How Stigma Impacts Post-Traumatic Stress Treatment for First Responders

How Stigma Impacts Post-Traumatic Stress Treatment for First Responders

You’re the one who answers the call.

The one who shows up.

The one who offers light through life’s darkest moments.

So how could you possibly be the one feeling lost?

Feeling lost is common for First Responders, even while at work doing what they love.

If you’ve experienced feeling lost, at work or at home, you’re certainly not alone.

First Responders and Post-traumatic Stress

The Canadian Mental Health Association (CMHA) says First Responders (police, firefighters, and paramedics), military personnel, doctors, and nurses all experience higher rates of post-traumatic stress than people in other professions.

For example, twice as many First Responders compared to the average population experience a post-traumatic stress injury. That’s according to The Center for Suicide Prevention.

Dr. Jonathan Wan, MD, FRCP(C), Medical Director at Homewood Ravensview adds that this can look quite different from person to person.

General signs of post-traumatic stress, according to Dr. Wan and the CMHA, include:

  • Anxiety, avoidance, and dread about attending work
  • Insomnia and/or nightmares about traumatic events
  • Feeling “on edge” and full of physical tension
  • Apathy or having reduced interest or pleasure in spending time with others or engaging in usually enjoyable activities
  • Persistent self-blame or guilt related to traumatic experiences
  • Re-experiencing the traumatic event
  • Feeling detached from reality or lost, disengaged, not really present
  • Emotional numbness or having hard time feeling or expressing emotions
  • Concentration issues (ie., brain fog)

Stigma Still Exists. You Can Fight Back.

“Unfortunately, stigma for First Responders reaching out still exists today,” says Steve Farina, City of Coquitlam Fire Captain, Vice President of Lower Mainland North at BC Professional Fire Fighters Association and Vice-Chair of the BCPFFA’s Mental Health Taskforce and Occupational Health & Safety Committee.

Stigma can be internal (ie., self-stigma) or external (ie., from peers or institutions).

Internal stigma

“The biggest barrier for reaching out seems to be self-stigma (that internal conversation where one feels weak, fearful of being judged, etc.),” says Farina.

Dr. Wan further explains that despite greater awareness related to mental health issues, reaching out can still remain difficult.

“Part of the reason is because internalized stigma can present as the negative attitudes and self-judgement we have about our own experiences,” he says.

External stigma

External stigma can come from comments said by colleagues and supervisors, or fears about what they may say or think.

Negative perceptions (ie., judgements) and harmful behaviours such as gossip towards First Responders who have experienced mental health challenges or mental health conditions are examples of external stigma, says Farina.

Dr. Wan adds that external pressures can range from peers looking unfavorably on taking time away for recovery to institutions not acknowledging the impacts of psychological injuries.

“Whatever the source, stigma can compound mental health difficulties and prevent individuals who would benefit from treatment in seeking prompt care,” he says.

Expert Advice for First Responders

Farina says his advice for any new First Responder beginning their career is to connect to a mental health professional right away.

While we understand it’s not always easy to reach out, Farina suggests there’s benefit to seeking support sooner than later.

For First Responders with post-traumatic stress injury diagnoses, the accumulation of psychological injuries in the workplace at the expense of one’s health seems to be a common occurrence, he explains.

It’s vital for First Responders to understand their health and act accordingly, adds Wan.

“The saying of putting your own oxygen mask on in a plane before helping others is a fitting analogy,” says Dr. Wan.

“Don’t wait until your backpack is full of traumatic calls and stress and you’re overwhelmed, burned out, etc.,” he says.

Farina’s suggestions:

  • Find a mental health professional you can trust and relate to
  • Establish a relationship and baseline history early in your career
  • Check-in regularly throughout your career

Leaving symptoms of post-traumatic stress untreated can build up into a traumatic stress injury or diagnosis of PTSD.

“PTSD usually appears within three months of a traumatic event, but sometimes symptoms may not appear for years,” according to the Canadian Mental Health Association.

The benefits of working with someone at any time, according to Farina, include learning tools to:

  • Destress
  • Down-regulate your nervous system
  • Develop the awareness to know when to take a knee and reach out for help or additional support

If you’re already experiencing early signs and symptoms of post-traumatic stress, Farina encourages you to reach out and tell your supervisor, spouse, trusted coworker, or friend.

The Homewood Ravensview Difference

Come home to yourself at Homewood Ravensview.

Since opening in 2019, we’ve helped over 400 First Responders find their path forward from post-traumatic stress injuries.

We’ve made it part of our mission to continue learning and developing programming specific to the unique needs of this critical group. We do this by learning from people who get it because they have experienced something similar and know that while every trauma experience is different, you can heal from this injury, too.

Continual Learning

In partnership with Wounded Warriors Canada, Homewood Ravensview employees were given access to specialized occupational awareness training for the treatment of trauma-exposed professionals such as members of the Canadian Armed Forces (CAF), veterans, and other First Responders (ie., police, fire, emergency service professionals, etc).

The Introduction to Trauma-Exposed Professionals training program, developed by Wounded Warriors Canada’s co-National Clinical Advisor, Dr. Tim Black, has been designed to help increase competencies in the divide that exists between trauma-exposed professionals and the public.

The training program provides culturally-specific clinical approaches to support the complex mental health needs of trauma-exposed professionals and, through our partnership, is available to all Homewood Health employees.

Healing Outside of the Uniform: Guardians Program

The Guardians program at Ravensview supports First Responders in their journey in recovery from mental health difficulties.

Highlights of Treatment

  • Personalized for your unique needs
  • Medication consultation and management
  • Access to group and individual therapy
  • Ongoing assistance from trained professionals
  • Peer support from other First Responders

Treatment starts with a comprehensive and multi-disciplinary assessment to better clarify your individual needs.

You’ll gain access to individual and group talk therapy and educational tools about psychology to support your overall wellness needs.

A diverse team of physicians will then discuss ongoing interventions that can include, but are certainly not limited to, medication management.

You’ll be involved in the process of your own medical care and get the support you, too, deserve.

According to Dr. Wan, every type of treatment occurs in a therapeutic setting with other First Responders. We’ve found this promotes safety and acceptance.

Homewood Ravensview believes in the transformative power of care because we’ve seen it firsthand. If you or someone you love feels lost from trauma or PTSD, take the first step – reach out. The courage to do so could be the beginning of your path forward.

 

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The Link Between Doom Scrolling and Young Adult Mental Health

The Link Between Doom Scrolling and Young Adult Mental Health

We live in an increasingly digital world, and we know it’s impacting and influencing our mental health.

Pre-pandemic data from the Canadian Internet Survey reported by Stats Canada suggests social media use negatively affects everything from our sleeping habits to how much physical activity we get and how well we can concentrate on everyday tasks.

According to the report, one in eight or 12-14% of social media users also reported feeling:

  • Anxiety
  • Depression
  • Frustration
  • Anger
  • Envy by comparison (ie., scrolling and seeing other people’s lives on social media creates feelings of envy)

“Many young people report being online with friends, family and others almost constantly . . . but some young people’s online behaviours have had such an effect on their lives that they have been labelled as ‘problematic,’ according to the Government of Canada’s findings from the 2018 Health Behaviour in School-aged Children (HBSC) Study.

If this resonates with you or someone you care about, you’re certainly not alone.

“Social media, in particular, has become a key source of news and information over the past few years,” says Dr. Monica Vermani, Clinical Psychologist and Author of A Deeper Wellness: Conquering Stress, Mood, Anxiety and Trauma.

The trouble is that “social media is a largely unregulated platform, rife with over-stated, unsubstantiated, unreliable, and highly questionable news sites that rely on attention-grabbing, sensationalizing, and fear-mongering tactics that employ pseudoscience, conspiracy theories, and highly manipulative misinformation to generate traffic and ‘clicks’ that monetize their online businesses,” she explains.

“This relentless exposure to negative stimuli fuels negativity, fear, and self-doubt, and hijacks and overwhelms habitual users’ critical thinking abilities,” she adds.

Young Adults Deserve More Than a Side of Anxiety and Depression with their Connections

For young adults, it’s arguable that increased accessibility and acceptability of social media use has worked to increase social connections.

But online connections may not be a suitable or sustainable replacement for real world experiences during this critical life stage. What’s more, they may be contributing to anxiety and depression.

“Young adults are in a state of transitioning into full adulthood, a process that involves distancing somewhat from their family of origin and establishing themselves in intimate-partner relationships, living on their own for the first time, and pursuing careers,” says Dr. Vermani.

“At this stage in life, building strong social networks and relationships with others is crucial to their sense of self and connection to the world,” she adds.

Unfortunately, problematic social media use has been associated with anxiety, depression, and weaker relationships and connections, according to the HBSC study report.

How Social Media Contributes to Feelings of Depression and Anxiety

“What we focus on expands, and this includes exposure to and habitual consumption of the negative messaging that has expanded since the start of the pandemic,” says Dr. Vermani.

How the social media and negative news consumption cycle exists, according to Dr. Vermani:

  1. Social media feeds negative thoughts
    Social media feeds negative thoughts or anxiety by reinforcing and perpetuating them. Dr. Vermani says social media-influenced negative thoughts, beliefs, and mindsets can significantly impact consumers’ mental health and exacerbate symptoms of depression or anxiety.
  2. Social media fuels negative thoughts
    Social media fuels negative thoughts by adding gas to the fire of dread, worry, fear, stress, anxiety, hopelessness, and depression that lead to catastrophizing worse-case scenarios, panic attacks, or suicidal ideations for those with anxiety and depression.
  3. Social media can make existing mental health conditions like anxiety and depression worse
    Dr. Vermani explains that increasing habitual doom scrolling negatively impacts sleep, worsens mood-based symptoms, and leads to lower productivity, decreased mental acuity, and ability to deal with real-life stressors and responsibilities over time.

Healthy Consumption: How Much Media Is Too Much Media?

Too much of a good thing is bad news, and social media is no exception.

Dr. Vermani says that regardless of the quality of media consumption, too much time on media of any kind — including social media — is linked to feelings of depression and low self-esteem.

This happens, she explains, “often as a result of self-judgment, as a result of over-exposure to the unreal and/or unrealistic standards and facades perpetuated on all forms of media and social media.”

She adds that frequent or obsessive use of screens can:

  • Exacerbate feelings of disconnection and loneliness (ie., feeling lost).
  • Increase physical or mental isolation as screen use is largely a solitary endeavor that drains energy and steals time viewers/users would typically spend connecting with friends and/or family members.
  • Lead to social anxiety (fear of scrutiny, judgment, and evaluation) and social unease or awkwardness.

“Exposure to fear-inducing headlines, conspiracy-based content, and apocalyptic forecasting triggers the fight-or-flight response, in particular, which sets off a continual stream of cortisol — the stress hormone,” she explains.

While cortisol is fine in small doses, over time, the brain and body become exhausted by the high levels of this stress hormone, she adds.

“This contributes to a host of medical problems (including immune system function, digestive issues, weight gain, blood sugar levels, and heart disease) as well as mental health issues and cognitive impairment,” says Dr. Vermani.

The University of British Columbia confirms that excess cortisol in the blood can cause a variety of symptoms, “including high blood pressure, weight gain, thinning of the skin, easy bruising, poor wound healing and many others (sometimes referred to as Cushing’s syndrome).” Unmanaged overtime, this can lead to adrenal disorders and deeper health complications.

Signs It’s Time to Seek Support

Warning signs that social media consumption is becoming problematic include:

  • Increased procrastination around life tasks and responsibilities
  • Relentless need for stimulation (with anxiety, agitation, and boredom when away from screens)
  • Obsession with negative cycling through current events even when performing or engaging in other tasks or social situations
  • Mindless consumption of media
  • Obsessive preoccupation with creating and sharing online content
  • Guilt and shame of ‘time-wasting’ when on social media for over two hours per day
  • Conflict with a partner, parents, friends, and/or an employer
  • Diminished self-esteem due to a failure to measure up to the unrealistic lifestyle, financial and beauty standards portrayed on social media
  • Increased fear of missing out (FOMO)
  • Neglect around self-care, exercise, relationships, and hobbies due to time spent on social media

Tips for Building Emotional Resilience Against Negative Effects of Social Media

 “It’s important that individuals in this age group take steps to build resilience to the negative impacts of over-exposure to doom-and-gloom social media and traditional media,” Dr. Vermani recommends.

This requires first recognizing when you’re engaging in catastrophizing, and working to challenge the likelihood or actuality of worst-case-scenarios taking place, and then examining and reframing negative thoughts.

Here’s what this looks like in more detail.

  • Build awareness around the number of hours per day you spend on screens, media, and social media
  • Tune-in to how a sensationalized article makes you feel
  • Admit when technology use has become problematic
  • Commit to change by limiting message checking and screen time
  • Take a break from social media to help restore balance and perspective
  • Start a buddy system to help with accountability
  • Practice thought-stopping (a cognitive-behavioral technique used for ending obsessive or anxious thoughts).
    • Try this: The next time you have difficulty turning off a negative thought, simply imagine a red stop sign. The power of engaging your imagination works to help curb negative thinking and rumination, says Dr. Vermani.
  • Create mindful moments by briefly disengaging from screens to reconnect with themselves through breath or movement.
  • Limit engagement in social media to when daily life tasks, responsibilities, and goals are complete
  • Stay focused on the here and now. Making sure the here and now involves spending time doing things that bring us joy will keep us grounded in the world around us, and actively engaged in life, adds Dr. Vermani.
  • Use positive affirmations, mantras, life-affirming sayings, and slogans that act as touchstones and reminders of the good in the world, other people, and ourselves
  • Seek help to gain control of problematic habits and negative impacts related to over-exposure to screens and media when they cannot do so alone.

Dr. Vermani says when mood, anxiety, and self-esteem are negatively impacted by social media exposure, a primary care physician or family doctor is a great first step to accessing treatment options.

 “People with mood, anxiety, and attention disorders often rely on self-soothing by scrolling on devices to alleviate symptoms of anxiety or distract from uncomfortable feelings. A mental health professional can help address the underlying cause of such problematic behaviors,” she says.

When You Need More Support: The My Path Young Adults Program at Ravensview

When social media or negative news consumption feels like it’s become all but too much or you’re not seeing results when changing behaviours, please bear in mind there are other options for support.

The My Path inpatient treatment program was designed with evidence-based programming, including group programming with other clients who are working on similar issues, so you can access real-world, in-person connections to others in your age group and professionals trained to understand behavioural compulsions, obsessions, and addictions.

We See Your Story as Unique

Our multi-pronged approach to fostering and establishing healthy connections and mental wellness in young adulthood means you’ll access treatment that acknowledges your uniqueness and supports you long-term.

You Should Know…

You don’t have to get sucked into the social media cycle of negative thoughts, anxiety, depression, or worse. You can learn how to cope with negative news and social media comparisons, navigate online relationships,and how to unplug for your overall mental and physical well being.

The My Path program is specifically and strategically designed for adults aged 19-25 years from all cultural and social backgrounds.

Our dedicated team of multidisciplinary professionals recognizes excessive or problematic social media use as another behavioural addiction similar to gaming and gambling. We also understand that you may be engaging in these types of behaviours as a means of coping.

We treat problematic use of technology as a symptom and we help you get to the cause of why you’re engaging in these behaviours in the first place.

While everyone’s story is unique, connecting with others in these in-patient community-based groups offers opportunities for developing the life-changing connections social media just can’t replicate or compete with.

Our expert staff are also equipped to support you with life stage challenges at the same time including, but not confined to, transitioning to adulthood, and questions around sexuality, identity, self-esteem, and social dynamics.

To learn more about what the My Path program can provide, please go to: https://ravensview.com/programs/young-adults/

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Post Holiday Blues: Is It Normal to Feel Sad After the Holidays?

Post Holiday Blues: Is It Normal to Feel Sad After the Holidays?

What are the post-holiday blues?

Post-holiday blues are different from depression. They are temporary feelings of sadness and anxiety. These feelings can begin as the celebrations and events of the season wind down and as routines return to normal.

After a short adjustment period, the post-holiday blues typically resolve on their own and people begin to stress less. This isn’t always the case, though.

Sometimes returning to regular programming after being in holiday or vacation mode can be more challenging than anticipated.

Facing difficulties in getting back to a regular schedule may contribute to feeling disconnected or lost.

Experts say signs of declining mental health or depression to watch for include:

● Less energy and changes to sleep patterns
● Less motivation or interest
● Less connection or increased self isolation
● Feeling lost and lonely
● Irregular eating behaviours, such as over- or under-eating
● Excessive worry and/or feelings of hopelessness
● Feeling compelled to or self-medicating with alcohol, drugs, or other substances/activities
● Thoughts of self-harm

Post-Holiday Stress and Mental Health Risks

While stress is a normal, everyday part of life, it becomes a potential problem when we have less support and coping tools than necessary to manage in a healthy way.

Without healthy coping strategies, anxiety and depression can build. Dr. Josh Hamilton, a psychiatric nurse practitioner and the Assistant Vice President & Dean of Post-Licensure Programs at Rasmussen University explains it’s not uncommon for people to turn to drugs and alcohol for any form of temporary relief during this life stage.

This is considered self-medicating. Rather than actually help you or someone you love stress less, though, drugs and alcohol can seriously worsen the symptoms they initially helped to briefly relieve.

If you’ve turned to drugs or alcohol to try to avoid feeling lost, or to cope with anxiety and depression, you’re certainly not alone.

Research suggests substance use disorders (including substance misuse, abuse, and dependence) tend to begin in early adulthood and continue into later life stages if left untreated.

It’s estimated that over 20% of Canadians will face troubles with problematic substance use during their lifetime.

Top four substances of use:

● Alcohol
● Nicotine (tobacco)
● Cannabis
● Opioids

The Dangers of Self-Medicating

If you’re trying to stress less, self-medicating isn’t a safe solution. There are short term risks with alcohol use. These include anxiety, depression, and suicide.

If you or someone you know is experiencing suicidal thoughts, please reach out today for help.

Talk Suicide Canada is available 24/7.
Text message (SMS) 45645 or call toll-free 1-833-346-4566
If you are someone you know is in immediate crisis, dial 9-1-1.

Post-Holiday Blues or Anxiety and Depression?

Hamilton highlights how important environmental or relational context is when making sense of how we feel, too. Knowing the difference between post-holiday blues and a clinical disorder like anxiety, depression, PTSD, or behavioural addiction can help you or a loved one determine when to seek support.

It’s also crucial to consider how the past few pandemic years may have had a cumulative effect, and contributed to feeling lost.

What may have been cause for concern pre-pandemic, such as feeling lost in general, says Hamilton, is more understandable after what we’ve been through the past several years.

Questions to Ask

Answering these questions for yourself or someone you care about can help provide some perspective on whether you’re dealing with post-holiday blues or something more serious.

For example, are you feeling lost in life because you’re not sure if you’re on the right relationship track; if you want to have children; or if you’re in the right career, or, are you experiencing feeling lost when spending time with people (ie., feeling alone in a room full of people)?

Hamilton explains while some specific scenarios of feeling lost are to be entirely expected, other more general feelings may be cause for clinical consultation with a healthcare provider or mental health professional.

You can also try asking whether or not your feelings are associated with actually being alone during this season or if it’s a larger life stage issue.

More questions to ask:

● How do you feel when reflecting back on the whole year (not just the past holiday season)?
● Is there a particular trigger (person, place, thing) causing these feelings?
● Can you explain how you feel?

By taking some time in the post-holiday period to reflect, you gain some control or at least an awareness of where feeling lost might be coming from.

Finding Relief During Darker Days

The literal darkness of the winter and holiday season doesn’t help matters much, either.

Hamilton explains the shorter days, earlier nightfall, and colder temperatures take a toll on our collective mental health.

We can of course support our wellness during this season by focusing on nutrition, sleep, physical activity, and remaining as social as possible.

“To help alleviate symptoms of stress, pessimism, or melancholy that often come with feeling lost, lean into self-compassion and embrace progress over perfection. There’s no rush to get to some end destination. True joy is found in enjoying the journey,” says Jhas.

Beyond the Benefits of Connection

Hamilton highlights the power of connection in healing from feeling lost.

He says asking for help may begin by telling friends and family how you’re feeling or reaching out to a mental health professional.

If you feel you may benefit from additional support, or are not getting what you need to cope with anxiety and depression, there should be no shame in seeking a deeper level of support.

“It’s like returning to your doctor with a cough that won’t go away,” says Hamilton. This should not feel embarrassing, but it’s understandable due to stigma if you feel nervous bringing up symptoms that aren’t resolving.

“Have a conversation to explore what’s going on with you,” suggests Hamilton. This conversation can take place with your primary care provider or with a private provider.

True to Homewood Health’s legacy, Ravensview’s Cornerstone program takes an interdisciplinary and holistic approach to treatment to accommodate the full spectrum of adult needs including physical, mental, social, and spiritual health.

We understand the unique difficulties people may face during this time of year, and we are here to help.

Contact us today at 1-866-203-1793 or reach out online.

Resources:

Aderibigbe, O. O., Stewart, S. L., Hirdes, J. P., & Perlman, C. (2022). Substance Use among Youth in Community and Residential Mental Health Care Facilities in Ontario, Canada. International journal of environmental research and public health, 19(3), 1731. https://doi.org/10.3390/ijerph19031731

Addiction Guide. Canadian Statistics.

Canadian Centre on Substance Use and Addiction. Alcohol.

Hamilton, Josh. Personal Interview. December 2022.

Jhas, Sonia. Personal Interview. December 2022.

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