image; depression; and excessive guilt
• Behavioural: Eating large amounts of food; eating late at night; sexual avoidance; hiding food throughout the house; eating to the point of physical discomfort; avoiding social events; eating without an appetite; isolating; and sleeping often during the day

If you or someone you know is struggling with an eating disorder, Mercy Canada can help. Our program is completely free to the women we serve. Call our toll-free number 1-855-55-MERCY (63729) for more details, or e-mail ask@mercycanada.ca to learn more.

• Self-harm can affect anyone, but it is more common during the teenage years and among females. (Canadian Mental Health Association)
• Girls are 4 times more likely to be hospitalized for self-harm-related injuries than boys. (Canadian Institute for Health Information)
• Approximately 45 Canadians enter hospitals each day following suicide attempts or self-inflicted injuries. (Canadian Institute for Health Information)

Self-harm has become a rampant epidemic that is affecting many young people today. The act of self-harm, sometimes referred to as self-injuring or cutting, is a deliberate, repetitive, impulsive harming of the body. It is usually done in secret and is often hard to detect.

SELF-HARM – SELF-INJURING – CUTTING:

People self-harm for various reasons – expression of pain and hurt deep within, self-punishment, or the need to feel something physical after having experienced emotional numbing.

Possible signs and symptoms of self-harm behaviour

• Inflicting cuts with any type of sharp object, usually on an area of the body not normally exposed
• Carving words into one’s body
• Constant scratching as a response to pressure or unexpected circumstances
• Picking at scabs and preventing the healing process from taking place
• Burning the skin on a regular basis with erasers, fire, or small heat-conducting appliances or metals
• Punching the body – including beating the head against walls or other inanimate objects
• Biting the inside of the mouth or skin of the arms, hands, or legs
• Pulling out hair, including eyelashes and eyebrows
• Breaking bones or severely bruising the body

Possible indicators someone may be struggling with self-harm

• A preference for wearing concealing clothing at all times (e.g. long sleeves in hot weather)
• An avoidance of situations where more revealing clothing might be expected (e.g. unexplained refusal to go to a party)
• Unusually frequent complaints of accidental injury (e.g. a cat owner who frequently has scratches on their arms)

If you or someone you know is self-harming, Mercy Canada can help. Our program is completely free to the women we serve. Call our toll-free number 1-855-55-MERCY (63729) for more details, or e-mail ask@mercycanada.ca to learn more.

• More than 80% of domestic assaults are committed against women. (Statistics Canada)
• On any given day in Canada, more than 3,300 women (along with their 3,000 children) are forced to sleep in an emergency shelter to escape domestic violence. (Statistics Canada)
• Studies have found that while the rate of domestic violence has fallen in recent years, victims have become less likely to report incidents to the police. (Canadian Women’s Foundation)

Physical abuse is the non-accidental physical trauma or injury inflicted by one individual on another. The abuser is usually a family member, caregiver, or someone known to the victim. Injuries are often the result of, but not limited to: choking, punching, kicking, biting, burning, beating, or use of an object to inflict harm. Physical abuse often, but not always, results in bruises, abrasions, burns, broken bones, and internal hemorrhages.

While physical injury may be the most obvious danger, emotional and psychological consequences of abuse are also severe. In its most severe form, physical abuse is likely to cause great bodily harm or even death.

Possible signs and symptoms that a person may have been physically abused

• Dressing in clothing designed to hide bruises or scars (e.g. wearing long sleeves in the summer or sunglasses indoors)
• Having frequent injuries, with the excuse of “accidents”
• Being depressed, anxious, or suicidal
• Frequently missing work, school, or social occasions, without explanation
• Seeming afraid or anxious to please their partner
• Going along with everything their partner says and does
• Checking in often with their partner to report where they are and what they are doing
• Receiving frequent, harassing phone calls from their partner
• Talking about their partner’s temper, jealousy, or possessiveness
• Having very low self-esteem, even if they used to be confident
• Showing major personality changes (e.g. an outgoing person becomes withdrawn)

SEXUAL ABUSE:

• 1 in 4 North American women will be sexually assaulted during their lifetime. (Sexual Assault Canada)
• There are more than 460,000 sexual assaults committed in Canada every year, but only around 3% are every reported to the police. (YWCA Canada)
• 80% of sexual assault assailants are friends or family of the victim. (Sexual Assault in Canada)
• Women under the age of 24 are at a much higher risk of being sexually assaulted. (Toronto Police Services)

Sexual abuse is any coerced sexualized behaviour or undesired exposure to sexualized behaviour between two or more individuals, children or adults, who may or may not know each other.

This includes:

• Any sexual behaviour (including exposure to pornography) between an adult and a child
• Any sexualized activity that includes coercion (e.g. force, threats, bribes, manipulation, and drugs)
• Sexual activity when one party is impaired (e.g. drugs/alcohol, intellectually disabled, and physically disabled)
• Exposure to sexual activity (live or in media)
• Sexual behaviour between children with an age discrepancy of 3+ years
• Coerced sexual behaviour between children
• Rape is the perpetration of an act of sexual intercourse when:
  • will is overcome by force or fear (from threats, use of weapons, or use of drugs)
  • mental impairment renders the victim incapable of rational judgment
  • the victim is below the legal age established for consent

Possible signs and symptoms of sexual abuse

• Possible impact of sexual abuse – depression, sleep disturbances, nightmares, frequent urinary infections, isolation from family and friends, or withdrawal from usual activities
• Tendency to become either obsessive or apathetic about hygiene
• Anxiety, passivity or overly “pleasing” behaviour, low self-esteem, self-destructive behaviour, and promiscuous activity
• Adults experience the ramification of sexual abuse through anger, rebellion, self-harm, fear, inappropriate sexual behaviour, or difficulty in developing close relationships
• Many people who have been sexually abused fall into obsessive compulsive behaviour patterns such as excessive bathing, teeth-brushing, or hand-washing due to feeling perpetually dirty
• Many victims of sexual abuse will turn to food as a source of comfort, which often develops into an eating disorder: anorexia, bulimia, and binge-eating
• Most sexual abuse against children is perpetrated by a family member (e.g. father, stepfather, aunt, uncle, sibling, cousin) or family intimate (e.g., live-in lover or friend of the parent)

If you or someone you know is a victim or physical or sexual abuse, Mercy Canada can help. Our program is completely free to the women we serve. Call our toll-free number 1-855-55-MERCY (63729) for more details, or e-mail ask@mercycanada.ca to learn more.

• Studies estimate there are hundreds of thousands of victims of sex trafficking in Canada every year. (Salvation Army)
• More than 90% of human trafficking in Canada is domestic, with less than 10% of victims being brought from other countries. (Parliament of Canada)
• Of 8 industrialized countries, Canada has the lowest rating, an F, for preventing human trafficking and providing support for victims. (The Future Group)

Sex trafficking is easily concealed, and it is vital that we be aware of its existence and warning signs. It is important to note that most victims do not self-identify as victims, have a strong sense of distrust, or are not aware that help is available.

Possible signs and symptoms that someone may be a victim of sex trafficking

• The inability to come and go as they please
• Being accompanied by a controlling person
• Rarely being allowed in public
• Providing commercial sex acts under the age of 18
• Working excessively long and/or unusual hours
• Working a lot but not having any money, possessions, or bank account
• Not having identification documents
• Owing a large debt and being unable to pay it off
• Living or working under high security measures (darkened or boarded windows, barbed wire, security cameras, etc.)
• Living where one works
• Appearing fearful, nervous, or paranoid – especially at the mention of law enforcement
• Avoiding eye contact
• Appearing malnourished or in poor health (including STDs, urinary difficulty, infertility, dental problems, etc.)
• Showing physical signs of abuse, restraint, confinement, or torture (bruises, scars, etc.)
• Not being able to clarify where they are staying
• Only knowing sex-related words in English
• Inconsistencies in their story
• Substance or drug abuse

If you or someone you know is a victim of sex trafficking, Mercy Canada can help. Our program is completely free to the women we serve. Call our toll-free number 1-855-55-MERCY (63729) for more details, or e-mail ask@mercycanada.ca to learn more.

• 1 in 5 Canadians will experience a mental illness in their lifetime. The remaining 4 will have a friend, family member, or colleague who will. (Health Canada)
• The economic burden of mental illness in Canada is estimated at $51 billion per year. This includes health care costs, lost productivity, and reductions in health-related quality of life. (Centre for Addiction and Mental Health)
• At any given time, almost 3 million Canadians have serious depression, but because of the stigma associated with admitting to emotional difficulties, less than one-third seek help. (Centre for Addiction and Mental Health)
• The World Health Organization (WHO) predicts that by 2020, major depression will be second only to heart disease as the leading cause of disability worldwide. (Mood Disorders Canada)

Everyone feels sad sometimes. Depression is when those feelings of sadness get so intense that you feel helpless, hopeless, or worthless for longer than a few days. If these feelings interfere with your daily life and cause emotional pain for either you or those around you, you may be dealing with depression. Depression varies from person to person, and not everyone who is depressed experiences every symptom. When these symptoms become overwhelming and keep you from engaging in and enjoying daily activities, you should seek help.

Possible signs and symptoms of depression include:

• Feelings of helplessness and hopelessness. A bleak outlook—nothing will ever get better and there’s nothing you can do to improve your situation.
• Loss of interest in daily activities. No interest in former hobbies, pastimes, or social activities. You’ve lost your ability to feel joy and pleasure.
• Appetite or weight changes. Significant weight loss or weight gain—a change of more than 5% of body weight in a month.
• Sleep changes. Either insomnia, especially waking in the early hours of the morning, or oversleeping (also known as hypersomnia).
• Anger or irritability. Feeling agitated, restless, or even violent. Your tolerance level is low, your temper short, and everything and everyone gets on your nerves.
• Loss of energy. Feeling fatigued, sluggish, and physically drained. Your whole body may feel heavy, and even small tasks are exhausting or take longer to complete.
• Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticize yourself for perceived faults and mistakes.
• Reckless behaviour. You engage in escapist behaviour such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.
• Concentration problems. Trouble focusing, making decisions, or remembering things.
• Unexplained aches and pains. An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain.

DEPRESSION AND SUICIDE RISK

• Nearly 4,000 Canadians die by suicide every year – an average of almost 11 per day. (Centre for Addiction and Mental Health)
• More than 75% of suicides involve men, but women attempt suicide 3 to 4 times more often. (Centre of Addiction and Mental Health)
• After accidents, suicide is the second leading cause of death for people ages 15 to 34. (Centre for Addiction and Mental Health)
• For every suicide death, there are 20 attempts. (Statistics Canada)
• 8 out of 10 people who attempt suicide hint about it to family or friends beforehand. (Mood Disorders Canada)
• 90% of people who commit suicide have a diagnosable mental illness. (Mood Disorders Canada)

Depression is a major risk factor for suicide. The deep despair and hopelessness that goes along with depression can make suicide feel like the only way to escape the pain. If you have a loved one with depression, take any suicidal talk or behaviour seriously and learn to recognize the warning signs.

Warning signs of suicide include:

• Talking about killing or harming one’s self
• Expressing strong feelings of hopelessness or being trapped
• An unusual preoccupation with death or dying
• Acting recklessly, as if they have a death wish (e.g. speeding through red lights)
• Calling or visiting people to say goodbye
• Getting affairs in order (giving away prized possessions, tying up loose ends)
• Saying things like, “Everyone would be better off without me” or “I want out”
• A sudden switch from being extremely depressed to acting calm and happy

(Helpguide.org, 2014)

Depression may occur alone or along with other mental health conditions, such as anxiety, eating disorders, substance abuse or attention-deficit/hyperactivity disorder (ADHD).

If you or someone you know is having suicidal thoughts, seek help immediately.

• Reach out to a family member, friend, or teacher.
• Contact a pastor, mentor, or someone in your faith community.
• If you feel you are in crisis, you can call one of Canada’s many crisis centres, which you can find here or call 911 for immediate assistance.
• Make an appointment with your doctor, mental health provider, or other health care provider.
• Contact the police or go to the Emergency room or if there is an active plan to commit suicide; do not leave the individual unattended.

If you or someone you know is struggling with depression, Mercy Canada can help. Our program is completely free to the women we serve. Call our toll-free number 1-855-55-MERCY (63729) for more details, or e-mail ask@mercycanada.ca to learn more.