Coping with Childhood Trauma from Past Abuse and Neglect
Coping with Childhood Trauma from Past Abuse and Neglect
In this article, we’ll be exploring the topic of past childhood trauma. While we always intend to be helpful when presenting information, we only encourage you to proceed if you recognize how this could affect you. Only you know best if it’s something you want to continue with. Please remember that if you have experienced past childhood trauma personally, we want to encourage you to take breaks while reading, especially if you are feeling uncomfortable or strongly react to what we’re sharing. We’ve included some resources near the end of the article that you may want to consult.
Many of us have experienced challenging moments in our lives. Memories of past childhood trauma may not be immediately obvious or apparent. They are often repressed in our minds or we may make a conscious effort to avoid thinking about these memories because they cause such a strong emotional response in us. While scientists are still researching and determining the complexity of connections between traumatic experiences and memories, “experts in child psychology argue that the memories formed from infancy to the age of 2 or 3 are very unlikely to be recovered.” (1)
We will look at how to recognize childhood trauma, find out how commonplace it is, and learn about some of the trauma people might have experienced that they have held on to and how it is affecting their adult lives. Then, we will talk about how repressed trauma may appear in adulthood and what our reactions to discovering it might involve. It’s important to understand that trauma is unresolved stress and does not become your identity. With the right understanding, practical coping tools, and a framework resolution, you can move forward and heal from these events to live well and feel better.
What is childhood trauma?
Childhood trauma is stressful experiences, such as abuse, neglect and household dysfunction, that occur before age 18. Traumatic experiences usually involve situations where children feel threatened either physically, emotionally or both. Trauma is highly individualized because not everyone is affected by the same things or in the same ways. That makes it quite challenging to determine the exact causes. However, studies show that childhood trauma can affect a person’s mental and physical health over time because our memories store both the events and the associated feelings/reactions.
What is a trigger for negative reactions?
When we don’t have an immediate frame of reference for something, our brains (whose primary purpose is to help us survive) may turn to memories of traumatic events. It can create an unexpected reaction. What’s happening is that we haven’t found a way to process and let go of the associated trauma. Our bodies, in turn, respond in several different ways:
- nightmares
- flashbacks
- confusion
- sleep disorders
- anxiety and panic attacks
- depression
- grief
- guilt
- shame
- nervousness in everyday situations
Attempts to try to address the trauma may lead to behaviours that are associated with a range of mental health conditions that could include:
- substance use
- self-harm
- eating disorders
- personality
- mood disorders
How common is childhood trauma, and how often does it occur? Are certain groups or people affected more than others?
Dr. Gabor Maté is a physician who has studied trauma’s connection to our health in a biopsychosocial context – how our health is affected by events we have experienced throughout our lives. He asserts that we need to acknowledge trauma because the interconnectivity between our psychology and physiology cannot be denied. (2)
Historically and currently, childhood abuse and neglect are often underreported for many different reasons ranging from children being generally unaware that what is happening to them is wrong, to being afraid to tell someone they trust what is going on. (3) In 2014, a General Social Survey conducted in Canada included questions about “maltreatment during childhood” for anyone over 15 to answer. It was ground-breaking because this study was the first-time data about childhood trauma and abuse had been collected nationally from adults. Here are some of the results: (4)
a.Those between the ages of 35 and 64 years of age at the time of the survey were the most common segment reporting abuse.
b.33% experienced physical or sexual abuse by someone over 18 or witnessed violence between known adults.
- More males (27%) than females (19%) experienced it and were almost twice as likely to report it. However, females were 3x more likely to have experienced sexual abuse before age 15.
- 65% of abused people reported occurrences between 1 and 6 times; 20% reported being abused between 7 and 21 times; and 15% reported abuse of at least 22 times,
- For 61% of respondents, parents and step-parents were responsible for the most severe physical abuse; but sexual abuse most often happened by someone outside of the family.
- 67% of victims never told anyone about the abuse.
c.40% of Indigenous people have experienced abuse compared to 29% of non-indigenous, and 42% of indigenous women have, compared to 27% of non-indigenous women.
d.48% of respondents who identified as members of the LGBTQ2 community reported having experienced abuse compared to 30% of heterosexuals.
e.Immigrants were less likely than non-immigrants to report a history of abuse as children. When abuse occurred, someone outside their family most often perpetrated it.
f.Drug and alcohol use were twice as common for people who had experienced childhood abuse.
g.There were negligible differences between people who had experienced childhood abuse when it came to education, employment, or income as adults.
Types of trauma
There are many different types of trauma that people have experienced.
Neglect
Neglect is where a child’s or teen’s needs are not attended to, exploited, pushed aside, or greatly resented. It can have immediate, short-term, and long-term consequences.
Neglect can be considered a general unawareness or systematic failure of a caregiver to respond to a child’s needs because they were overwhelmed or preoccupied. It’s often unintentional, perhaps reflecting low awareness and emotional intelligence or even a remnant of intergeneration trauma. In some instances, basic needs could be provided by caregivers, but it’s the emotional and psychological needs that are not. Sometimes it’s a case of caregivers “mishand[ling] one key area of support.” (5) For example, a child could be experiencing a lack of:
- comfort
- nourishment
- shelter
- medical care
- emotional support
- education
- caregiving (leaving a child alone or in the care of a third party who cannot provide adequate care)
- general resources such as food and clothing or even love when they are part of a large family
Neglect can be a “failure to act or notice a child’s emotional needs,” which results in chronic emotional and psychological crises that can affect brain development. (6)
From the caregiver’s behaviour, a child learns that their needs are unimportant and that seeking adult support is often futile. In households with strict rules – such as no crying, no sadness, or no loud voices – the adults discourage natural, spontaneous responses from the child or teen. Instead, they should acknowledge that the child is likely instinctively expressing a need to feel close and share their emotions. By denying them the opportunity to process their feelings, these children grow up learning that mentioning these natural responses is something to fear. In the child’s adult relationships, this can manifest as mental and physical difficulties where they:
- feel low self-worth
- have low self-esteem
- display low confidence
- have trouble with loneliness
- are focused on perfectionism or avoidance, and
- find comfort in self-deprecation
Children also learn from caregiver behaviours such as being emotionally detached, anxious, or constantly worried.
Abuse
Abuse can be viewed as an intentional, conscious action or decision by a caregiver to deny a child care or harm them. In many circumstances, the abuse is physical or sexual. The abuse creates trauma.
Children who have experienced neglect and abuse are vulnerable to other traumatic events that are offshoots of the original trauma. It could be that they are threatened by, become involved in, or witness an event such as (7):
- bullying
- community violence
- multiple complex traumatic events
- natural disasters
- early childhood trauma that occurs before age 6
- intimate partner violence
- traumatic medical stress
- refugee trauma
- traumatic grief such as the loss of a parent or close caregiver, or family member
- the end of a relationship (divorce)
- having a learning disability
- having a caregiver with untreated mental illness
Recognizing the signs of unresolved trauma
Symptoms of unresolved trauma start when adults experience stress or when experiences remind us about something that happened when we were children. Adults who have experienced childhood trauma aren’t always able to recognize their own trauma because they have usually developed strong self-reliance and have often been the ones to build a solution to cope with these experiences independently.
As a result, it may be challenging to consider that symptoms of unresolved trauma may look like somewhat ordinary things. But these are often the body and mind’s ways of alerting us to problems that originated in childhood:
- Chronic pain – migraines, joint and nerve pain, back pain, fibromyalgia, etc.
- Fatigue – constant low energy, weakness, brain fog, sleepiness, etc.
- Digestive issues – nausea, diarrhea, constipation, IBS, etc.
- Hypersensitivity/Hypervigilance – awareness of sensations to sounds, lights, environments, etc.
- Anxiousness – increased heart rate, panic disorders, fears, etc.
- Depression – low moods, lacking motivation, feeling hopeless, etc.
Adverse Childhood Experiences (ACE)
Adverse Childhood Experiences (ACE) is “used to describe all types of abuse, neglect, and other potentially traumatic experiences that occur to people under the age of 18 years.” (8) ACE scoring is a methodology to help adults reflect on situations that may have affected their development. ACEs have the potential to uncover symptoms of childhood trauma because an adult can better articulate whether they feel they’ve been able to deal effectively with the ACE. In fact, “one in every six adults experience at least four ACEs, according to the CDC. These experiences can be particularly harmful because they occur at such a vulnerable phase of growth. In early childhood, brain development and social-emotional growth are at a critical stage.” (9)
How to recognize if childhood trauma is affecting you as an adult
It’s important to realize that not all trauma is due to mistreatment or abuse. Children can experience frightening events in their lives, such as accidentally getting separated from their caregiver in a store or being startled and uncomfortable because of loud noises in their environment. They can also experience trauma when they experience something new or, for the first time, like visiting a doctor or dentist. These events can create memories associated with trauma, but the cause was not neglect or abuse.
Some professionals help people sort through types of traumas by helping determine whether they have experienced what they are referring to as Big T Trauma or Little t Trauma, which attempts to explore them in the context of how the event affected someone’s physical safety to produce the traumatic response. This approach can help someone determine if these experiences are affecting our innate sympathetic nervous reactions, also known as fight, flight and freeze.
Big T traumas are “generally related to a life-threatening event or situation…[like] a natural disaster, a violent crime, a school shooting, or a serious car accident,” but “chronic (ongoing) trauma, such as repeated abuse, can also qualify as big T trauma.” (10)
Little t traumas are “events that typically don’t involve violence or disaster but do create significant distress… [such as] a breakup, death of a pet, losing a job, getting bullied, being rejected by a friend group.” (11)
Common reactions to trauma
Framing childhood trauma may be difficult because we tend to discount the impact of events that happened to us in childhood. After all, they happened at a time in our lives when we didn’t have the evaluative tools, control, and self-determination that adults do to process situations.
Our adult perspective and viewpoints can also cloud or invalidate the child’s reaction to the trauma. For example, uncharacteristic responses from adult figures that may have been frightening to you as a child and perceived as threatening may not be viewed the same way today. There’s also a tendency to internalize responsibility for the caregiver’s actions, taking on blame for a situation and excusing the caregiver. It can be because, as a child, you were told you were responsible for that adult’s behavioural choices at the time.
Many adults also experience disassociations where they strategically avoid certain situations. Generally, it’s because they cause them discomfort as adults. An example of disassociation would be how as an adult, you can never be late, or it can cause you to panic. The root cause may be a childhood experience where a caregiver was late to pick you up. The emotions that the event made you feel may have influenced your development so that you unknowingly relive an unresolved traumatic experience from your childhood.
Ways to heal from childhood trauma
Now that we have looked at what trauma is, and unveiled how people may have experienced trauma, as well as abuse, it is time to look at ways which we can heal from childhood trauma. The following gives some strategies for healing.
- Learn to approach memories calmly and recognize and be curious about our automatic reactions. It is fundamental to learning about what triggers us, which can help process those triggers, removing their intensity over time.
- Try to fill in the blanks/gaps in memories by approaching them with storytelling. This method can help gently bring memories forward because it allows us to be more mindful as adults. We can leverage more emotional regulation tools that we have learned to understand these situations and process the experiences from a different perspective. It also helps us release the fearful associations and acknowledge how we can choose to remove the trauma, so it doesn’t continue to have a hold on our current lives.
- Explore a wide range of treatment options:
- CBT – cognitive behavioural therapy helps people re-think their thoughts and beliefs about traumatic events and activate healthy coping skills.
- DBT – dialectical behavioural therapy helps to build skills in responding to stressors and emotional regulation.
- EMDR – eye movement desensitization and reprocessing helps retrain areas of the brain that hold traumatic experiences by following a series of specific eye movements performed under the direction and guidance of an EMDR therapist.
- Somatic Experiencing (or similar types of therapy) – create positive mind/body connections that help reset the nervous system. These could include treatments such as:
– Meditation
– Deep breathing
– Yoga
- Clinical EFT (Emotional Freedom Technique) focuses on stimulating acupressure points in the body with a repeated light touch.
- Clinical Myofascial Release focuses on specific guided motions to expand and contract tissues that relax and release tension and trauma.
Childhood trauma resources
You may want to review some of the most innovative thinking about childhood trauma from people who have extensively studied links between it and health as adults. They advocate for different approaches for physicians to acknowledge and address trauma’s effects on our lives.
- Dr. Gabor Maté has written several books on the topic, including the recent release “The Return to Ourselves: Trauma, Healing and the Myth of Normal”
- Dr. Bessel van der Kolk created the National Child Traumatic Stress Network https://www.nctsn.org and has published a book about trauma titled “The Body Keeps the Score”
- Dr. Nadine Burke Harris gave a TED talk: “How childhood trauma affects health across a lifetime, “where she discussed studies prepared by the Centres for Disease Control (CDC) and Kaiser Permanente. She has published a book titled, “The Deepest Well: Healing the Long-Term Effects of Childhood Adversity”
We have also included links to some Adverse Child Experience (ACE) Questionnaires that you may be able to explore as you begin working on healing from childhood trauma.
- ACE Questionnaire from The Canadian Association for Mental Health, CAMH.
- Finding your ACE score from the National Centre for Juvenile Justice, Family Violence and Domestic Relations, and Child Welfare and Juvenile Law NCJFCJ
Above all, please be gentle with yourself as you explore your childhood trauma. It can be a difficult, lengthy, and complicated process to work through as an adult, and you may find that you are not ready to talk about it. Remember that you don’t need to figure everything out alone. Taking time and space to heal is one of the most significant gifts you can give yourself.
References:
1. Positive Kids n.d). The Child Psychology of Abuse and Repressed Memories. PositiveKids.ca. Retrieved February 10, 2023 from https://positivekids.ca/2017/01/09/the-child-psych…
2. Maté, G. (2023 February 22). George Stroumboulopoulos in conversation with Dr. Gabor Maté Live on Instagram. Instagram @strombo, @gabormatemd.
3. Burczycka, M. (n.d.). Family Violence in Canada: A statistical profile, 2015, Section 1: Profile of Canadian adults who experienced childhood maltreatment. Statistics Canada. Retrieved February 10, 2023 from https://www150.statcan.gc.ca/n1/pub/85-002-x/20170…
4. Ibid.
5. Holland, K. (Medically reviewed by Legg, T.J., PhD, PsyD.) (2021 October 21). Childhood Emotional Neglect: How It Can Impact You Now and Later. Healthline.com. Retrieved February 10, 2023 from https://www.healthline.com/health/mental-health/ch…
6.Ibid.
7. The National Child Traumatic Stress Network. (n.d.). What is childhood trauma? Trauma Types. The National Child Traumatic Stress Network (NCTSN.org). Retrieved on February 10, 2023 from https://www.nctsn.org/what-is-child-trauma/trauma-…
8. Su, Wei-May & Stone, Louise. (2020 July). Adult survivors of childhood trauma: Complex trauma, complex needs. Australian Journal of General Practice (AJGP). Volume 49, Issue 7. Retrieved on February 10, 2023 from https://www1.racgp.org.au/ajgp/2020/july/adult-sur…
9. Newport Institute. (n.d). Big T vs. Little t Trauma in Young Adults: Is There a Difference? Newport Institute.com. Retrieved on February 10, 2023 from https://www.newportinstitute.com/resources/mental-…
10. Ibid.
11. Ibid.
It's not Just you. The Post-Pandemic Workplace is Stressful for Everyone
It's not Just you. The Post-Pandemic Workplace is Stressful for Everyone
Whether it takes place at home, in an office, or out on the front lines, work can be a stressful experience. In fact, Canadian workers are among the most stressed in the world.
“A lot of people don’t even realize they are experiencing moral distress. They have this general sense of outrage at the system and don’t see it for what it is.”
Work-related stress existed long before the pandemic, but it rose to new heights as our workplace fundamentals changed overnight. While the terrifying uncertainty of the early pandemic is now far behind us, the aftershocks continue to impact our mental wellbeing.
A Capterra survey found that while the percentage of Canadian employees reporting negative mental health quadrupled during the pandemic, that percentage hadn’t diminished in 2022. In fact, it had increased very slightly.
A 2022 Gallup report found that Canada is one of the most stressed regions of the world. In 2022, 44% of employees saying they experienced stress a lot of the previous day—the highest percentage in a decade.
Workers of all types are feeling stressed
Whether you perform your job remotely, on site, or on the front lines, you may be feeling work-related stress.
Nearly one in five workers in Canada are now fully remote, and while many people enjoy this work style, for others, it has created feelings of isolation and blurred the boundaries between work and life in an unhealthy way. A 2022 survey by Cisco found that stress levels had increased for more than one in five remote or hybrid workers (22%).
Many on-site workers are also struggling for reasons that include health concerns and badly-behaved customers. According to Capterra, nearly one-quarter of on-site workers (24%) rated their mental health as “bad” or “very bad.”
But first responders—the people whose work puts them in emergency situations regularly—experience some of the highest levels of work-related stress.
Alexis Winter, former Director of Nursing at Homewood Ravensview, a Canadian private mental health and addiction inpatient treatment facility on Vancouver Island, British Columbia, works with many first responders through the facility’s Guardians Program.
She agreed that the pandemic and its aftermath have worsened the mental health of front-line workers of all types.
“They’re putting their bodies on the line, and that the general population wasn’t supporting them,” Winter explained. “Health care staff were putting themselves in dangerous situations and feeling villainized. They were feeling like, ‘We don’t matter.'”
The phenomenon is directly correlated with more acute conditions such as burnout and post-traumatic stress disorder (PTSD), said Winter. Unfortunately, it’s all too easy for people to ignore the symptoms.
“A lot of people don’t even realize they are experiencing moral distress. They have this general sense of outrage at the system and don’t see it for what it is.”
The impact of work-related stress
Stress is a natural reaction to situations that seem overwhelming or threatening, priming our bodies to release stress hormones that trigger a “fight or flight” response that can protect us from danger. In a workplace setting, these situations can include physically unsafe environments, discrimination, bullying, unrealistic workloads, financial uncertainty, lack of autonomy—the list goes on and on.
But when we experience repeated exposure to these triggers over time, stress stops having a beneficial effect and starts adversely affecting our mental and physical health. In addition to anxiety, burnout, depression, and PTSD, stress can cause hair loss, memory loss, acne, hives, ulcers, heart disease, hypertension, acid reflux, headaches, insomnia, fertility issues, sexual dysfunction, obesity, and increased consumption of drugs and alcohol.
Many first responders are at elevated risk of mental health issues related to their work.
69% of Canadian journalists and media workers suffer from anxiety and 53% have sought medical help to deal with work stress and mental health.
48% of Canadian nurses say the pandemic affected their work-life balance to a great extent and 50% experienced abuse by clients or the public at work.
53% of Canadian physicians report symptoms of burnout in 2022—1.7 times higher than the pre-pandemic number.
50% of Canadian police officers reported having high levels of perceived stress.
86% of firefighters in the Northwestern Ontario fire service experienced symptoms of PTSD.
Recognizing the problem
Being able to recognize when stress is becoming harmful is critical to mental health.
People usually know when they’re stressed at work, but many see it as a normal part of having a job. If you find yourself dreading work or feeling hopeless and helpless on a regular basis, it’s a sign that your work stress may be rising to unhealthy levels.
“It’s about self-awareness,” Winter explained. “Noticing whether you’re feeling really tired, whether you’re feeling negative toward things you used to believe in. How do you feel after taking a break? Do you come back feeling good and ready to work? If you don’t feel that sense of regeneration after time away from work, it’s a sign that stress has become trauma or moral distress.”
The continuum model provided by the Mental Health Commission of Canada is a helpful tool for understanding mental health as a continuum and gauging the severity of a person’s reactions to workplace stress. By evaluating yourself against each point in the continuum, you can gain a better understanding of your mental health and your potential need for lifestyle changes or professional help.
Coping with work-related stress
If your work-related stress levels are rising, there are things you can do to manage them. Here are some of the self-care strategies recommended by the team at Homewood.
Recharge. Take regular and assigned breaks at work. Take your vacation days, avoid working unnecessary overtime, and focus on rest and recovery whenever possible.
Prioritize. Know your limits. Create a routine for creating a boundary between work and the rest of your life. Make exercise, proper nutrition, and adequate sleep a priority.
Organize. Create a work environment that is tidy and organized. Break down seemingly overwhelming projects into smaller, achievable tasks.
Celebrate. Recognize and celebrate your successes (big and small) and try to keep your self-critic in check.
Connect. Seek the support of your team members or leader, and access organizational supports, such as health and counselling resources.
Winter also offers these coping mechanisms from her own practice.
Avoid relying on drugs and alcohol. “If you come home feeling really stressed out about work, don’t reach for a glass of wine or a beer immediately. Even if you only have a single glass each evening, try bringing yourself down in other ways so that using these substances doesn’t become a habit.”
Adopt a mindfulness practice. “If you’re experiencing depression, you’re living your life in the past. If you’re experiencing anxiety, you’re living your life in the future. A daily mindfulness practice, even 10 minutes before bed, helps you bring yourself into the present and alleviate those symptoms of depression and anxiety.”
Create better boundaries. “Something as simple as turning your phone off when you leave work can make a huge difference, because even that five-minute check is actually taking up 20% of your brain space for the next little while. I now have a separate work phone and a personal phone.”
Ask for help. “If you’ve taken some time away from work and you’re still feeling burned out, or if your beliefs about the safety of the world or the goodness of people has changed, it’s time to go beyond self-care and start asking for help.”
An experience we all share
Many of us are lucky enough to earn a sense of purpose from our work as well as a pay cheque. But with so much of our time and identity tied up in work activities, it’s easy for work to become a source of significant stress, and the pandemic only intensified the phenomenon. Whether we work from home, in an office, or on the front lines, it’s not uncommon for the daily grind to grind down our mental health.
What’s important is to recognize when our stress levels creep up so that we can take action, whether that involves rebalancing our work-life focus, practicing better self-care, or reaching out to people who can help us heal.
Tuning In: The Role of Music Therapy in Mental Health and Addiction Treatment
Tuning In: The Role of Music Therapy in Mental Health and Addiction Treatment
Kirsten Davis, a music therapist at Homewood Ravensview, a private inpatient facility for mental health and addiction recovery in British Columbia, sits in front of a piano with her patient. The woman is terrified, her body tense, her fingers reluctant to so much as touch the keys. Gradually, Davis encourages her to play a chord. Then another. And another. What happened next is a testament to the extraordinary healing power of music.
“She started to relax,” Davis recalls. “Together, we played, and she started to laugh and do silly things on the piano, like playing it with her elbows.”
Goofing off at the piano may not seem like much of breakthrough, but Davis’s patient was a residential school survivor who was struck by the nuns who taught her every time she played the wrong note. Traumatized, she had not touched a piano since. But at Ravensview, she was finally ready to face her fears and find her voice.
“At the end of the session, she discovered that the piano was not this scary monster anymore,” says Davis. “It was something that could be fun and joyful.”
The healing power of music
Humans have instinctually recognized the power of music for centuries. In ancient Greece, music’s effect on the mind and body was considered so intense that some believed it should be controlled. In ancient Egypt, physicians used music to help patients recover from illness. And in many Aboriginal cultures, music is viewed as a powerful healing tool.
Today, music is globally recognized as a therapeutic intervention in a wide variety of clinical contexts. To date, more than 1,000 scientific studies have been published on the topic of music therapy and its impact on everything from asthma management to autism to pre-term infant care to palliative pain relief. Music therapy has also become a vital component in mental health and addiction treatment options for conditions such as anxiety, depression, dementia, stress, PTSD, and addiction to alcohol, drugs, or prescription medications.
In this article, we’ll look at how music is being integrated into holistic treatment programs in Canada to help people identify, explore, and regulate their emotions to discover new resilience, confidence, and authenticity.
What is music therapy?
Music therapy uses music as a therapeutic tool to address emotional, cognitive, social, and physical needs of individuals. It is delivered by a trained and licensed therapist who uses music to help people achieve therapeutic goals, such as improving communication and expressive skills, managing stress, and enhancing overall well-being.
Music therapy can involve a wide array of activities, including group drumming sessions, learning to play an instrument such as the guitar or piano, singing and breathwork, sharing and analyzing songs, creating new music, lyrics, or soundscapes individually or as a group, or simply listening to music for relaxation or emotional discovery.
Davis believes that music therapy provides an important outlet.
“There’s so much work that we do in treatment that’s based on talking,” she says. “If we can provide ways for people to express themselves without using words, that’s really important.”
Priya Shah, who provides music therapy at Homewood Health Centre, an inpatient treatment facility in Guelph, Ontario, sees music as a way to explore difficult emotions or experiences safely.
“Music can act as a form of symbolic distance,” she explains. “Someone can say they relate to a specific song or lyrics without actually saying, ‘This is what happened to me,’ or ‘This is how I’m feeling.’”
Who benefits from music therapy?
As part of mental health and addiction treatment services, music therapy benefits a wide range of individuals as part of a holistic treatment approach. At Homewood Health facilities, music therapists collaborate with other expressive arts therapists (art, creative writing, and horticulture), cognitive behavioural and dialectical behavioural therapists, physicians, and nurses to develop programs for:
- People with acute or life-threatening psychiatric conditions or addictions
- People who have been diagnosed with depression, bipolar disorder, or anxiety disorders such as generalized anxiety disorder, social anxiety disorder, panic disorder, or agoraphobia
- First responders, including firefighters, paramedics, law enforcement, military personnel, and veterans, who have post-traumatic stress disorder (PTSD) or occupational stress disorder (OSI)
- People with neurocognitive impairment or forms of dementia including Alzheimer’s
- Youth in their teens to early 20s with mental health or addiction issues or a history of trauma and secondary diagnoses such as eating disorders or self-harm
How music therapy supports recovery
Shah and Davis both describe music as a versatile medium that can promote the emotional wellbeing of people undergoing mental health and addiction treatment by helping them to connect with, understand, and share their emotions in a safe and creative environment.
Connecting with emotion
Shah says that people often come to music therapy with a certain emotion in mind that they’d like to evoke through music. With the help of a trained music therapist, they can get in touch with those sometimes-overwhelming emotions in a safe space.
“Sometimes patients come to a group saying, ‘I want to release some anger,’ or, ‘I want to cry,’” says Shah. “There can be moments that feel uncomfortable, messy, and chaotic, but music can act as a form of symbolic distance. In individual or group sessions, we practice using music to build distress tolerance.”
Understanding emotion
Being able to name, understand, and accept the emotions they feel also plays an important role in a person’s recovery, and it’s a skill many people in recovery have difficulty with.
“Music can help people identify and express emotions,” Davis says. “We’ll sometimes listen to a song and pull it apart to understand what mood it’s expressing and why people are connecting with that.”
Sharing emotion
Music can also be used to bring people together and help them understand and accept one another and themselves. By sharing a favourite song or lyric with a group, or by creating music and sounds that express their feelings and experiences, people can learn to connect with others and build relationships of trust.
“A lot of the benefit comes from relating to peers and connecting with people who have had similar experiences,” Davis explains. “People find such comfort in realizing they’re not alone, that there are other people who have had those kinds of experiences.”
Creating a safe space
People receiving treatment for mental health and addiction issues face intense psychological challenges, and the emotions and experiences that music evokes can be overwhelming if they are not explored with the help of a trained therapist.
To help their patients safely explore and gain control over the intense emotions that can come up during a therapy session, Shah and Davis ensure that every session is personalized, structured, and nonjudgmental.
Personalized
Shah never sets a routine or schedule. Instead, she checks in with the individual or group to assess what’s needed in the moment and that sets the direction for the session. Activities can include listening to music, singing, playing instruments, creating music or soundscapes, writing lyrics, analyzing or talking about a piece of music, or even dancing.
Davis also takes care to customize the music selection to reflect participants’ tastes. For example, for the “My Path” mental health treatment program for youth at Ravensview, the music selection leans toward hip-hop, rap, and pop.
“For young people, research shows that music is very connected to identity development,” says Davis. “It can help them get in touch with their angst and anger at a safe distance and sharing that music with peers can really validate their experience.”
Structured
Despite being flexible in her approach, Shah believes in carefully structuring therapy sessions so that participants can be playful and experiment, but also have a framework to guide them if they need it.
“Creating sound isn’t always harmonic or pretty. Building comfort with those messy parts of music is an important part of the process,” Shah says. “There can be a lot of perfectionism and fear of getting things wrong. Having something structured can give people something to hold on to, some comfort and instruction. Part of my job is knowing when to challenge and when to let music be a safe place.”
Nonjudgmental
Davis and Shah both agree that one of the most crucial elements of music therapy is its ability to help people overcome negative thoughts and self-image, and both therapists actively create affirmative, accepting spaces.
“People come in with a lot of expectations of themselves,” says Davis. “And they come in thinking that this is about performance, or accuracy, or talent. People will say, ‘I’m tone deaf. I can’t carry a tune in a bucket.’ And we have to break through that, because music is genetically programmed into everybody.”
The impact of music therapy
The effect of music on patients in a therapeutic setting has been researched extensively. Over the past 20 years, more than 1,000 studies have been published on the topic, and there is considerable evidence that music therapy is an effective treatment adjunct for a wide range of mental health and addiction treatments.
Music therapy and trauma
There is evidence that music therapy is a useful therapeutic tool for reducing symptoms and improving functioning among individuals with trauma exposure and PTSD.
Music therapy and schizophrenia
Music therapy helps people with schizophrenia improve their mental state, social functioning, and quality of life.
Music therapy and dementia
People with Alzheimer’s disease and dementia saw improved non-verbal expression, reduce anxiety and depression.
Music therapy and addiction
A study of 53 women found that those who experience situational or chronic anxiety related to their addictive disorder saw a significant decrease in anxiety with music therapy.
Music therapy and youth mental health
A meta-analysis of nine papers suggested that for children and teenagers with conditions such as depression and anxiety, music therapy had the potential to improve communication, reduce depression, and increase self-esteem.
Writing a new song
Music can play a critical role in the journey toward recovery by helping people with mental health and addiction issues to safely explore, reconnect with, and regulate powerful and sometimes destructive emotions. By exploring rhythm, melody, sound, and lyrics, they can reconnect with and replenish their inner stores of joy, courage, and creativity on the way to recovering and rediscovering their authentic selves.
When you Fear the Unknown: Coping with Uncertainty
When you Fear the Unknown: Coping with Uncertainty
We do our best to talk ourselves into believing many different things when facing something unknown. Sometimes, we say that “everything happens for a reason,” “this too shall pass,” or “it is what it is” to calm our minds, soothe our worries, and ease our fears.
While it’s not always as simple as that, we are processing and trying to cope with uncertainty. It’s instinctive. We need reassurance and clarity to feel secure.
In this article, we’ll reframe uncertainty as a part of life that is constant and explore signs to recognize when it’s affecting us negatively. We will also investigate why we have such difficulty dealing with uncertainty, a trait referred to as Intolerance of Uncertainty (IU). There are things we can do to become more comfortable with uncertainty – since it doesn’t ever go away entirely and can resurface when you least expect it.
Uncertainty is part of life
Have you ever wondered what it would be like if our lives weren’t full of uncertainty and we had everything mapped out? It’s hard to imagine because no one comes into this world with complete blueprints for their life. Not knowing how things will play out can be a source of anxiety and can cause panic attacks.
Our brains are always on the lookout for dangerous situations. We can sense fear, and “our bodies respond automatically” to protect us. (1)
When facing uncertainty, we might experience an increased heart rate and more rapid breathing to “increase oxygen and blood going to our muscles” and sweat to control our temperature. (2) We also re-prioritize bodily functions “that aren’t immediately important” in a stressful situation and release adrenaline “to give us energy” and cortisol to both “relieve pain” and “block rational thinking” to focus on survival. (3)
Essentially, we activate our fight, flight, freeze, flop, and friend responses (4):
- Flight – responding to a dangerous situation physically or verbally
- Flight –removing yourself from the situation to put you in a safer space
- Freeze – “going tense, still and silent” as an “instinctive survival response”
- Flop – shutting down your mind in response to pain and having your muscles relax and become loose so “your body goes floppy”
- Friend – instinctively calling for help from a friend, bystander, “and/or ‘befriending’” an aggressor to try and negotiate or talk your way out of a situation
What else do we tend to do in the face of uncertainty?
Humans “crave information about the future” and “perceive ambiguity as a threat,” so our brains try to “protect us by diminishing our ability to focus on anything other than creating certainty.” (5) Think for a moment about how we have been learning to deal with uncertainties stemming from the pandemic or what we tend to do when we’re uncertain about our health and perhaps awaiting a medical diagnosis. These are stressful situations for us to figure out because they introduce changes to our regular routines.
For example, while awaiting a medical diagnosis or noticing a change in their health, many people search the Internet for information that could explain their symptoms. Unfortunately, this behaviour can result in an overwhelming amount of information, that is not always credible and can lead to more worry and uncertainty. Looking for answers is part of the quest for certainty: we can’t help ourselves.
Of course, we also can experience uncertainty in other areas of our lives. For example, “research shows that job uncertainty,” that is, worrying about our work and connected finances, is often worse than “actually losing our job.” (6)
Intolerance of Uncertainty (IU)
In some cases, extreme worry, anxiety, and stress associated with not knowing can create problems that may affect how someone handles a situation. Some people can cope with more uncertainty than others who “cannot stand even the smallest amount of uncertainty.” (7) People that are uncomfortable with uncertainty may opt to stick with familiar situations and spend much of their energy on avoiding, eliminating or controlling the negative associations they experience with uncertainty. (8) They could be viewed as perfectionists, have an “inflated sense of responsibility” or even “behave as though they have a phobia of uncertainty.” (9) In cases where anxiety creates peak amounts of distress that seriously affect someone, specialized therapy may provide some comfort and relief. The COVID-19 pandemic is a recent example of people experiencing high degrees of Intolerance of Uncertainty. Researchers have discovered that the general uncertainty associated with the pandemic correlates to excessive amounts of physiological and psychological stress, which in turn has created increased anxiety, emotional problems, depression, and other mental health concerns. (10)
Unhealthy ways of coping with uncertainty
There are several ways that people try to cope with uncertainty that are unproductive and result in more significant stress.
- Using worrying as a tool for trying to predict the future. Worrying can give you the illusion of control over uncertain circumstances.
- Compulsively seeking information can make people feel overwhelmed, depressed, or panicky. It results in a situation where it’s difficult to determine what information is credible and what is misinformation because it all creates more uncertainty.
- Isolating ourselves only results in increased feelings of anxiety and loneliness. During the early days of the pandemic, for example, when restrictions were a way to reduce the spread of infection, many people experienced anger, doubt, mistrust, and fear because they had never experienced anything similar.
How can you get more comfortable with uncertainty?
Psychologists have offered tips on how to deal with uncertainty more effectively. These include (11):
- Using self-compassion and allowing time and space to feel and experience your emotions.
- Practicing acceptance where you reflect on how life has always been uncertain.
- Staying in the present to avoid overthinking or distractions that have us examine the past or guess at the future.
- Reflecting on past experiences to address uncertainty and promote personal growth.
- Practicing self-care, embracing our instincts and self-awareness can help ground us and offer a chance to relax and recharge.
- Planning for change and uncertainty to feel better prepared to respond to future situations.
Keep things manageable by choosing three areas of focus
1. Start by focusing on what is within your control and act only on those things. If you find yourself drifting back to negative thoughts, try clearing your mind using meditation, exercising, or doing something else you love.
2. Reduce social media, news, and Internet use so you develop greater awareness of what information you are consuming and sharing. Consider that social media rarely presents authentic situations. Stick with credible sources and avoid comparisons to other people or situations.
3. Finally, focus on what brings you joy including:
- Hobbies
- Social connections
- Spending and making time for those who you determine you want in your life and where you are both benefiting from the relationship
- Gratitude journaling
- Affirmations and being kind to yourself
Being able to reframe your thinking about uncertainties in our lives may help you learn to become more content with them. You’ll reduce harmful stress and negative thought patterns and achieve better well-being, ready to embrace life with more optimism daily.
References:
1. Rape Crisis England & Wales (n.d.), The 5 Fs: fight, flight, freeze, flop and friend. Rape Crisis England & Wales. Retrieved January 20, 2023 from https://rapecrisis.org.uk/get-help/tools-for-victims-and-survivors/understanding-your-response/fight-or-flight/#:~:text=The%20%27fight%20or%20flight%27%20response,fight%27%20or%20%27flight%27.
2. Ibid.
3. Ibid.
4. Ibid.
5. Carter, Christine. (2020 July 27). Seven Ways to Cope with Uncertainty. Greater Good Magazine: Science-Based Insights For A Meaningful Life, University of California, Berkely. Retrieved January 21, 2023 from https://greatergood.berkeley.edu/article/item/seven_ways_to_cope_with_uncertainty
6. Ibid.
7. Anxiety Canada (n.d.). Intolerance of Uncertainty. Anxiety Canada. Retrieved January 21, 2023 from https://www.anxietycanada.com/articles/intolerance-of-uncertainty/
8. Psychology Tools. (n.d.) Intolerance of Uncertainty. Psychological Tools. Retrieved January 21, 2023 from https://www.psychologytools.com/resource/intolerance-of-uncertainty/
9. Ibid.
10. Russo, Francine. (2022 February 14). The Personality Trait “Intolerance of Uncertainty” Causes Anguish during COVID.” Scientific American. Retrieved on January 21, 2023 from https://www.scientificamerican.com/article/the-personality-trait-intolerance-of-uncertainty-causes-anguish-during-covid/
11.The Wellness Society. (n.d.). How to Deal with Uncertainty: 6 Tips From a Psychologist. The Wellness Society. Retrieved January 21, 2023 from https://thewellnesssociety.org/how-to-deal-with-un…
Women’s Mental Health: Concerns, Barriers and Support
Women’s Mental Health: Concerns, Barriers and Support
Sex and gender interact with a variety of other determinants of health to influence our mental health. Despite efforts to focus on equality, gender bias continues to create complications that can take quite a toll on women’s mental health.
Social beliefs and cultural practices influence us, even before birth, and carry on throughout our lives as we grow and develop into adults. They help build our understanding of what we can enjoy and how we “should” act. Sometimes, however, they become barriers preventing women from seeking the support they need.
This article will look at women’s common mental health concerns and explore some of the distinct physiological factors that affect their health. We will also share available resources and treatment options.
Common mental health concerns for women
At the turn of the Millennium, the World Health Organization decided to update its inaugural Status of Women’s mental health study published in 1993. The new document included a prediction: that depression would become “the second most important cause of disease burden in the world by the year 2020.” (1) Researchers further stated that “women in developed and developing countries alike [were] almost twice as likely as men to experience depression.” (2) And they warned that, “violence and self-inflicted injuries” would “have special relevance for women’s mental health.” (3)
Today, just a few years beyond that forecast, women are experiencing mental health challenges that outpace available support. Researchers have continued to focus on profiling the unique differences around the kinds of mental health challenges women tend to experience most frequently. They’ve found that “women are more likely to be diagnosed with anxiety or depression, while men tend toward substance abuse or antisocial disorders.” (4) They have also validated that women and men exhibit various differences in symptoms. The symptoms women may experience are more likely:
- Internalizing disorders, where emotions aren’t shared and “typically results in withdrawal, loneliness, and depression,” is more common in women. Men tend to do the opposite, developing “substance abuse” and “antisocial problems” that see them “externalizing their emotions which leads to aggressive, impulsive, coercive and noncompliant behavior.” (5)
- Focusing on negative emotions and going over their problems more repeatedly than men do. It’s a gender-based difference that characterizes women’s experiences with depression, where they seem more vulnerable to becoming “stuck” instead of engaging in more active problem-solving. (6)
- Hormonal triggers certainly contribute to changes in women’s bodies, and they are often seen as a natural cause of both pre- and post-natal depression. But the truth is that they are not always at the root of issues. There are other genetic and biological factors also at play.
Reconsidering the influence of harmful gender-biased narratives related to hormones
Recalling common behavioural stereotypes about women’s bodily functions probably doesn’t take much thought. Many factors beyond an individual woman’s biology influence their mental health. Still, it’s harmful gender-biased viewpoints that continue to perpetuate unfair beliefs.
The Lancet, a highly respected medical journal, published a series of studies exposing how gender beliefs can influence women’s care.
- One study revealed that while women’s sex hormones and an impairment of their fight-flight-flee responses shaped their experiences with depression, there were other psychosocial factors at play. Women reported that things such as low self-esteem, experiences with body shaming, and relationship stressors such as violence and sexual abuse also contributed to their depression. (7)
- When looking at anxiety, trauma and stress-related mental health conditions, researchers hypothesized that biological differences made women more vulnerable. They investigated how monthly fluctuations of hormones such as estrogen and progesterone affected women’s thinking and behaviours but ignored any psychosocial influences. (8)
- We shouldn’t ignore societal expectations’ role in influencing women’s physical and mental health, especially regarding reproductive health issues related to infertility or fundamental reproductive rights. Pressures and stresses can lead women to feel that they have lost control and a sense of direction over their lives. Consider how categorially many other non-biological issues contribute to women’s poor health. There are economic, legal, and environmental influences, as well as poverty and inequality related to women’s wages, opportunities, and living conditions.
Social and cultural beliefs feed discrimination and bias against women trying to secure care
Social and cultural ideas about femininity and masculinity influence our thoughts and actions and impact situations they shouldn’t. (9) For example, it’s not uncommon for women to report incidents where they have not been taken seriously by physicians. One report shared findings of over 1000 women over the age of 16 who completed a survey in the province of British Columbia. Many women frequently reported the need to advocate for their health to obtain diagnostic exams and treatment because their symptoms and concerns have been dismissed, stigmatized, or attributed to incorrect diagnoses. (10) Many women shared that they initially didn’t “think their gender played a role in their care…when asked to share specifics about their experiences, [but] it became clear that being a woman did influence their treatment.” (11)
It isn’t wholly unexpected. Research focused exclusively on male subjects has provided information and influenced medical practices for decades. Excluding females has, in some cases, delayed understanding of drug interactions and their effects on female hormones and health conditions. (12) Dr. Alyson McGregor writes about what she believes to be a “flawed assumption” that medicine that “makes sense in a male body [also] must make sense in a female one.” (13)
Historically, misinformed attitudes and beliefs about menstrual cycles sometimes led to women being misdiagnosed for serious medical conditions. Alarmingly, however, women still report that these attitudes cloud their current-day healthcare experiences. One panel of physicians said that they’ve come across women in their practices that have experienced situations where “heart disease [was] labelled as anxiety, an autoimmune disorder [was] attributed to depression, [and] ovarian cysts [were] chalked up to ‘normal period pain.'” (14) Another study revealed that 51% of women felt that a physician “had diminished or overlooked their symptoms” (15)
There are also differences between treatment approaches for women’s and men’s mental health conditions that can be attributed to unconscious biases in medical care. Developing more awareness to identify and address these problems is a big step towards improving women’s health care in general, but also helping to deliver critical support to women who are experiencing serious mental health conditions.
What are some ways for women to cope with these concerns?
Providing clear examples and information about a wide range of situations helps advocacy groups in their quest to influence reforms. When women share their experiences, it can create a demand for policy changes. Here are some ways that women can take action:
- Be prepared when you meet with doctors. Have up-to-date lists of prescriptions, vitamins, and supplements, and note any allergies to ensure that doctors are working with complete information.
- Be bold and ask questions. If answers aren’t immediately available, physicians do leverage their networks to better understand your experiences and provide the best care options for you.
- Trust that you are the most in-tune and well-informed person about your body. Intuitively, we often can tell when something feels off. When you experience symptoms of something unusual, take action to get medical care and keep pushing for answers.
- Seek out local and national organizations that are working to understand and improve women’s healthcare experiences. A quick web search of “woman’s health advocacy” can often provide local and national contacts. By connecting with these groups, you might learn about medical trials or discover other ways to improve women’s health care, including offering financial donations.
- Ask for second opinions or consider switching physicians if you aren’t satisfied with your experience. The latter may be more challenging to orchestrate because of the corresponding problem of physician shortages.
Hospitals are also doing their part to change the face of women’s healthcare by introducing specialized nursing roles, such as Forensic Nurse Examiners (FNE). These roles exist so that women build their value and self-worth after experiencing violence and abuse. Working with an FNE can help women develop confidence about their treatments and mental health recovery from traumatic events.
What are some factors that affect women’s mental health?
Awareness of the unique differences associated with women’s mental health concerns is essential because these can shift as we age. Some of the most common factors that affect women include:
- Premenstrual Syndrome (PMS) results from hormone fluctuations during women’s monthly menstrual cycles. It can include a variety of symptoms, such as headaches, bloating and increased emotional sensitivity. Depression and anxiety can intensify the symptoms.
- Premenstrual Dysmorphic Disorder (PMDD)shares a similar group of symptoms to PMS; however, it differs because they are significantly worse. PMDD is characterized by “extreme mood swings, tension, irritability, and severe depression. ” In many cases, it affects personal and professional relationships and worsens around a woman’s period. (16)
- Pressures many women feel about achieving or maintaining an idealized body image or lifestyle that social media has influenced are often referred to as body dysmorphia. Women believe that they must conform to what they see online, and this can result in other serious complications, such as:
- Eating disorders
- Women comprise the majority of people with eating disorders, at 85-95% of those diagnosed with bulimia or anorexia nervosa. (17)
- Anxiety
- One study showed that approximately 10% more young women experience anxiety-related conditions than men. (18)
- Depression
- While up to 5% of the world’s population is affected by depression, women’s occurrence rate is double that of men. (19)
- Suicide
- Women attempt suicide 1.5 times more than men. (20)
- Eating disorders
What are some of the barriers that prevent women from seeking treatment to improve their mental health?
Race and culture
One study found that lack of access to mental health support and cultural stigmas prevent women from getting the help they need. In some cultures, women with mental health challenges face severe stigma. Other times, language barriers create problems. For example, some languages do not have words to describe someone experiencing mental health challenges. (21)
Female international students studying in North America face intense pressure to balance their studies, earn income, and adjust to new living situations. In some cases, while they may have gained more independence and responsibilities, they struggle with family and cultural obligations that they must also maintain. Many of these women who experience mental health challenges don’t know where to turn for help.
Age, education, and income
According to Mental Health Research Canada, women under 25 are “over-represented among those with high anxiety, stress and depression and are less likely to seek mental health support, citing an inability to pay or not having insurance coverage as barriers.” (22) The problem can be partly attributed to a shift in employment practices. Full-time roles are becoming more difficult to find as younger women struggle to break into their fields. As a result, they often start off taking low-wage, contract positions that rarely offer benefits. When they need specialized support and healthcare, sometimes the fees associated with these services become prohibitive when weighed against covering basic living expenses. Mental health issues will go unresolved and become increasingly more severe.
Urbanization
- Mental health treatment is only sometimes available in smaller communities, and people must travel to regional centres for expanded services. For example, in Canada’s far north, people face everyday challenges with general medical care, but even more so with the ease of obtaining mental health services. Many rural communities also find the availability to coordinate care and treatment with traditional Indigenous medicine quite challenging.
What are some resources available for women seeking mental health treatment?
While many local resources are available, we would like to profile some broad-based solutions that women may be interested in exploring.
If you live in Canada, visit the Government of Canada website and search for “Mental Health Support: Get Help” to find links to national and provincially-based services.
https://www.canada.ca/en/public-health/services/mental-health-services/mental-health-get-help.html
If you are in the United States, start with the US Government’s Women’s Health website
https://www.womenshealth.gov/mental-health/get-help-now
What can we do to support women and their mental health better?
There are some initial steps we can begin to take that will offer better support for women and improve their mental health:
- Acknowledge gender inequality.
- Ensure that women are better supported at home and in workplaces.
- Speak out against misinformation.
- Hold employers accountable for developing diversity, equity and inclusion policies that are respectful and inclusive for all women.
- Remember to act with kindness and compassion, always.
With encouragement, awareness, and increased availability of resources, women can develop better resilience and feel more supported.
References:
1. World Health Organization, (2000). Women’s Mental Health: An Evidence Based Review. Mental health Determinants and Populations Department of Mental Health and Substance Dependence, World Health Organization. Retrieved December 29, 2022 from https://apps.who.int/iris/bitstream/handle/10665/6…
2. Ibid.
3. Ibid.
4. American Psychological Association, (2011). Study Finds Sex Differences in Mental Health. American Psychological Association. Retrieved December 29, 2022 from https://www.apa.org/news/press/releases/2011/08/me…
5. Ibid.
6. Nolen-Hoeksema, 1987; Nolen-Hoeksema, Wisco, & Lyubomirksy, 2008, as cited by Eaton et. al, (2011). Brief Report: An Invariant Dimensional Liability Model of Gender Differences in Mental Disorder Prevalence: Evidence From a National Sample. Journal of Abnormal Psychology, American Psychological Association. Retrieved December 29, 2022 from https://www.apa.org/pubs/journals/releases/abn-121…
7. Riecher-Rössler, A. (14 November 2016). Sex and Gender differences in mental disorders. The Lancet Psychiatry. Retrieved December 29, 2022 from https://www.thelancet.com/journals/lanpsy/article/…30348-0/fulltext
8. Ibid.
9. Reviewed by Coveney, S (2022 January 31). The Gender Gap in Mental Health. News Medical Life Sciences. Retrieved December 29, 2022 from https://www.news-medical.net/health/The-Gender-Gap…
10. BC Women’s Health Foundation in partnership with Pacific Blue Cross (2019 October). In Her Words: Women’s Experience with the Healthcare System in British Columbia. BC Women’s Health Foundation. Retrieved January 10, 2023 from https://assets.bcwomensfoundation.org/2020/10/28162020/BCWHF-In-Her-Words-Report-2019.pdf
11. Furfaro, H. (2022 September 16). Why women with serious mental illness often get worse care than men. The Seattle Times. Retrieved December 29, 2022 from https://www.seattletimes.com/seattle-news/mental-h…
12. McLean Hospital, (2020, July 22). The Impact of Age and Gender on Mental Health. McLean Harvard Medical School Affiliate. Retrieved on December 29, 2022 from https://www.mcleanhospital.org/essential/impact-ag…
13. McGregor, A.J.,M.D. (2020 May 19). Sex Matters: How Male-Centric Medicine Endangers Women’s Health and What We Can Do About It. Hachette Book Group Inc. p.7. Retrieved December 29, 2022 from https://www.alysonmcgregormd.com/book
14. Northwell Health – Katz’s Institute for Women’s Health. (n.d.). Gaslighting in women’s health: No, it’s not just in your head. Northwell Health. Retrieved on December 29, 2022 from https://www.northwell.edu/katz-institute-for-women…
15. CBC News. (2019 October 10). Half of women in B.C. say doctors have played down their health concerns, report finds. CBC News. Retrieved December 29, 2022 from https://www.cbc.ca/news/canada/british-columbia/bc…
16. McLean Hospital, (2022, March 4). Understanding Mental Health Over A Woman’s Lifetime. McLean Harvard Medical School Affiliate. Retrieved on December 29, 2022 from https://www.mcleanhospital.org/essential/understan…
17. Cooper, S. (2022 June 13). Women’s Mental Health: Facts and Statistics. Innerbody.com. Retrieved December 29, 2022 from https://www.innerbody.com/womens-mental-health-fac…
18. Ibid.
19.Ibid.
20. Ibid.
21. Pasieka, C. (2022 April 10). Racialized women face significant barriers when seeking mental health care, study finds. CBC News. Retrieved December 29, 2022 from https://www.cbc.ca/news/canada/toronto/racialized-…
22. Canadian Mental Health Association (CMHA). (2022 October 25). CMHA testimony before FEWO: young women and girls mental health study. CMHA.ca. Retrieved December 29, 2022 from https://cmha.ca/news/cmha-testimony-before-fewo-yo…
Employee Fatigue, Isolation and Loneliness
Employee Fatigue, Isolation and Loneliness
Employee Fatigue
Many employees have transitioned to working remotely, whether that means working from a home office, or their kitchen table – employers and employees have had to adapt. Working from home and having endless access and connectivity to your work can lead to longer working hours, which may in turn, lead to burnout. Unable to partake in face to face meetings, as well as having limited social interactions with colleagues may have employees feeling isolated. Maintaining good communication with your co-workers is essential in combating fatigue and isolation, and promotes stronger remote work arrangements.
Here are a few considerations to make the work from home transition easier:
- Have a dedicated workspace
- Where possible, select a workspace with natural light
- Create a schedule
- Change out of your pajamas and get dressed for the day
- Maintain a healthy diet and hydrate
- Take breaks
It is imperative to emphasize the importance of taking breaks during your workday, even when working from home. It’s often a simple oversight, however, by-passing breaks may occur as you adjust to a new work environment. You may also justify additional work time in an effort to increase your perceived value and productivity. Think back to when you were at your physical workplace, you likely spent some time taking a break from your desk and catching up with co-workers during your lunch – you still need breaks from your home workspace. By taking breaks throughout your workday, you combat both fatigue and burnout. When stepping away from your computer screen or going for a brisk walk to get some fresh air – you give your eyes and mind a much-needed break. “Working at home begins to fail when individuals forgo breaks. In fact, not sticking to a schedule can have major implications for both productivity and mental and physical health.”(1) Also, try eating your lunch away from your screen.
Isolation
Whether you’re in quarantine because you have contracted the virus, or isolating to do your part in slowing the spread of COVID-19, being confined to your home with a decrease in social interactions can take a toll on your mental health. In a recent survey, it was found that “people are starting to feel the full effects of these practices: 54 percent of Canadians feel lonely or isolated.” (2) Having strategies that will help you cope during isolation is extremely important. Some tactics to try include:
- Create a daily routine. Keeping up with a routine will give you structure for your day.
- Stay informed, but limit your media intake to reputable sources.
- Stay active. Go for a walk or a bike ride, while maintaining physical distancing.
- Keep in touch. Call or video chat with your friends and family.
- Find a healthy distraction. Learn a new hobby or practice a skill you’ve been neglecting.
Loneliness
Everyone will experience loneliness differently, it is a personal experience. Some employees may not experience it at all, but others not accustomed to extended periods of time away from others, or those who covet social interactions may experience extreme feelings of loneliness. Regardless of your position, all feelings are valid. Remember you are not the only one feeling this way. “Now more than ever there is less reason to feel any shame or apprehension about loneliness; it may feel easier to share with others if you are finding it tough, and you are more likely to feel supported and understood by others.” (3) It can be helpful to address your needs with friends or family members as social support is a healthy way to stay connected. The feeling of loneliness may seem never-ending, so it’s important to stay connected to yourself and know your feelings are valid. Try meditation or journaling to reflect on how you’re feeling each day.
The Australian Psychological Society states that “we experience loneliness because it is a trigger for us to reach out and connect with others.” (4) Ensure you stay connected with your professional and personal networks. With the technological possibilities nowadays, there are many ways to stay in touch with people, regardless of where they are. Set up a weekly online video call, play virtual card or board games with friends or having a virtual family dinner can help you feel connected to your support system.
Self-Care
When what we have known as the “norm” is no longer relevant and there are so many drastic changes, it is important that we care for our mental health. One of the many ways to do so, is through self-care. The importance of “developing a healthy self-care practice means that you are willing to do some work to discover what makes you feel fulfilled. You’re also willing to try and achieve a better balance between your physical and mental health.” (5) Society has such a large impact on what we see as “ideal” self-care routines, but it is important to do what makes you feel good and fulfilled, as everyone’s self-care routine will look a bit different.
If you’re unsure where to get started, some very basic self-care tips include: getting enough sleep, eating healthy, exercising, limiting your screen time, and spending some time outside.
In addition to self-care, it is important to also practice self-compassion. Don’t resist your feelings of isolation or loneliness, but instead “find ways to be accepting of them as coming and going.” (6) We’re all in this together.
References:
- Collie, Meghan (2020). Source: https://globalnews.ca/news/6929809/coronavirus-wor…
- Collie, Meghan (2020). Source: https://globalnews.ca/news/6793214/coronavirus-can…
- Australian Psychological Society (2020). Source: https://www.psychology.org.au/getmedia/2612f989-02…
- Australian Psychological Society (2020). Source: https://www.psychology.org.au/getmedia/2612f989-02…
- Life Lines, Issue #07. Self-Care: Time and Attention for you
- Cuncic, Arlin (2020). Source: https://www.verywellmind.com/how-to-cope-with-lone…
Youth, Teens and Mental Health
Youth, Teens and Mental Health
Children And Mental Health Disorders
It’s no secret the emotions and actions of youth and teenagers can be a dizzying array of ups, downs, quirks and contradictions.
As adults, it may be difficult to imagine children suffering from such difficult challenges, yet child psychiatrist, Dr. Jean Clinton, worries the number of young people today experiencing mental health problems is on the rise. The statistics do paint a striking portrait: close to 20 percent – one in five – young people are actively dealing with a mental health issue. These include:
- Anxiety disorders
- Attention-deficit/hyperactivity disorder (ADHD)
- Bipolar disorder
- Conduct disorder
- Depression
- Eating disorders
- Psychosis
- Schizophrenia
- Suicide
Of these, anxiety disorders most commonly affect children and teens, with six percent experiencing them at some point. Suicide, the most concerning of mental health issues, is the number one non-accidental cause of death among Canadian youth. The Canadian Mental Health Association (CMHA) reported that a shocking five percent of youth attempted suicide in the past year, while another 12% had given suicide serious thought. Without question, our youth and teens are facing stressors and pressures in their lives which are manifesting in ways that go well beyond the often inconsequential “growing pains”.
Just as concerning, only one in four will get the help they need. This can create a disruptive ripple effect: the mental illness itself makes its way into the daily fabric, relationships, academics and physical health of the child. This, in turn, can negatively impact their future development, their overall mental and physical well-being and their perceptions of success in their adult lives.
It’s crucial that we eliminate the stigma and fear surrounding mental health, while opening up helpful dialogues that will benefit youth now and in the years to come.
Mental Health Disorders: What To Look For
With 50-70% of mental health disorders showing up before 18 years of age, it’s important to identify those who are struggling as early as possible. Some of the most common signs to watch for are:
- Avoiding people, places or situations they normally engage with or suddenly keeping to themselves
- Changes in eating patterns, feelings or behaviour surrounding food, weight or physical appearance
- Changes in self-esteem or self-image
- Changes or decline in relationships at school, home, or with other kids
- Changes or decline in school or extracurricular performance
- Changes or inability to sleep, relax or concentrate
- Deliberately hurting themselves or others
- Inability to cope with everyday life, issues or activities
- Lack of regard or interest in the feelings or property of others
- Lack of self-care or neglecting themselves
- New or increased use of alcohol and/or drugs
- New or unusual physical behaviours or ailments like recurring head or stomach aches, neck pain, excess energy or nervous habits (i.e.: nail biting, hair twisting, thumb-sucking, odd or repetitive movements)
- Overreactions to relatively small incidents
- Reduced interest in social or extracurricular activities they normally enjoy
- Speaking of suicide or having a preoccupation with death
- Sudden changes or extremes in emotion such as feeling rejected, worthless, hopeless, sad, helpless, anxious, worried, guilty/self-blaming, disillusioned, angry or afraid
- Sudden or unexplained changes in behaviour (i.e.: an active child becomes withdrawn or a good student’s grades drop)
Certain circumstances may also make children more susceptible to mental health disorders. These include:
- A family history of mental health disorders
- A history of previous suicide attempts
- Being gay, lesbian, bisexual or transgendered
- Ethnicity and societal discrimination
- Facing or having witnessed trauma, including abuse
- Having been the victim of, or having engaged in bullying
- Having recently gone through a major life change (moving to a new country, city or school)
- Having substance abuse problems
If you’re concerned about your child, talk to them about how they’re feeling. Letting them know you care is a powerful first step in showing they aren’t alone.
Ensuring Children Don’t Suffer Alone: Being Proactive and Offering Support
Daunting as it may be to broach the subject of mental health and kids, there’s reason to be optimistic: 70 per cent of mental health cases that appear in children can be addressed through early intervention.
Getting ahead of mental health disorders, and offering support to those who need it empowers both the at-risk child and the adults who love them. The good news? There are a multitude of ways to do just that.
Foster resiliency: As a parent, resist the urge to “bubble-wrap” or constantly protect your kids. Instead, actively provide the tools and skills to help your child problem solve, resolve conflict and help cope with the normal roadblocks, responsibilities and inevitable setbacks they’ll face. Boost their self-confidence by supporting good decision-making, assertiveness, perseverance and self-determination.
Communicate: Openly, honestly and often. Some of our favourite expert advice:
- Notice the little conversation openers your child offers up
- Ask non-judgemental questions and really pause to listen to what they have to say
- Acknowledge their feelings
- Answer questions directly and honestly
- Give your undivided attention
- Resist the urge to quickly jump in with solutions or advice
- And, above all, make time to connect whenever you can
Apart from keeping the lines of communication open and natural, checking in frequently also provides a great baseline; if things change where your child’s mental health is concerned, you’ll be far more likely to notice it, and they’ll be far more likely to share their struggles with you.
You and your child may also consider creating a signal (i.e.: a code word or specifically worded email or text message) to be used when they’d like to open a discussion about something important. This can help set the stage for a conversation they may not otherwise know how to begin.
Nurture a healthy, safe environment at home: Establishing routines and setting clear boundaries, rules and limits are key, as is building in daily time together. Mealtimes are fantastic opportunities to talk and listen (especially when devices are put away!). In fact, research suggests kids who share fewer meals at home with their family actually become sexually active or experiment with drugs at earlier ages, while kids living in a healthy, supportive environment have better mental health and less risk of mental health disorders.
Be respectful: Demonstrate that you value and accept your child for who they are.
Create a network of strong relationships: Help your child build a wider support system through friends, team sports, their church or other social activities. Even taking care of a pet can prove deeply fulfilling and beneficial to mental health.
Provide outlets to relieve anxiety and stress: Physical activity, meditation and the arts are super for self-expression, growth and work wonders on a young person’s overall mental health and ability to handle stress.
Avoid involving children in adult problems: When dealing with your own personal issues, look to other adults for support instead of bringing your child into the fray. Not arguing in front of your child or asking them to pick sides is important to ensuring your child’s mental health is maintained.
When necessary, seek professional help: If your child needs more intensive support, don’t hesitate. Your EFAP or family doctor are great places to start. They can help you navigate the various therapists, therapies, support groups, help lines and other services available, and determine which may be the best fit for your child. Provide information on your EFAP or local help line to your child so they can access services themselves, confidentially, if they ever need someone else to talk to.
Mental Health and Stability Outside the Home: Staying Informed About Your Child
Whether school, sports, work or their social lives, your child likely spends significant time away from the predictability of home. Be assured, however, that staying in the loop is possible, encouraged and supported by your community. You need only reach out or take some initiative to get a read on how your child’s doing outside the home. Consider:
Keeping an eye on online activity: Monitor your child’s social media activity or messaging apps to see how they’re feeling, coping and interacting with others. Keep it subtle and non-intrusive so your child feels their self-expression and privacy are being respected.
Communicating frequently with those who interact with your child: Teachers, guidance counsellors, administrators, friends, youth leaders and other parents can offer unique insights into how your child or teen may be acting or feeling when you’re not present.
Getting involved…together: Joining your child in activities they enjoy, or volunteering together for a good cause provides a space for bonding, self-esteem building, communication and connections that are often different than at home.
Mental health disorders in children and teens can be a source of great trepidation and fear, but it needn’t be. Acknowledging the very real challenges and complexities facing children – and letting them know you’re there to listen and help – this can be just what’s needed to ensure they feel supported, allowing them to flourish, during this exciting and dynamic time in their lives.
Recreational Therapy: Moving Toward Mental Health and Addiction Recovery
Recreational Therapy: Moving Toward Mental Health and Addiction Recovery
By learning to move their bodies in new ways, Canadians with mental health and addiction challenges are rediscovering their strength, resilience, and joy.
Walking in a park. Taking a moment to focus on your breath. Holding a yoga pose. These activities may seem simple — even frivolous. But they are part of a therapeutic approach that is transforming outcomes for people undergoing mental health and/or addiction treatment in Canada.
Recreational therapy improves physical, social, emotional, and cognitive functioning through leisure, recreation, and play. For people with mental health and addiction challenges, recreational therapy not only changes our bodies, but it also changes our brains on a chemical level. The result can be greater self-confidence, self-esteem, social connections, motivation, strength, and a sense of purpose — all of which support treatment and recovery.
The benefits have been proven through extensive research, and in 2016, the World Health Organization (WHO) officially recognized exercise as a proven therapy for mild to moderate depression and anxiety.
“We tend to separate ‘exercise’ from all the other ways we move our bodies, but it’s a continuum, and all movement is valuable.”
Recreational therapy is for everyone
Becoming and staying active isn’t always easy. Only one in five Canadians meet the recommended level of physical activity. People seeking mental health treatment in Canada for issues such as depression, anxiety, PTSD, or addiction often face even greater barriers to adopting an active lifestyle, including negative self-image, low energy, and physical health concerns.
In these cases, a recreational therapist can help the individual to overcome those barriers and incorporate movement and recreation into their mental health treatment options. A recreational therapist is a healthcare professional who helps individuals improve their physical, social, emotional, and cognitive functioning through recreational and leisure activities.
Chris Seftel, strength and conditioning coach at The Residence at Homewood, an inpatient treatment facility in Guelph, Ontario, says many of his clients mistakenly believe that this type of therapy is only for people who are young and fit.
“I work with a vast range of clients, from high-level athletes to sedentary desk workers, and from people in their twenties to people in their eighties,” says Seftel. “The exercises are tailored to each person’s abilities, needs, and preferences.”
Ronnie Birkland, recreational therapist at Homewood Ravensview, a private inpatient facility on Vancouver Island, British Columbia, agrees that this type of therapy is infinitely adaptable.
“We’re all at different stages in our lives,” he says. “We have different injuries, different backgrounds, and all of these things can make us feel intimidated. My job is to break that down and modify the activities so they don’t feel overwhelmed.”
“There’s a perception that recreational therapy has to be tough or intense, but it doesn’t. It doesn’t need to be hard. It doesn’t need to feel like work.”
How recreational therapy works
Recreational therapy is part of a holistic approach to mental health and addiction treatment. At The Residence at Homewood and and Homewood Ravensview, for example, the recreational therapist is an integral part of an assessment team that also includes an occupational therapist, dietician, nurse practitioner, social worker.
The recreational therapist works closely with the individual to build a foundation of trust, explore recreational options, and build a personalized program designed to deliver immediate and long-term benefits.
Building trust
Building trust between the client and the therapist is a big part of the process. People begin the journey to recovery at a very vulnerable point in their lives, and recreational therapy asks them to take a big leap of faith.
Birkland creates connections with his clients through empathy. “I’ve been through trying times myself,” he says. “I can tell them from my own experience, ‘This is what helped me. This is my blueprint.’ I allow myself to be real and let them feel that they’re in a safe place and that we’re in this together.”
Seftel builds trust with his clients by following a rigorous, evidence-based approach that conforms to recommendations set by organizations including the World Health Organization (WHO), Canadian Network for Mood and Anxiety Treatments (CANMAT), and the Canadian 24-Hour Movement Guidelines. Knowing that his methods are based on credible research reassures people who are putting their recovery in his hands.
Exploring the options
Working with the client one on one, the recreational therapist gets to know them closely — their background, goals, and concerns, the types of activities the client has participated in and enjoyed in the past, and the level of effort the client is willing or able to make as a starting point.
“There’s a perception that exercise has to be tough or intense, but it doesn’t,” says Seftel. “It doesn’t need to be hard. It doesn’t need to feel like work. I try to talk about ‘perceived exertion’ instead of ‘high intensity.’ For someone who has been almost immobile, high-intensity exercise could look like a three-minute walk. And that’s still therapeutic.”
Birkland agrees that the experience should be more uplifting than grueling.
“More often than not, there are things the individual loves to do, but they have not connected with them for years,” Birkland says. “They used to find joy in these activities, but that got taken from them at some point. Rediscovering that joy completes the healing process.”
“I’ve been through trying times myself. I can tell them from my own experience, ‘This is what helped me. This is my blueprint.'”
Creating a program
Seftel and Birkland both focus on designing recreational programs that align with the individual’s interests, preferences, and capabilities. Depending on these considerations, the program could begin with something as gentle as a five-minute walk three times a week or something more physically challenging, including hiking, running, swimming, weight or circuit training, yoga, or pickleball.
Over a period of weeks, the therapist helps the client set and achieve new movement and fitness goals so that they can see tangible progress and experience a sense of achievement.
Following through
Ultimately, the goal is to give the individual the tools they need to make recreation and exercise a permanent part of their lives. That means finding a program that fits their lifestyle, their location, their abilities, and their budget.
“When the 24/7 caregivers, doctors, and therapists aren’t there anymore, when they’re back in ‘real life,’ they have the tools they need to care for themselves and take control of their overall wellbeing,” says Birkland.
“People start to develop some self-compassion. Rather than ruminating on the mistakes they’ve made, they’re focusing on the positive things they’ve done, the things they’ve accomplished.”
The proven impact of recreational therapy
Extensive scientific evidence shows that exercise and movement have a measurable, positive impact on people with conditions such as depression, addiction, anxiety, and post-traumatic stress disorder (PTSD).
People with depression. Aerobic exercise and weightlifting have been shown to be effective in restoring neuroplasticity and reducing the symptoms of major depression. (Neuroplasticity is the ability of the brain to form and reorganize synaptic connections.)
People with addiction. Several studies suggest that exercise participation can reduce cravings, improve withdrawal symptoms, and reduce triggers in heavy cigarette smokers.
People with anxiety. Studies show that exercise is a viable treatment option for anxiety. Exercise increases the amount of a specific protein called brain-derived neurotrophic factor (BDNF) that protects and repairs the brain and reduces feelings of fear.
People with post-traumatic stress disorder (PTSD). Exercise decreases the activity of the sympathetic nervous system and hypothalamic-pituitary-adrenal (HPA) axis, which affect our physiological reactions to stress, including secondary conditions such as sleep apnea and migraines.
Vigorous exercise can also release natural “feel-good” chemicals such as endorphins and endocannabinoids (eCBs), which create feelings of euphoria (also known as a “runner’s high”). Research suggests that these good feelings can help to support sobriety and stave off or reduce the intensity of depression and anxiety.
Seftel says one of the earliest effects he notices is a change in energy levels for his clients. “People are amazed that after putting in the effort, they actually come away with more energy, not less. It’s this incredible sense of accomplishment.”
For Birkland, it’s the psychological changes that shine through. “People start to develop some self-compassion. Rather than ruminating on the mistakes they’ve made, they’re focusing on the positive things they’ve done, the things they’ve accomplished.”
Recreational therapy: Myths and realities
While modern therapeutic recreation has been in existence since the 1950s, it’s still not widely known in Canada as a treatment for mental health and addiction. Birkland and Seftel say it’s common for clients to feel apprehensive about starting a therapeutic program and exercise because of misinformation about this treatment modality.
These are some of the most common misunderstandings about recreational therapy and exercise.
Myth: Recreational therapy means hitting the gym.
Reality: You can move and improve anywhere. “People think of exercise as spandex and dumbbells and sweat,” Seftel says. “But there are hundreds of ways to incorporate movement into your day. Walk in your neighbourhood. Do yoga in your living room. There’s no wrong way to do it.”
Myth: Only high-intensity exercise is effective.
Reality: Any level of movement is beneficial. “Instead of ‘high intensity,’ I try to talk about ‘perceived exertion,'” says Seftel. “We tend to separate ‘exercise’ from all the other ways we move our bodies, but it’s a continuum, and all movement is valuable. Wherever you currently are is exactly where you need to be for us to start working forward.”
Myth: You need to meet a minimum fitness threshold.
Reality: People of any age or ability can participate. Research shows that people of all ages, abilities, and fitness levels benefit equally from recreational therapy. “There are always those blocks, that inner critic, the judgment inside,” says Birkland. “For so many, if they’re not good at it, they don’t want to try it. Throughout my time with them, I ask the questions that help them break down those barriers.”
“Motion creates motion”
For many people, recreational therapy starts small. But the impact is huge. Research shows that moving our bodies and pushing our physical limits — even just a little — can have a profound effect on our health and resilience. For people coping with mental health and addiction, this treatment can start a cascade of beneficial effects to aid recovery that go far beyond the physical.
“Recreational therapy opens so many doors in terms of the experiences you can have and the communities you can create,” says Seftel. “Movement is such a massive part of our lives, and motion creates motion.”
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.
Resources
- Canadian Mental Health Association. Post-traumatic Stress Disorder.
- 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.
- Dr. Jonathan Wan, MD, FRCP(C), Medical Director at Homewood Ravensview.
- The Center for Suicide Prevention. First Responders, Trauma & Suicide.
- BC First Responders Mental Health
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:
- 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. - 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. - 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/
Resources
- Stats Canada. Canadians’ Assessments of Social Media in Their Lives.
- Monica Vermani, clinical psychologist and author of A Deeper Wellness: Conquering Stress, Mood, Anxiety and Traumas. Personal interview. December 2022.
- University of British Columbia. Adrenal Disorders.