Surviving Grief

In every type of job, eventually, we will experience significant loss either personal, professional or both, and therefore, grief. The grief may result from death in an individual’s family, or it may be the death of a coworker or employer. It may be the loss of employment, either from a single dismissal or a significant restructuring and lay off of workers. Whatever the source, the resulting grief can end up being problematic and disruptive to the ecosystem of the workplace.

Types of loss and grief

Some of us only associate grief with the death of a significant other or pet, but people can experience pain after any consequential loss that affects their life. Different types of loss include that of a job or relationship, and in some instances, after the diagnosis of an illness or other major health problems.

There is no one way, or right way, to grieve. However, there is a singularly effective way to receive and empathize with the grieving of others. Brené Brown, author of Daring Greatly, distinguishes between the disconnecting properties of sympathy and the connection we gain through empathy. She refers to nursing scholar Theresa Wiseman, whose research shows empathy to be: the capacity to recognize others’ perspectives as their authentic experience, to understand others’ emotions and articulate them, and to avoid judgment. (1)

Within today’s work environment, there are multiple cross-sections of cultures and religions. Each culture has a set of beliefs that describe how the world works and people’s roles in the world, including their roles in the grieving process. (2)

It helps to remember that each culture has particular and often unique views about the meaning of life and what happens after we die. In general, ideas about the meaning of death help people make sense of it and cope with its mystery.

Some cultures believe in life as a cyclical rather than linear phenomenon; that we return to life after each death. Others believe that the spirit of someone who has passed directly influences the living family members; after death, the spirit of the individual watches over them.

In each culture, death is associated with a set of rituals and customs to help people with the grieving process, offering ways to process and express their grief.

In some cases, a person’s experience of grief may differ with cultural norms; for example, in the case of someone who is quiet and reserved and not quick to cry or express their grief. Some may have a level of despair that feels out of step with the norm, but despite those norms, we need to allow individuals the space to grieve in a way that feels right to them. Although another’s rituals may seem foreign compared to those of our own, these routines provide a means for communities to support the bereaved.

People often adopt the beliefs and values of their culture to meet their unique needs and circumstances. As a result of this, grief responses within a culture can vary from person to person. A family with members from more than one cultural background may develop unique rituals and customs, combining elements from several cultures.

A person who is bereaved can often feel lost in the sense of chaos and confusion. Regardless of where they come from, rituals and customs provide a sense of routine and normalcy. They provide direction and structure at a time when the chaos of emotion could easily prevail. Consider the following when a co-worker is grieving:

What are the bereaved family’s beliefs surrounding death?
What emotions and behaviours are typical for the bereaved person’s culture?
Who should attend certain ceremonies, and how are attendees expected to act and dress?
What types of offerings, material or emotional, are expected?
Are there appropriate verbal or written condolences?

Consider talking with someone who shares that same cultural background, or you can start with internet resources if that feels more comfortable. Being ignorant of the cultural differences of grief could cause undue conflict or misunderstanding in the workplace; however, showing compassion and acceptance will create connections and help in the moving forward phase. Here are a few considerations:

When the person returns to work:

At the first opportunity, express your condolences (if you have not already done so).
Make it as normal as possible. Try not to change your facial expression and tone of voice when speaking with your co-worker.
Carry on with normal work routines. If you typically eat lunch together, continue doing so.
Try to be sensitive in your conversation. If you are unsure what to say or how to treat them, acknowledge that, and ask them if they wish to discuss the loss, or instead wish to concentrate on workplace tasks. They will tell you what they need and don’t need, and you should respect their wishes.

The following examples illustrate things you should avoid saying when trying to support someone who has recently experienced a loss.

What not to say:

“I know how you feel.” Each loss is different. You could, instead, ask how he or she feels, but only if you know they are okay with talking about the loss at work. Also, don’t share your own story of loss as a sign of empathy.
“It’s part of God’s plan” or “It is God’s will.” This can make people angry and they may respond with, “What plan?” For some, religion may not come into play.
“Call if you need anything.” They aren’t going to call. It is much better to offer something concrete, such as: “I have some free time, and if needed, I would like to come over and help where possible.”
“He/she is in a better place now.” These clichés can be hurtful as circumstances may be of a sensitive and/or difficult nature.
“It’s time to get on with your life.” We all grieve in our own way and our own time. It is not your place to suggest what length of grieving is warranted.

Stages of grief

We know now that there are five stages of grief that most individual tends to go through, but how those stages play out in a person’s life will be unique and probably full of nuance, involving emotions that come and go, in a seemingly cyclical fashion. (3)

The five stages of grief

Denial
Anger
Bargaining
Depression
Acceptance

People experience grief in many different ways, often in a unique mix of sadness, shock, anger, fear, or anxiety. Some feel numb, while others feel relief or peace after a loss.

Some can even feel removed from the world and disconnected from daily life, including work. In all of these cases, support is necessary to move on and forward.

In order to heal, you have to acknowledge the pain and allow yourself the opportunity to grieve. Unresolved grief can lead to complications such as depression, anxiety, substance abuse, and health problems. Exploring your feelings and thoughts through writing, painting, music, or other forms of creative expression can be a powerful way to help heal. And remember, crying is a natural way to help release the hurt.

Be aware that some coworkers may not have experienced a significant loss, and do not have the psychological tools or experience to support their peers. For them, it is vital to have an established plan for supporting their colleagues without becoming consumed by the situation.

How to move forward

Grieving a loss can sometimes feel endless and unbearable, and yet we eventually must return to some daily routines.

Although some of those routines may have changed, the need to work often remains constant. What happens then? Moving forward doesn’t mean forgetting; it’s merely making new connections so we can thrive. Being conscious of our distressing emotional thoughts can be the impetus to moving forward in our own lives, but how do we become the kind of support for a grieving colleague if and when required in their time of need? (4)

Through our work, we have found that employees have a dual responsibility. First is the responsibility to the employer; second is the responsibility to keep the work environment running like a healthy ecosystem, part of which is taking a reasonable amount of interest in the well-being of coworkers. Almost all of us will spend the better part of our working lives surrounded by people who are not considered to be our friends. While we may spend more time with them than with our family and/or social friends, the interactions are typically communal and on the surface, rarely run deep. Coworkers and supervisors are often at a loss as to how to react in the wake of a personal and significant loss. It’s difficult to know what to do or say, what not to do or say, and how long the uneasiness will last. (5)

We form well-intentioned comments out of care and concern, yet may convey unknowingly a lack of sensitivity to one’s grief experience. The bereaved may take this perceived reservation to mean that it’s time to ” snap out of” their sadness though they have little control over their emotions and may lack the ability to regulate their attention. Workers whose jobs take high concentration may experience distracting thoughts about the deceased and may make mistakes that they wouldn’t typically make.

Added to the intense emotions they are experiencing is anxiety about how employers and coworkers perceive them. A bereaved person may have a fear of further loss, of their job, perhaps compounding the sadness and anxiety they are already experiencing. These are two ways you can support a grieving colleague; it is wise to find a compassionate middle ground where supportive actions and giving space are in balance. While it may seem well-intentioned, saying, “ take your time” or “whatever you need” may be insufficient and may result in an uncomfortable void between colleagues.

Where existing relationships permit and while ensuring you respect the right to privacy, you may ask about the loss during the course of related conversations.

At the same time, it’s essential to remain respectful and aware of when the conversation becomes uncomfortable and the person is giving verbal and non-verbal cues of their need to stop the conversation. Grief counsellors suggest phrasing it authentically. For example, ” I don’t know what to say, but I care, and I’m here when you want to talk.“

Remember that grief isn’t linear, and it can be quite complicated. Feelings, thoughts, reactions, and challenges related to this type of pain are very personal. These thoughts or feelings can sometimes seem at odds with each other, with the intensity of grief changing over time. On top of this, it is not uncommon to feel like the grieving has reached an end only to be derailed by an unexpected trigger. Holidays, for example, are known triggers because they hold so much emotion, nostalgia, memory, and familial pressure.

What can you do?

Different strategies can help you to learn to live more effectively with this experience.

First, do not try to speed up your mourning, or the mourning of those around you. It is normal to need time to accept the loss.
Do not hesitate to talk about your feelings or reactions with people who may be close to you. Ask them for help. If you talk about your feelings, you will likely recover faster from the loss.
Be attentive to others experiencing the same loss. In this way, you will benefit from mutual support and understanding.
Take care of your physical health. It is possible that your grief will cause stress and sickness. Consult your physician if you are worried about your health.
Take time to reflect on other losses that you have suffered. You will likely discover similarities. This should normalize what has happened, and give you hope.
Gradually resume your favourite activities, particularly those that energize you or ‘recharge your batteries.’ Develop new interests, make new friends.
The loss of someone close to you is a painful experience. It often leaves us in a state of helplessness or confusion. Remember: it takes time to learn to live with such an experience. Also, remember that many resources are available, should you need help.
If necessary, do not hesitate to call us. A professional from your Assistance Program can help you through your mourning period.

We all work through grief at our own pace. A workplace with a thoughtful and easy to follow a plan for dealing with pain over loss is going to have the best chance of mitigating bereavement-related losses while avoiding having grieving become problematic and disruptive. (6)

References:

1. The RSA. YouTube (2013) Source: https://www.youtube.com/ watch?v=1Evwgu369Jw&list=PLt7b6WnSW1ynvTqyu3l_WnAEMhMmwXYl

2. LivingMyCulture. (2019) Source: https://livingmyculture.ca/culture/

3. Kessler, David (2019) Source: https://grief.com/the-five-stages-of-grief/

4. What are Stuck Points in Grief? WYG (2019) Source: https://whatsyourgrief.com/what- are-stuck-points-in-grief/

5. Perreault, Yvette. (2011) Source: https://www.catie.ca/sites/default/files/When%20 Grief%20Comes%20to%20Work_e.pdf

6. When Grief Goes From Just Plain Miserable to Problematic. (2018) Source: https://whatsyourgrief.com/grief-goes-just-plain-miserable-problematic/

February 12, 2020

The Many Faces of Anxiety

Despite the debilitating symptoms that anxiety can lead to, it is treatable. With the support of friends and family, as well as a combination of counselling, self-care techniques, and a doctor’s advice, people with anxiety can lead healthier, happier lives.

If you’re suffering from anxiety, support from EFAP providers, physicians, and primary care practitioners is crucial. Here are the facts you need to know about the many faces of anxiety, including the signs and symptoms, and what you can do to put yourself on the road to recovery.

The main types of anxiety disorders

Anxiety comes in many forms, and is highly dependent on the existing physical, emotional, and psychological stressors in your life. (1) Typically, anxiety can be classified into six categories:

Generalized Anxiety Disorder (GAD). One of the most common forms of anxiety, this disorder is typically characterized by chronic, persistent, and severe feelings of anxiousness, panic, fear, tension, and worry without immediate provocation, or the ability to identify the source of these feelings.
Panic Disorder. Characterized as a condition consisting of persistent panic attacks, panic disorder is accompanied by extreme and unexpected fear, shortness of breath, heart palpitations, dizziness, and nausea.
Agoraphobia. Characterized as fear and avoidance of places or situations that might cause a person to panic or feel trapped, helpless, or embarrassed. Often accompanied by Panic Disorder because people come to fear places in which they have had a panic attack.
Social Anxiety Disorder. Characterized by excessive self-consciousness in everyday situations to the point of developing a social phobia. People with extreme forms of Social Anxiety Disorder may endeavor to avoid social events at all cost.
Separation Anxiety Disorder. Though this typically affects children who are separated from their parents, this disorder can affect adults with equal severity, and involves a fear or anxiety of being separated from a loved one. Separation anxiety can occur due to a separation in any relationship, including friends, loved ones, and even pets.
Phobias. Classified based on the extreme fear of a person, thing, archetype, or abstract concept. (2) These fears typically develop in early childhood, but may develop later in life based on a traumatic incident or stressful situation. Phobias can get in the way of a person’s daily life, if the subject of the phobia is persistently present.

Though anxiety disorders typically develop in a person’s 20s or 30s, they can be triggered at any point in a person’s life, especially if a traumatic or stressful event has occurred. If a person has an existing genetic predisposition to mental health issues, the likelihood of developing a form of anxiety is higher than if no predisposition is present. In addition, a person can have a combination of several anxiety disorders simultaneously.

The signs, symptoms, and causes

Although genetic predisposition, traumatic events, and current life circumstances are all factors in the development of an anxiety disorder, the exact cause of anxiety disorders is relatively unknown. Therefore, the diagnosis and treatment of anxiety disorders can only be properly assessed on a case by case basis.

If symptoms persist over a few months, or if the anxiety elevates in severity, an anxiety disorder is typically present. (3)

These symptoms can include:

Panic, fear, and a persistent sense of uneasiness
Sleep issues
An inability to stay calm or still, especially in a stressful situation
Tingling in the hands, feet, and other limbs
Cold or clammy skin
Shortness of breath
Tension in the joints or muscle tissue
Dry mouth
Nausea
Localized pain, especially in the jaw, neck, and chest

If you have any of the above symptoms and suspect that you may be suffering from an anxiety disorder, speak to your doctor or a mental health professional with the capability of making a definitive diagnosis.

The long term effects

If left untreated, anxiety can take a definite toll on the physical and mental health of the individual, and its impact can cause issues with attention, memory, neurological impulses, and an overall sense of health and well-being.

Persistent, untreated anxiety can have long term repercussions on several aspects of the body, including: (4)

The Central Nervous System. Elevated levels of stress over an extended period of time can increase hormone distribution throughout the body, resulting in weight gain and hormonal issues.
The Cardiovascular System. Increased heart rate and difficulty breathing can increase the risk of high blood pressure, heart disease, and various coronary events.
The Excretory and Digestive System. Stomach aches, loss of appetite, and digestive issues are all contributing factors to the development of chronic digestive issues, such as Irritable Bowel Syndrome (IBS).
The Immune System. Acute stress has been linked to weakening the immune system, leaving anxiety sufferers more vulnerable to infections and illnesses.
The Respiratory System. Rapid, shallow breathing can worsen symptoms related to asthma and other respiratory illnesses.

Anxiety can affect anyone of any gender, race, or background. However, research indicates that anxiety disorders typically affect women more prevalently. In Canada, of the 0.7% to 1.5% of the population affected, the majority are women, and in the United States, women are twice as likely to develop an anxiety disorder as their male counterparts. Overall, an estimated 1 in 10 Canadians are affected by an anxiety disorder, and 18% of the population are affected in the United States.

Getting Help

In all cases where anxiety is concerned, support is crucial. Most people with anxiety will find that having a strong, supportive environment helps in their journey towards a happier, healthier life, free from anxiety. (5) If you’re suffering from anxiety, be sure that you’re surrounded by friends, family, and colleagues that support your mental health journey.

Treatment for anxiety is prescribed on a case to case basis, but the three most common treatments are: (6)

Talk therapy, which involves receiving counselling services from but not limited to a licensed psychotherapist or psychologist.
Cognitive Behavioural Therapy, a form of talk therapy that involves identifying and changing any potentially harmful and unhealthy behaviours. (7) Talk therapy is the most effective intervention for overcoming and managing an anxiety disorder.
Medication, which is prescribed only when necessary by a licensed psychiatrist or doctor, and is only used in the case of some forms of anxiety or anxiety disorders.

Once an anxiety disorder is considered to be under control, or deemed manageable, it’s crucial to practice forms of self-management in order to aid you in your recovery process. The process of managing anxiety is very individual, but will often include avoiding specific triggers that could elevate your stress levels, practicing relaxation techniques (e.g. meditation or yoga), speaking with supportive friends or peers, exercising, and continuing to check in with your therapist or medical professional on a regular basis.

Practicing self-care, whether it involves talking to friends, having a warm bath, or going to the gym, is an integral aspect of your recovery journey.

Conclusion

Although anxiety can feel debilitating, it doesn’t have to get in the way of your everyday life. Recovery is all about patience: remember that it can take time before you start feeling a difference, especially if you’ve started to take medication. Give yourself the time and space to heal, and you’ll find that the journey is ultimately more manageable.

With proper treatment, it’s possible to recover from an anxiety disorder and live a healthier, more productive life, free from any fear or worry that might have once hindered you in having a strong, stable sense of self.

References:
1. HHS.gov Source: https://www.hhs.gov/answers/mental-health-and-substance-abuse/what-are-the-five-major-types-of-anxiety-disorders/index.html

2. Wodele, Andrea & Solan, Matthew. (2017) Source: https://www.healthline.com/health/phobia-simple-specific

3. Browne, Dillon. (2018) Source: https://www.medicalnewstoday.com/articles/323454.php#treatment

4. Cherney, Kristeen. (2018) Source: https://www.healthline.com/health/anxiety/effects-on-body#8

5. WebMD (2019) Source: https://www.webmd.com/anxiety-panic/guide/anxiety-disorders#1

6. Smith, Melinda & Segal, Robert & Segal, Jeanne. (2019) Source: https://www.helpguide.org/articles/anxiety/therapy-for-anxiety-disorders.htm

7. Gitter, Ana. (2019) Source: https://www.healthline.com/health/behavioral-therapy

by admin

Avoiding Substitute Addictions

In this article, we’ll be looking at:

What is a substitute addiction?
How to detect substitute addictions?
Is there such a thing as a positive replacement addiction?
How to prevent substitute addictions?
How to recover from them?

What is a substitute addiction?

When someone replaces one type of addiction with another, it’s often called addiction replacement or a substitute addiction. To explain this phenomenon, several studies have demonstrated that a vast array of substance and behavioural addictions may serve similar functions such as relaxation, overstimulation or escape. Moreover, addictions tend to desensitize the reward system.1 The dopamine-deprived brain, in the early phase of sobriety, will find compensation in euphoria-generating activities and could transfer its past addictive behaviours to new negative habits such as gambling, binge eating, sex addiction, compulsive exercise, Internet-based dependencies or workaholism.

Although substitute addictions can emerge during or after the treatment process for the original addiction, it’s viewed as a frequent occurrence during recovery.

Sometimes the substance of choice will be replaced by a new substance but it is not the most likely form of substitution. While it is widely believed that a person remitted from a substance use disorder (SUD) is more likely to develop another SUD, a research project studying a sample of over 13,000 addicted adults has shown a substance replacement ratio of only 13.1% when interviewed three years into their recovery process. Among the factors significantly increasing the odds of a replacement SUD, the study cited: being male, young, never having been married and psychiatric comorbidity.

However, other forms of substitute addictions might be tempting because they seem less harmful, like compulsive shopping or eating. The substitution pattern may also go both ways. Food and drugs are affecting the same pleasure and reward circuits of the brain, and it has been observed that some bariatric surgery patients turn to drugs as a replacement for food binging.4 This research demonstrates that an addict is not only craving a substance. They may also be trying to fill an emotional need, dull inner pain or avoid dealing with important personal issues.

How to detect substitute addictions?

Substitute addictions share much of the same characteristics as the original one. Two important questions to consider are, is the behaviour compulsive and is it out of control?

Here are some of the characteristics one should consider when assessing whether or not a case of substitute addiction is developing. Is the behaviour, activity or substance:

A quick source of relief when bursts of emotional pain and anxiety occur?
Becoming the new way to feel instant gratification or a “high”?
A “must” part of the daily routine?
Significantly taking away from time usually devoted to family and responsibilities?
Being pursued even if negative consequences add up, such as isolation, financial problems, physical or mental health issues, and deteriorating relationships?

Any positive answers to the above questions may be cause for additional consideration.

While recovering from an addiction, addictive personalities are vulnerable for additional addictions that could fulfill their needs. However, according to the replacement theory, they will seek out substitute addictions that are less harmful than the original such as behavioural addictions or high-base rate addictions such as alcohol and nicotine. Still, one should not interpret this phenomenon lightly, as addiction substitution reinforces the behaviours of an addictive personality and thus may increase the risk of relapse.

Is there such a thing as a positive substitute addiction?

What if the substitute addiction involves a positive activity such as exercise? Does it become a positive substitute addiction? Although less harmful, if performed compulsively, the new addictive habit will fuel up an addictive personality all the same. It will continue to diminish self-control and one’s sensitivity for dopamine.

As a result, the addicted person will become even more vulnerable for additional addictions and relapse.

For example, at least according to some researchers, reading a novel, gardening, or playing a musical instrument tends not to lead to destructive addictive patterns of behaviour. There may be qualities inherent in a behaviour that tends to prevent it from becoming an object of addiction, at least for most people.

Three primary characteristics can define a behaviour as not likely to become addictive:

If a behaviour is consistent in flow and lends to a slow pace, such as gardening, for example.
If a behaviour involves deliberate, step-by-step planning and processing of information.
If a behaviour leads to longer term gains rather than short-term, hedonic gains that, over time, lead to relative losses.

In light of those characteristics, all habits can’t be categorized under the substitute addiction label, and some could actually help in the recovery process.

How to prevent or avoid substitute addiction?

Another quality that could define a positive new behaviour may be connectedness. Sticking to the gardening example, one could entertain a connection with nature. Many persons with addictive personalities chose to switch to an entirely new social circle, for a better connection to healthier people that evolve away from their usual and in many instances, toxic networks where everyone and everything is focused on the addiction.

British journalist Johann Hari, based upon his research, has taken the position that the opposite of addiction is not sobriety, but connection. Addiction is not to be only understood in terms of the pleasurable effects of substances, but to be linked to the addicted person’s inability to connect in healthy ways with others. As Psychology Today puts it: “Addiction is not a substance disorder, it’s a social disorder.’’

Following that logic, one of the best ways to prevent substitute addictions may well be to connect through positive networking and healthy activities. This would seem to align with 12-step programs that connect to peers in recovery and, spiritually, to a Higher Power.

However, not so fast.

In his paper “Drug addiction, love and the Higher Power”, researcher and addiction specialist Steve Sussman writes that “prayer, meditation, early romantic love, and drug abuse may have in common, the activation of the brain’s dopamine liberation process and the generation of intense emotional states. In this sense, reliance on a Higher Power may operate as a substitute addiction, which replaces the psychobiological functions formerly served by drug use.” Sussman goes on to say that an addict in some instances may avoid working on the underlying problems and rely on the Higher Power to fix it.

Others point out that addictive-like reliance on a Higher Power may provide a means to maintain relatively optimal dopamine turnover in the brain’s reward system after terminating a drug of abuse. This is critical, given evidence that there is low dopamine production both early and late in the abstinence process, which persists if untreated.

How to recover from substitute addiction?

If there seem to be arguments on both sides regarding 12-step programs, the most effective way to recover from all addictions, original and substitute alike, seems to be to work on oneself through therapy in a state of abstinence.

Most often, an underlying issue attracts the addictive behaviour so it can act as a coping mechanism. The issue can be, for example, an anxiety-generating situation, an unfinished grieving process or can be linked to a past traumatic event. Identifying and uncovering these issues and trying to heal them will contribute to the recovery process and help to prevent new addictions from developing.

Some of the most effective, evidence-based methods to fight addiction are:

Cognitive and Dialectical Behavioural Therapy (CBT and DBT): Through CBT, one learns to identify and correct problematic thinking and behaviours by helping to develop more accurate thoughts and effective coping strategies.
Motivational Enhancement Therapy: Particularly effective with alcohol and cannabis addictions in engaging people to enter treatment.
Trauma-Informed Approaches: Address consequences of traumatic experiences, change problematic thinking and developing coping strategies. Recognize one’s need to be respected, informed, connected, and hopeful regarding their own recovery. Understand the interrelation between trauma and symptoms such as SUD, eating disorders, depression, and anxiety.

The ultimate connection leading to recovery will always be to yourself.

References:

1. Sussman, S., Lisha, N., & Griffiths, M. (2011). Prevalence of the Addictions: A Problem of the Majority or the Minority? Evaluation & the Health Professions, 34(1), 3–56. Source : https://doi.org/10.1177/0163278710380124

2. Hodgins, David & Kim, Hyoun S (Andrew) & Stea, Jonathan. (2017). Increase and Decrease of Other Substance Use During Recovery from Cannabis Use Disorders. Psychology of Addictive Behaviors. 31. 727-734. 10.1037/adb0000307. Source: https://www.researchgate.net/publication/318745738_Increase_and…

3. Blanco C, Okuda M, Wang S, Liu SM, Olfson M (2014). Testing the drug substitution switching-addictions hypothesis. A prospective study in a nationally representative sample. JAMA Psychiatry. 2014 Nov;71(11):1246-53. doi: 10.1001/jamapsychiatry.2014.1206. Source : https://www.ncbi.nlm.nih.gov/pubmed/25208305

4. Substituting Addictions, by Jeanene Swanson. The Fix (October 23, 2014). Source: https://www.thefix.com/content/substituting-addict…

5. Sussman, Steve & Black, David. (2008). Substitute Addiction: A Concern for Researchers and Practitioners. Journal of drug education. 38. 167-80. 10.2190/DE.38.2.e.

6. Elliott, L., Golub, A., Ream, G., & Dunlap, E. (2011). Video game genre as a predictor of problem use. Cyberpsychology, Behavior, and Social Networking, 15, 127-128.

7. Lesieur HR, Blume SB. Pathological gambling, eating disorders and the psychoactive substance use disorders. Journal of Addictive Behaviors. 1993;12:89–102. [PubMed] [Google Scholar] AND Sussman S, Lisha N, Griffiths M. Prevalence of the addictions: A problem of the majority or the minority. Evaluation & the Health Professions. 2010;34:3–56. [PMC free article] [PubMed] [Google Scholar] (SD: same study as I, above)

8. Herrnstein RJ, Prelec D. Melioration: A theory of distributed choice. The Journal of Economic Perspectives. 1991;5:137–156. [Google Scholar]

9. Robert Weiss Ph.D. The Opposite of Addiction is Connection. Psychology Today. Sept. 30, 2015. Source: https://www.psychologytoday.com/us/blog/love-and-s…

10. Sussman S, Reynaud M, Aubin HJ, Leventhal AM. Drug addiction, love, and the higher power. Eval Health Prof. 2011;34(3):362–370. doi:10.1177/0163278711401002 Source : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC31851…

11. Markou A, Kosten TR, Koob GF. Neurobiological similarities in depression and drug dependence: A self-medication hypothesis. Neuropsycho-pharmacology. 1998;18:135–174. [PubMed] [Google Scholar]

12. Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). Source: National Institute on Drug Abuse; Behavioral Therapies : https://www.drugabuse.gov/publications/principles-…

13. Source : MentalHealth.org: https://www.mentalhealth.org/get-help/trauma

by admin

Me-Time: Managing Stress and Finding Work-Life Balance

Work-life balance is an individual measurement and may vary daily, monthly, and over extended periods of time. The right balance will differ as your lifestyle changes. Your needs and wants evolve throughout the various stages of life, from single life, to being married, to the possible addition of children or new career aspirations, and to nearing retirement. There is no perfect formula or ideal balance. The right equation differs because each individual has different priorities, goals and influences that shape our needs at home and at work.

A common and perhaps familiar narrative unfolds across the country week to week. Your work colleagues arrive early, stay late, they’re on the way to successful careers, or so it seems. To keep up, you do the same. You perform and extend your working day without notice of the cumulative toll being placed on you and your surroundings. Out of gas and out of time, you realize the impact on family, work, and yourself. If you feel you need a 36-hour day to do it all, then you might need to make better use of your day. In fact, it might be you need to integrate more hours of the kind at the end of your daily to-do list. Hours of Me-time.

When social worker Carroll Wilson welcomes an overworked, overstressed, overwhelmed patient at her office, she often shares one of her key metaphors: “On a plane, you’re instructed to put on your oxygen mask first, because if you don’t, you’ll run out of oxygen and won’t be able to help others around put on theirs. So it is with time management in the context of self-care”, she says. “Not giving oneself quality time is like running on empty. Ultimately, everyone needs Me-time.”

In this article, we’ll be looking at:

• why we need time for ourselves and what the cost is if we don’t find it;

• how to get additional free time for ourselves;

• time-management tips;

• environmental tips; and

• psychological tips.

Why do we need Me-time?

Without quality personal time, not only will you run out of energy, slow down and be less productive, but soon you’ll find yourself underachieving in every life department, personal and professional, and your anxiety may increase exponentially. Myths around human invincibility are hard to debunk. Perceived superwomen and supermen are still valued role models. But for most if not all, the model is unsustainable. Several studies have shown that working long hours for extended periods of time have led to occurrences of physical and mental ailments including cardiovascular disease, anxiety and depression.(1) As a result, fatigue, absenteeism, lower productivity and organizational turnover rates tend to increase. According to Statistics Canada, a lack of work-life balance cost Canadian businesses a combined 20 billion dollars a year in health claims, lost productivity and absenteeism.(2)

Are you at risk of job burnout?

You may be more likely to experience job burnout if:

you identify so strongly with work that you lack a reasonable balance between your work-life and your personal life;
you try to be everything to everyone;
you work in a helping profession, such as health care, counselling or teaching;
you feel you have little or no control over your work; and/or
you feel that some aspects of your job have become monotonous.

A national study on balancing work and care-giving in Canada reported one quarter of the population works 50 hours or more per week, a rise of 50% as compared to a decade prior. One third of Canadians feel they have more work to accomplish than time allows. That figure rises to 40% when family roles are taken into consideration. More than half of the survey’s respondents took work home with them, putting in an average of seven extra hours a week from home. Nearly two thirds spent more than an hour a day catching up on e-mails and one third spent more than an hour emailing on their days off.(3)

Preventing burnout:

Obviously when what you’re doing is no longer fueling your passion and/or commitment to your career, it’s time to seriously assess your situation. Evaluate how you can change your current situation to re-ignite your enthusiasm.

Discuss your options with your supervisor and HR. What are the options for professional development within your company? Is there a way to explore careers in other departments? Perhaps your supervisor can help in giving you new challenges or changing expectations?
What gives you joy outside the workplace? If you love to sing or play an instrument, join a choir or band. Pursue your interests by taking courses, getting involved in the community and meeting people with similar interests.
Volunteer. Helping others is a great way to get a better perspective on life. There are many ways to have your talents, interests and experience make a big difference in the lives of others.
Make a bucket list. Having and pursuing personal goals, no matter how trivial they may seem, can reignite your enthusiasm and that can spill over into all areas of your life.
Seek support. If you think you may be experiencing symptoms of poor work-life balance including but not limited to trouble concentrating, irritability, weakened coping skills, headaches and muscle stiffness, don’t ignore these potential warning signs. See your family doctor to rule out any underlying physical issues. Reach out to friends, loved ones or co-workers.

What about those days off? Only about one third of Canadians use their earned vacation days, and of those vacationers, 28% of them took less than one half of their allotted time?(4)

Learn to combat those assumed pressures, because, in the end, it’s also work that suffers. It has been proven that getting personal quality time and achieving work-life equilibrium reboots the brain, increases concentration, improves creativity allowing outside the box problem solving, and ultimately helps us to feel more engaged at work. Moreover, personal time is very effective for stress management, and provides room for reflection and self-growth, contributing to better relationships.(5)

How to get additional free time for ourselves

If you experience prolonged periods of time without work-life balance, it may have adverse effects on your mental and physical health. Several studies have shown that working long hours for extended periods of time have led to occurrences of physical and mental ailments including but not limited to fatigue and stress.

The good news is that you don’t have to find hours of daily Me-time to reap the benefits. Analysis showed that those who experienced high quality, rather than the most Me-time enjoyed better work-life balance, well-being and were more engaged at work.(6)

Time-management tips

Wake up 30 minutes before the rest of your household to exercise, meditate or do something you enjoy.
Make weekly or monthly dates with yourself: cinema night, driving golf balls, a couple of hours at the spa, etc.
This one is not easy. Track, prioritize and respect your personal time as if it were on par with the importance you give to time allotted to work or devoted to family and people close to you.

Environmental tips

Allow yourself to avoid the physical ‘to-do checklist’ environments of your life (home office, kitchen, shed, etc.). You don’t have to travel far away or wait for a special occasion. Seek outdoor activities, contemplate beautiful scenery nearby and breathe some fresh air.
Ditch technology! At least disconnect from email, social media, chat rooms, work-related communications and stressful news.
Delimit and protect your time and space.

On the topic of clearer boundaries, communicate your need for alone time to people around you. It is okay to go for a walk and to eat alone in a park close to the workplace, even if it means breaking the habit of the usual cafeteria/café gathering with colleagues. It is okay to have a room to yourself at home with a closed door, and without interruptions when you find time to read or pursue your hobby.

Psychological tips

Of course, the first person to negotiate with and convince is…yourself!

Learn to say yes to yourself and no to others.
Remove guilt! It helps to remember that taking care of yourself through some Me-time will increase your energy, availability and patience when you come back to either the workplace or family. It enables you to be the best partner, parent and colleague you can be.
Get rid of perfectionism! When you spend time on something you have to do but is not very important, go for good enough instead of seeking perfection.It will afford you time for things that matter to you.

It might also be useful to use some re-framing techniques to improve one’s perception of quality time. For example, Me-time doesn’t have to always mean alone-time. One study found that Me-time can attain the same benefits to yourself if it includes freely chosen activities involving people you love.(6) For a parent, it might mean to re-frame a common statement such as “I have to spend time with my kids” and turn it into “I get to play with my kids”. Some caretaking and nurturing activities like cooking, for example, can thus switch from ‘’task’’ to ‘’hobby” status in no time.

Achieving work-life balance takes effort. It is important to practice work-life balance regularly to keep yourself on track with what is important in your life at that moment. With continued practice, you can create a roadmap to a life with less stress and more focus on what’s important to you.

References:

Editorial. “Another view: Worked to death.” TheRecord.com, TheRecord.com, 2 Nov. 2015, www.therecord.com/opinion-story/6077710-another-vi…
Canada, E. A. (2017, February 16). Psychological Health in the Workplace. Source: https://www.canada.ca/en/employment-social-develop…
O’Kane, Josh. “Canada’s work-Life balance more off-Kilter than ever.” The Globe and Mail, 26 Mar. 2017 (The article refers to a 2012 National Study on Balancing Work and Caregiving in Canada). Source: http://beta.theglobeandmail.com/report-on-business…
Results of an APD Canada Study as cited in Jackman-Atkinson, K. (2018). It’s About Time: Canadians Not Taking Advantage of Full Paid Vacation. Neepawa Banner & Press. Retrieved on April 2, 2019 from https://www.chrisd.ca/2018/05/21/ vacation-time-canada-workers/#.XKQQGy3MylN
Why ‘’me’’ time matters when it comes to your happiness. Source: https://my.happify. com/hd/why-me-time-is-important-for-happiness-infographic/
British Psychological Society (BPS). “Good quality me-time vital for home and work well-being.” ScienceDaily. ScienceDaily, 7 January 2015. Source: www.sciencedaily. com/releases/2015/01/15010720455…

by admin

Vacation: Relax, Refresh and Reconnect

Do you remember how you felt on your last vacation? Transport yourself back to the sights, the sounds, the smells and try to recall the physical and mental release. Recapture the moments where you felt these three R’s: relaxed, refreshed and reconnected.

Most of us would agree that we lead over-scheduled, and, in many instances, sleep deprived lives. Our occupations consume nearly 40% of our waking hours. Weekends and days off are typically scheduled with activities and chores to keep the home functioning and seem to pass by with the blink of an eye. There’s nothing quite like a change to routine and scenery when you need to recharge. Making time to disconnect from your everyday life will boost your mental health, leave you energized and have you returning to work restored and with renewed vigour.

Relax – it’s an essential part of self-care

Would you believe that only about 1/3 of Canadians use their earned vacation days, and of those vacationers, 28% of them took less than ½ of their allotted time?(1)

Allowing yourself to get away from everyday routines and responsibilities, including time to unwind and removing occupational stressors, can help you “increase your emotional agility, develop empathy and inspire creativity.”(2) But it can be the shared experiences with friends and family that provide some of the biggest benefits over the long run. Taking time to re-establish bonds in a relaxed environment helps create deep memories that can be recalled later. It’s these shared experiences that stay, fostering happiness that outlasts the fleeting experience of the vacation itself.

As Canadians, we seem to have a love/hate relationship with vacation time, which may be both surprising and a bit confusing. When asked whether they needed a vacation, 66% of those who work in the food and beverage industry, 62% of agricultural workers and 61% of retail workers responded that they do compared with 47% of those who work in financial services and the legal industries.(3)

In a survey commissioned by Expedia that looked at vacation habits of people around the world, including Canada, results showed that the average Canadian receives,“17 vacation days but only take[s] 15.”(4) At the same time, Canadians share a general sentiment that they don’t receive enough vacation time: “53% of full-time employees in British Columbia feel either ‘very’ or ‘somewhat” vacation deprived” with that number rising to 60% in Ontario.(5) Some reasons for this may point back to our inability to entirely disconnect from work.

Why aren’t we using our vacation days?

Employees who don’t take any vacation are often struggling with the belief that they need to be visible or present to be seen as valuable at work. They might be concerned about their job security or worry that, while they are away, they could miss the chance to get recognition or a promotion. Remember that when you don’t take your vacation, you’re leaving part of your compensation on the table.

Often, many of us have a hard time disconnecting. Nearly half of workers surveyed indicated that they would “check work email or reach out to the office while on vacation,” with another 13.8% saying they would be ready to jump back into to help solve a problem at work.(5) It’s important to turn off your work connections, even for a short time.

As employees, we view employers who offer more vacation time as most attractive, and almost half of us would be willing to change companies to receive more time off.(6) But, there’s also the real problem that nearly 75% of workers put in anywhere from 11 to 31 extra hours in the weeks before and after scheduled time off.(7) People are feeling challenged to find work/life balance and are “having trouble leaving work behind when they go on holiday. About 10 per cent said they feel guilty taking their vacation days because they felt they were leaving the work for their coworkers to complete.”(8)

It doesn’t matter when we’re trying to get away – be it seasonally or during the most popular vacation times of the year, all of the additional time spent at work preparing to be away on vacation typically affects our sleep routines. We’re exhausting ourselves before we even leave when we should be maximizing our sleep beforehand so that we start to feel relaxed and begin our time away feeling refreshed.

Adopting a pre-vacation sleep schedule

We’ve adopted the belief that when trying to prepare for vacations at both work and home, it’s okay to burn the candle at both ends – that is, lose sleep before vacation to catch up on it during those first few days off. While this kind of relief is needed, it’s not really positioned at the right time. To maximize your vacation experience, you should actually be getting more sleep beforehand, so you feel relaxed from the moment you’re away.

Aim to get between seven and nine hours of sleep each night

Try winding down before bedtime with a warm bath or calming activities like meditation, breathing exercises or listening to soothing music.

Create a predictable sleep schedule to condition your body and help it learn appropriate times for rest and wakefulness

Steer clear of caffeine and other stimulants. Coffee,tea, soft drinks and chocolate are all culprits whose effects can linger well into the evening and make it difficult to fall asleep

Having a template for work/life balance and a moderately adhered to sleep routine allows you to feel relaxed and refreshed as you begin your vacation.

Saving for vacation

Another reason many of us are not using vacation time is because of the belief that vacations are too expensive.

The reality is that vacations don’t need to be lavish. The wonderful psychological benefit, the refresh, actually begins while we’re planning what to do. Completing research and making arrangements stimulates our minds and we become excited at the prospect of what we’re going to do while on vacation. Once you determine where you want to go, you can plan your vacation expenditures in advance. Saving a little each week throughout the year to put into a “vacation fund” helps you set and commit to a budget. You’d be surprised how quickly giving up a few coffees each week can turn into found travel money! If you decide on a destination that you need to travel to by plane or train, book well in advance – up to 8 weeks – to take advantage of the best possible pricing. You should also find out if there are opportunities to save or special fares available.

Vacations can involve travel, adventure, learning new languages, making new friends, listening to music, trying new foods, and exploring other cultures. Studies have shown that people recharge more, retain the benefits of vacation more and remember the holiday more often when they are focused on experiences rather than souvenirs.

But, if you can’t afford to go far, or for a long time, don’t worry. Mini-vacations of 2-4 days can deliver the same benefits as an epic vacation, for much less cost. Doing something at low or no-cost, and close to home – typically called a stay-cation – can also provide you with the rest and relaxation of a destination vacation. Look for chances to extend a few days over weekends and take advantage of government-mandated vacations – such as statutory holidays.

How we vacation can also have a big effect on relaxation, refreshing and reconnecting

No matter how long you plan to be away, the destination can matter. Sticking to familiar places you’ve travelled to before can be great because you can get right to relaxing, knowing what to expect and where to go. But as one psychologist who studied the benefits of taking holidays explained, going somewhere new could be a bit better than returning to the same places because it, “get[s] [you] out of your comfort zone.”(10) He argues that uncertainty results in personal growth, deep thinking about personal interactions and learning about how to operate and interact in the world.

There is also increasing evidence suggesting that one of the best ways to reconnect and recharge is to spend time in natural surroundings. Activities like taking a 90-minute walk outside, barefoot, in a practice called “grounding,” helped people realize not just mental benefits, but also physical ones. “Ecotherapy” (a name given to a wide range of treatment programs which aim to improve your mental and physical well-being through outdoor activities in nature) has even been used to treat psychological problems. People can contribute to conservation projects, garden or work on organic farms.(11) Depending on where you are, you might even explore some balneotherapy – or natural hot springs – to reduce stress and relax. One clinical study documented the many benefits ranging from increased blood flow to improved brain function and reduction in anxiety and stress.(12) It’s even been proven that “simply watching nature films or listening to audio recordings of natural sounds can reduce stress.”(13) So, don’t worry if you experience some bad weather days, because you can cozy up in your hotel room watching nature videos or reading a book and recharge too.

These activities all have proven benefits and are low or no-cost ways to help recharge, even if just for a weekend.

Do you really need to take a vacation?

Over time, with everything we take on in our regular routines, we experience stress, and our brains become more cluttered an inefficient. As employees, we need to recharge. Taking a vacation is like helping your body reset its operating system.(14) But skipping vacations will “wreak havoc on your health and well-being.”(14)

Cardiovascular health (14)

A woman who hasn’t taken a vacation in six or more years is 8 times more likely to develop heart disease. Men who don’t take vacations have a 32% greater risk of suffering a serious heart attack.

Reaction Times (14)

Splitting attention spans between screens, conversations and also worrying about having enough time to get things done causes stress. “You lose the ability to pay attention

Stress (14)

Stress creates a physical response in that we hold a clenched stance and carry tension in our jaws because we are in a constant state of being ready to react. Vacations can take away the stressors, and your body can relax and return to a healthier state.

Loyalty, productivity, and job satisfaction (14)

People who use their vacation days are happier and less likely to leave their jobs. “For every 10 hours of vacation time taken, productivity improves 8%.”

So, what are you waiting for? Start planning your next vacation now and enjoy the shared experiences to come.

Results of an APD Canada Study as cited in Jackman-Atkinson, K. (2018). It’s About Time: Canadians Not Taking Advantage of Full Paid Vacation. Neepawa Banner & Press. Retrieved on April 2, 2019 from https://www.chrisd.ca/2018/05/21/ vacation-time-canada-workers/#.XKQQGy3MylN
Kashdan, T. (2018). The Mental Benefits of Vacationing Somewhere New.Harvard Business Review. Retrieved March 19, 2019 fromhttps://hbr.org/2018/01/the-mental-benefits-of-vacationing-somewhere-new
Abedi, M. (2017). Here are the Canadian workers who are most vacation deprived— and why. Global News. Retrieved March 19, 2019 from https://globalnews.ca/ news/3835044/canadians-vacation-deprived-work-life-balance/
ADP&Leger.(2019).Canadian workers stuck paying the Time Off Tax. [Infographic] Retrieved March 19, 2019 from https://www.adp.ca/-/media/Canada%202015/ press%20room/2018/TOT%20Dec2018/ADP_TimeOffTaskQ2_Infographic_EN_ FINAL.ashx?la=en-CA&hash=013A5C7B7397C8B561E26D28769B6FDFCB1E0361
Li, W. (2018). Half of Canadians don’t get enough vacation, survey says. The Star Vancouver. Retrieved March 19, 2019 from https://www.thestar.com/ vancouver/2018/11/02/half-of-canadians-dont-get-enough-vacation-survey-says.html
ADP&Leger.(2019).CanadianworkersstuckpayingtheTimeOff Tax. [Infographic] Retrieved March 19, 2019 from https://www.adp.ca/-/media/Canada%202015/ press%20room/2018/TOT%20Dec2018/ADP_TimeOffTaskQ2_Infographic_EN_ FINAL.ashx?la=en-CA&hash=013A5C7B7397C8B561E26D28769B6FDFCB1E0361
Cision.(2018).MorethanHalfofWorkingCanadiansSufferingfromthe“TimeOff Tax”. Newswire. Retrieved March 19, 2019 from https://www.newswire.ca/news- releases/more-than-half-of-working-canadians-suffering-from-the-time-off-tax-703118721.html
Li, W. (2018). Half of Canadians don’t get enough vacation, survey says. The Star Vancouver. Retrieved March 19, 2019 from https://www.thestar.com/ vancouver/2018/11/02/half-of-canadians-dont-get-enough-vacation-survey-says. html
Weller, C. (2017). There’s a scientific reason why 2-week vacations are actually a waste. Business Insider. Retrieved on March 19, 2019 from https://www. businessinsider.com/how-long-should-i-travel-2017-7
Kashdan, T. (2018). The Mental Benefits of Vacationing Somwhere New.Harvard Business Review. Retrieved on March 19, 2019 from https://hbr.org/2018/01/ the-mental-benefits-of-vacationing-somewhere-new
Haas, S. (2018). Nature can help you have a better vacation, according to a travel psychologist.The Points Guy.Retrieved March 19, 2019 fromhttps://thepointsguy. com/guide/have-a-better-vacation-in-nature-travel-psychology/
Rapoliené et al. (2015). The Reduction of Distress Using Therapeutic Geothermal WaterProceduresinaRandomizedControlledClinicalTrial.Hindawi:Advancesin Preventative Medicine. Retrieved on March 19, 2019 from https://www.hindawi. com/journals/apm/2015/749417/
Haas, S. (2018). Nature can help you have a better vacation, according to a travel psychologist. The Points Guy. Retrieved March 19,2019 fromhttps://thepointsguy. com/guide/have-a-better-vacation-in-nature-travel-psychology/
Degges-White, S. (2018). You Really Do “Need” a Vacation. Psychology Today. Retrieved on March 19, 2019 fromhttps://www.psychologytoday.com/ca/blog/ lifetime-connections/201807/you-really-do-need-vacation

by admin

The Invisible Wounds of Mental Health Disorders

Mental health disorders often strike in two ways. On one hand there are the symptoms, the distress, and the disabilities caused by serious mental health disorders. On the other, are the impacts of stigma and the pain that people struggling with these disorders feel as a result of social disapproval. In both cases, the strikes leave invisible wounds.

Invisibility, at first, may be considered a magic power to those experiencing symptoms of mental health disorders. Because one can hide them, and nobody will notice, right? Like the monster under our childhood bed, it will just disappear, right?

Wrong. In fact, signs and symptoms will likely just grow even bigger until they can no longer be hidden.

In this article, we’ll be looking at:

Stigma and its detrimental effect on seeking help
Coping mechanisms and the negative outcomes of not seeking help
How to detect mental health distress in a colleague or employee
How to open up the conversation about mental health in the workplace
Strategies on how to fight stigma in the workplace

To help shed some light on those issues, we’ve asked the expert advice of Dr. Sandra Primiano, a psychologist who serves as Homewood Health’s Senior Director for the Homewood Clinics.

The Monster Under Bill’s Desk

Let’s bring in Bill as a fictional character for the illustrative purposes of today’s read. Bill has a mental health disorder. Other than that, who’s Bill? He could be your colleague, your employee, your friend. Bill could even be you. He could really be anybody as no one is immune from experiencing a mental health disorder and the corresponding challenges.

Mental health disorders arise from a complex interaction of genetic, biological, personal and environmental factors. Mental illnesses affect people of all cultures, ages, education and income levels. Yet, specific risk factors do exist. They include a family history of mental illness, age, sex, substance abuse, chronic diseases, workplace, and life event stresses (2). But then again, the vast majority of people have been subject to risk factors.

Nevertheless, the stigma factor brings in many reasons for Bill to hide his mood swings, energy loss, rising anxiety and the many other wounds that manifest themselves inside his mind and body. Within the workplace environment, where the pressures of performance are high, temptation to hide the wounds are equally high.

That means many, like Bill, will try to hide the monster under their desks. In 2015, the Financial Post headlined that more than half of employees who are living with a mental health disorder do not seek help (3). Similar results have been obtained in studies on white-collar workers and the utilization of an Employee Assistance Program (EAP). One study found that employees were worried that their managers would have a negative opinion of them if they were aware of their use of mental-health services (4). Moreover, employees were reluctant to use counseling services at work if they believed it would negatively affect their career opportunities (5).

Stigma can be defined as a mark of shame, disgrace or disapproval which results in an individual being rejected, discriminated against, and excluded from participating in a number of different areas of society.

Source:
World Health Organization

Who could blame them? Even psychiatrists are reluctant to divulge, as 50% of 567 psychiatrists surveyed by the Michigan Psychiatric Society admitted that they would treat themselves in secrecy rather than have mental illness recorded on their medical chart (6).

As Dr. Primiano says: “All that fear of judgement, and then the repercussions: could I lose my job, maybe my team will think I’m unfit. I think there are so many barriers linking to fear of judgement and then self-judgement. Why do I feel like this? None of my colleagues have these kinds of problems, I’m a bad professional, and I must be terrible. You add all of this judgement to whatever you may be feeling and it ends up being a very bad situation.”

Indeed. People living with mental health challenges and illnesses and those who care for them report that stigma and discrimination negatively impact almost every area of their lives and can frequently be more harmful than the illness itself (7).

The Coping Mechanisms

But what happens if Bill doesn’t seek help?

“Depends on what your issues are,” says Dr. Primiano. “Some people can have a natural recovery when they have stable personalities, no childhood adverse experiences, and good support as they may get through certain issues that have come up with family and friends. Without those protective factors,” she says “they’re at a high risk of experiencing numerous negative consequences to themselves.”

With the gradual impact of depression, for example, an employee might be coping and coping until they can’t cope anymore. Coping mechanisms might be positive, such as seeking a support network outside the workplace, but if the network is weak, the issues too severe, then coping mechanisms might include damaging behaviours, such as denial, rationalization, workaholism, or self-medication through alcohol and drug abuse. Different people will react in different ways to similar issues.

“For example, if you look at the veteran population,” says Dr. Primiano, “50% have alcohol use disorders, why? Because they’re self-medicating symptoms that they can’t get rid of. So there’s a high incidence of substance abuse disorders in people who suffer from PTSD and anxiety disorders as well.”

How to Detect Mental Health Distress in a Colleague or Employee

Let’s get back to Bill. He’s feeling increasing pain and suffering from the wounds of mental illness. But he doesn’t talk. No one seems to notice. You’re his colleague. How can you notice that’s something’s wrong?

“You might not notice symptoms but you may notice behaviours, says Dr. Primiano. If we focus on a workplace environment, we see a lot of absenteeism or people’s productivity can go down. There can be issues with concentration, memory and you’ve got to repeat things many times. Other things colleagues and managers can notice, but they don’t know what it’s related to, are changes in people’s personality, for example, shifting from someone who’s generally friendly and good-humored to having angry outbursts or appearing suddenly anxious.”

Some of these signs can be subtle, she mentions, such as leaving the room suddenly in a meeting.

Dr. Primiano adds that those are things to pay attention to as a colleague or as a manager as it gives an opportunity to start the conversation that will put an end to Bill’s isolation. But how to go about it?

How to Open up the Conversation About Mental Health in the Workplace

Dr. Primiano suggests starting that conversation openly, such as “I noticed those behaviours and I wanted to check in with you. We all have off days… How is it going?”

That can give them the opportunity to open up or share something in terms of their well-being, their mental health, which could allow you to guide them to resources such as an employer’s EFAP (Employee & Family Assistance Program). It lets them know it’s a safe place and that this person is open to me talking about this…

From a manager’s perspective, while starting the conversation doesn’t mean Bill is going to share, Dr. Primiano argues it’s more likely to occur than if you open by saying: “Why aren’t you performing well?… That needs to change, get your numbers up!”

Preparation for that talk is key, as linking an employee’s health to performance issues or behaviours in the workplace can be a very delicate matter to tackle. It’s essential to maintain an employee’s privacy. Managers cannot ask about one’s mental health, the conversation must focus on performance issues and/or concerns. Firstly, you should get informed about the resources, accommodations and processes your organization can offer an employee in distress. Then, when approaching a colleague or employee, make the best use of your interpersonal skills to help the person feel safe and comfortable and don’t forget to value the person’s strengths as a person and contributions as an employee. And of course, encourage the person to seek help (8).

There are some things to stay away from, such as delivering a pep talk; finger pointing; saying you’ve been there unless you really have in a way the person can relate to; labeling an issue as a specific diagnosis; invading someone’s privacy about the underlying causes of issues. The focus should be on listening and finding solutions (8).

“Of course, a person may not be ready to open up and may not acknowledge mental health challenges right away,” says Dr. Primiano. “The reaction might be strong and defensive. If this happens, just back off. At least, you will have planted a seed.” It’s essential to note these conversations are private and further action must be at the direction of the colleague, employee, friend or Bill, as illustrated in our discussion, unless there is an underlying risk of harm to the person and/or their immediate family members.

Kharoll Ann Fouffrant, a social worker specializing in gender and woman’s studies, knows a thing or two about stigma, being a black woman living with a mental health disorder. She says: “People perceive me as being strong even though I talk openly about having a mental illness. That being said, when I have a rough day and express it, people don’t seem to take it seriously. Or if they do, often I end up having to manage the person’s discomfort while I’m the one needing help.”

The open conversation about mental health is indeed important, and not only when the going gets tough.

Strategies on how to fight stigma in the workplace

Studies have shown that contact strategies (fostering positive interactions with people disclosing lived experiences of mental illness) yield the best results in fighting stigma, especially when it comes to changes in behaviour.

While education strategies, such as campaigns aimed at debunking myths about mental illness, might have some impact on attitude, their effect on behaviour is limited (9). Different conditions can improve the effectiveness of contact strategies (10), such as:

Treating the person as an equal;
Giving the individual the opportunity to interact and exchange ideas about mental health and recovery;
Sharing common goals.

Those conditions can be established in the workplace. One way is to encourage peer support by offering a safe place for employees having recovered from mental illness to share their stories. For Dr. Primiano, it makes sense because one is more likely to open up in such an environment. “They will trust and connect with people who understand them because they have been through similar things and are able to guide them.”

But in the end, good services and resources have to be in place for Bill, or anyone, to seek help.

References

Corrigan, P. et R.K. Lundin (2014) Coming out proud to eliminate the stigma of mental illness. Illinois. USA. Link: http://comingoutproudprogram.org/files/COP%20Resou…
Public Health Agency of Canada’s website. Link: https://www.canada.ca/en/public-health/services/ch…
Link: https://business.financialpost.com/executive/caree…
Walton L. Exploration of the attitudes of employees towards the provision of counselling within a profit-making organisation. Couns Psychother Res. 2003;3(1):65–71. Link: https://onlinelibrary.wiley.com/doi/abs/10.1080/14…
Carroll M. Workplace counselling: a systematic approach to employee care. London: Sage; 1996. Link: https://books.google.ca/
Myers, M. (2001). Presidential address to the Canadian Psychiatric Association. New century: Overcoming stigma, respecting differences. Source: Mood Disorders Society of Canada (2006) Stigma: The Hidden Killer. Link: http://www.troubleshumeur.ca/documents/Publication…
Mental Health Commission of Canada (2015) Guidelines for Recovery-Oriented Practice. Link: https://www.mentalhealthcommission.ca/sites/defaul…
Mental Health Works’ website. Link: http://www.mentalhealthworks.ca/how-can-i-approach…
Corrigan, P. W. and A. K. Matthews. (2003) Stigma and disclosure: Implications for coming out of the closet ». Journal of Mental Health, 12(3), 235-248. Link : https://www.researchgate.net/publication/232073439…
Groupe provincial sur la stigmatisation et la discrimination en santé mentale (GPS-SM). (2014) Cadre de référence : La lutte contre la stigmatisation et la discrimination associées aux problèmes de santé mentale au Québec. Link : https://aqrp-sm.org/wp-content/uploads/2014/04/cad…

by admin

Addiction and Recovery: Insights from Homewood Alumni

When you’ve lived with addiction and had the courage to get treatment, by working through your obstacles, you usually end up facing life lessons and gaining life experience that is often relatable to persons in similar situations and useful for those who are unaware of the challenges that addiction brings.

Interestingly enough, two aspects that almost always surface are: 1) how someone’s family has played an important part in their recovery journey and 2) how redeeming it’s been to learn about the science of addiction.

In this article, we’ll hear from some Homewood Alumni who have generously agreed to share their insights and key learnings when facing their addictions. We’ll also hear from Dr. Michael Berry, Clinical Director at Homewood Health’s Ravensview treatment facility in Victoria B.C., an expert who guides individuals on the path to recovery and helps people write new chapters focused on their healing and attainment of sustained sobriety. When stories are shared with such honesty and transparency, they can radiate hope and help others who may be early in their recovery journeys or who are experiencing some setbacks along the way.

Family Ties

Like other diseases, addiction can have a profound effect on your own life, but equally so for family members and others that you care about. There is a certain measure of complexity with their involvement in securing a recovery path: family members often have significant influence in helping you find your way to treatment, and they also need to learn about addiction as a disease and be well supported to understand that recovery is a life-long process.

Research has shown that stress is a significant risk factor and catalyst for “activating” an addiction (1). Living with a family member who has an addiction can upset relationship dynamics, and this often stresses the family to the breaking point as the addiction takes a stronger hold on their lives (2). As much as the addicted person is often using an addictive substance like alcohol to cope, family members can unknowingly take on certain dysfunctional behaviour patterns to help them deal with what is happening to their loved one, and become part of the addiction ecosystem.

Dr. Michael Berry emphasizes the importance that Homewood’s inpatient programs place on exploring these types of stress-response roles within family systems and the interactions they precipitate as part of the recovery process. “There’s the addict, the enabler, the peacekeeper, and the black sheep to name a few,” he says. He went on to describe a popular and very practical model used to help patients, a social network diagram that places the addicted person in the middle, and then spreads out people they care about in concentric circles according to who they are closest to. It helps people visualize the relationships, the dynamics and the vulnerabilities that are all around them to help make peace and make choices.

James, a Homewood alumnus who in June celebrated four years of sobriety, spoke about how much he wanted to move away from his alcoholism but was fearful. A combination of help from his employer in the form of a “last chance,” his girlfriend at the time (now his wife), and his father brought him into the program:

I had shown up to work and shouldn’t have been there. My girlfriend was under so much stress, and she was also an enabler for my alcoholism. My employer told me that I needed to get treatment, starting immediately, because as a first responder, I couldn’t perform my job safely and while they had been patient with me, my job was now on the line. So, even though I was worried about being away for 30 days, I agreed to go to Homewood. My girlfriend reassured me that she would take care of everything at the house, and I should “just go!”. It was very hard. While she was relieved that I was going to be getting treatment, she cried every single night I was away. That day, I needed to tell my parents about my alcoholism because I needed their help to get to Homewood. I was terrified of their reaction. The people at Homewood spent two hours with my dad, talking to him about addiction and explaining about how it was a disease and how my recovery was going to start as long as I was willing to participate. That really opened up his eyes and helped him understand.

I was in treatment for 35 days and a lot of the work I did there set me up to see the value of experiences. I was able to bring my parents in for picnics, I immersed myself in all of the activities to get the most I could from my time there. For the first time in my life, I learned how to talk to the people I cared about and how to listen. Homewood had some of the best meetings I have ever been to. The videos they showed us of other first responders made me realize I wasn’t alone and that there was a way forward. In the end, all of the right people were in the right places at the right times for me. This time was a chance for me to reset my life, not pick up a drink, and not be stressed. It was the start of a lot of really hard work that helped me learn how to be accountable for who I was.

Dr. Berry believes that family conferences are critical during the entire course of someone attending an inpatient program. They help address the blame that people affected by addiction can feel. Meetings emphasize how recovery is about treating the whole person rather than just the disease, an important distinction that recognizes the biological and environmental influences inherent with addiction. Dr. Berry further indicated that alcoholism can be passed from one generation to the next and that children of alcoholics move through the stages of addiction more rapidly. Having information about the science of addiction can generally help everyone move forward in recovery.

Addiction is a Disease

It’s essential to recognize that addiction is a disease caused by a combination of behavioural, environmental and biological factors that actually change someone’s brain (3). And while Homewood’s Dr. Michael Berry agrees that research has shown there are genetic links – some studies report that genetic risk factors account for about half of the likelihood that an individual will develop addiction – he focusses on a model where someone’s genetic predisposition might be activated through stress (4) that ties to the neuro-biological elements of the brain that are on the lookout for rewards (through addictive substances) to get relief and feel satisfied.

Our Brain on Drugs

Different addictive substances – drugs or alcohol — affect the brain’s neurotransmitters within the body by mimicking chemicals that are naturally produced there. Unfortunately, they aren’t exact copies of natural brain chemicals. While these imposters work, they don’t actually send the same messages that the natural chemicals would. And each substance affects different parts of the brain in their own way. As a result, the body receives abnormal messages in a kind of broken telephone game, and sometimes too many messages create over-activated circuitry that causes disruptions in our thinking and makes it hard for the natural chemicals to regain control over the processes (5).

Substance abuse changes our brains over time because we learn that these substances feed the pleasure-seeking part of our brain and cause it to release dopamine as a reward. Our brains respond favourably, by learning that something important is happening and needs to be remembered. The brain makes it easier to achieve this feeling again without having to think about it because it changes neural connections, forming a habit. It’s these large surges of dopamine brought on by substance abuse that teach the brain to seek drugs at the expense of other healthier goals and activities.

Ridding the body of the addictive substances that are mimicking naturally produced brain chemicals is key to starting recovery, but is also very dangerous if not done correctly. Gillian, another Homewood alumnus, shared her lifelong struggle with substance abuse and how not having the right supports available to her early on affected her recovery journey.

I’ve struggled with my physical and emotional health for over 35 years. Early on, I was prescribed morphine for a painful health condition. I found I was staying in the hospital up to four days per month. I supplemented this with alcohol. I needed treatment and came to Homewood for help. It was scary. After two days, I called my husband because I wanted to go home. On the fourth day, I had a seizure. I completed five weeks of treatment and was done with the morphine. Unfortunately, I returned to alcohol within three months. I would start drinking in the morning and blackout by early evening. I wouldn’t eat all day, but I would wake up hungry and try and eat something.

I was fighting with my son and decided that I couldn’t keep this lifestyle, so I went back to Homewood after 3 or 4 months. This time, I opened up and maintained my sobriety for eight years. I got a new doctor who in the process of learning about my health, ordered a full medication review and took me off everything. I became very sick and actually spent 12 days in the hospital. I lost 30 pounds in 7 weeks and started to experience panic and anxiety. The only thing I could keep down was two meal replacements a day. I was actually detoxing.

Science continues to look for different ways to treat addiction, everything from new forms of aversion therapy where long-term doses of medication are implanted in a recovering patient’s skin that cause the person to vomit if they drink, to investigating medications that can prevent people from falling prey to unseen triggers (6). While this research is interesting and in some cases, promising, Dr. Berry states that the combination of pharmacological treatment; psychotherapy, such as CBT (Cognitive Behavioural Therapy); and alternative therapies such as art, horticultural, and music therapy have clinically proven to produce the best results for many people. This model is grounded in Homewood’s philosophy of treating the whole person and not just the disease. Gillian agrees that a more holistic approach is better in the long run, “Alcohol is so much more than drinking – a pill wouldn’t change things for me. Quick fixes are easy but not the most effective and they don’t help me clear the wreckage of my past”.

A Model for Sustainable Recovery

Recovery is a lifelong process and takes effort. While addiction is not a choice, recovery from addiction is. The path to recovery improves work, finances, family life and health and uses many different pathways … including professional treatment services, informal supports and support groups (7).

Both James and Gillian attest to how helpful a wide variety of supports are, especially peer support groups such as Alcoholics Anonymous (AA). Talking to people and sharing their stories continues to be a big part of their recovery journeys. Planning for and being aware of what may cause relapses allows James to be proactive and not hold stress about this. He embraced many tools learned from Homewood, AA and keeping connected with his sponsor such as journaling, time management, and maintaining a regular routine.

Dr. Berry agrees that an action plan should cover a broad range of supports that ultimately, puts the emphasis on experiencing an engaging and gratifying life filled with meaning, purpose and fulfillment. In the end, if those things are missing, and a person is disengaged with the activities of life because they are so focused on the addiction, the journey has no point.

The Basics for an Addiction Recovery Plan (8)

Stay engaged with your recovery and treatment.
Attend to basic responsibilities – these will help you stay on track
Make a relapse checklist where you:
a. List your triggers
b. List tools that you have that can help you stay grounded when in stressful or encountering triggers
c. List people in your support network who you should contact
Prioritize self-care, healthy relationships and remember to celebrate all achievements, no matter how small.
a. Avoid negativity and have honest conversations with yourself
b. It may mean changing jobs
c. Ask yourself if you are focused on what you want to be doing, and if you feel supported.
d. Stay connected to formal programs.

Recovery may also have you confronting relationships that are not safe and leave you wrestling with some of the choices you have to make about whether connections and contacts you have need to be altered, adjusted or avoided. “It’s not easy, and it requires candid conversations. Sometimes we can manage these as part of therapy, but other times it’s going to happen outside of it,” says Dr. Berry.

Gillian recognizes how difficult that can be. She lives with her husband, who is a first responder, in a community where drinking is one of the main activities everyone does. “We have golf-carts where we drive around the condos, and everyone is always outside with a drink in their hands,” she said. Even her husband jokes that he needs to slow down – but he isn’t ready to do that himself yet. That’s one of the toughest things Gillian has to deal with since reminders and triggers are literally right on her doorstep. Through her work with Homewood, she recognizes those vulnerabilities, and also sees how different aspects of the programming she has benefited from over the years would help others she cares about too – from neighbours to her husband and her children”. She keeps on track by, “accepting the recovery rules, taking it a minute at a time and going with the flow.” She realizes that things won’t happen overnight and that continuing to attend daily recovery-focused meetings and practicing her faith helps her deal with the challenges she faces in the environment. She is also looking at getting back into volunteering and becoming more involved in service for others in recovery to help her find things she can be proud of accomplishing.

James, too, is working towards becoming a certified peer support to help other first responders confront their own situations and addictions courageously. He spoke about the pressures of being part of the culture within his profession – where there are a lot of people with big personalities who are controlling, and where socializing can be hard. “It’s a tough place to be sometimes, but I’m trying to be the better version of me that I know I have to,” he said. It’s for himself, but also his (now) wife, and their two young daughters. What he does differently now is talk with honesty and purpose, to everyone who will listen, and cultivate positive experiences and spaces at home, at AA, and at work.

Dr. Berry adds that kindness and self-compassion, understanding blame, and accepting accountability for all of your actions should be paramount in any recovery plan too because while you’re, “not solely responsible for all of the problems you face, you are ultimately responsible for the solutions.”

References

(1) Heshmat, Sharhram, Ph.D. (2017, May 10). Stress and Addiction, Psychology Today. Retrieved on June 19, 2019 from https://www.psychologytoday.com/ca/blog/science-ch…

(2) Alvernia University (n.d.), Coping With Addiction: 6 Dysfunctional Family Roles. Retrieved on June 19, 2019 from https://online.alvernia.edu/infographics/coping-wi…

(3) Centre on Addiction (n.d.) Addiction As A Disease: The Disease Model of Addiction. Centre on Addiction website. Retrieved on June 19, 2019 from https://www.centeronaddiction.org/what-addiction/a…

(4) Centre on Addiction (n.d.) Addiction As A Disease: The Disease Model of Addiction. Centre on Addiction website. Retrieved on June 19, 2019 from https://www.centeronaddiction.org/what-addiction/a…

(5) National Institute on Drug Abuse (n.d.) Drugs and the Brain. Drugs, Brains and Behaviour: The Science of Addiction. Retrieved on June 19, 2019 from https://www.drugabuse.gov/publications/drugs-brain…

(6) Smith, Fran. (2017) How Science Is Unlocking the Secrets of Addiction. National Geographic Magazine, Online. Retrieved June 19, 2019 from https://www.nationalgeographic.com/magazine/2017/0…

(7) Canadian Centre on Substance Use and Addiction (CCSA).(2019) Life in Recovery from Addiction in Canada. Report at a Glance. Retrieved June 19, 2019 from https://www.ccsa.ca/sites/default/files/2019-04/CC…

(8) Futures Recovery Healthcare (2018, October 29). 10 Tips For Creating A Sustainable Addiction Recovery Plan. Creating An Addiction Recovery Plan after Rehab. Retrieved on June 19, 2019 from https://futuresrecoveryhealthcare.com/knowledge-ce…

by admin

Healthy Habits: Actions to Recovery

When we feel safe, secure and well connected to our families and people within our communities, we develop a sense of belonging and an understanding of who we are. These attributes allow us to have confidence in our actions and enable us to live our lives in ways that are satisfying and meaningful. In short, we create a baseline for what good mental health feels like.

In contrast, when we’re overwhelmed and/or looking to solidify our relationships and roles, we can experience mental health challenges that create further disconnectedness and detachment. Treatment and therapy are a key component of the critical support needed to re-establish the baseline of feeling well, which leads to healing, but there are also actions we can undertake to compliment and encourage sustainable recovery.

The process of recovering your mental health helps you find the parts of yourself that were lost; helps you learn about what makes you strong and where you are most vulnerable; encourages you to accept support from people who care about you; and shows you ways that you can create a life focused on positive interactions. Recovery from a period of poor or challenging mental health isn’t instant, and it’s something that will always be with you: “It is important to remember that recovery is not synonymous with cure.” (1) Remember to be kind to yourself along your journey and include, “hope, dignity, self-determination and responsibility.” (2)

What does recovery look like?

For recovery to be successful, you need to embrace actions that will help you heal. The personalized care you receive is going to help you learn about and create a positive sense of self. There is no single service or solution, therapy or treatment that will improve everyone’s mental health, because everyone is different. There are however, things you can do to help find what feels right for you:

Accept and understand that you are receiving personalized care that is going to help you create a “positive identity outside of being a person with [a mental health disorder].” (3) Developing an understanding that you are not defined by the labels of any diagnosis you receive: you are a whole person, which embodies all of your characteristics and traits surpassing those tied to your medical diagnosis.
- Be willing to accept help, recognizing that your current health, your social interactions and quality of life can be improved.
- Be prepared to trust that the people developing your personalized recovery plan see you as an individual and will be putting supports in place that will help you given your individual situation and needs.
- Find and hold onto hope. It’s an essential part of recovery that helps to keep you motivated and focused during recovery.
Recognize you will be involved in making choices that support your best recovery path and allow yourself to take responsibility for as much as you can in your life.
- Be willing to learn and accept that you will regain control in your life. Part of your treatment may help you identify things that have been harmful in your past and acknowledge how these may not be helpful as a part of your recovery. Instead, you may be encouraged to try new things with the support of the professionals and people who care about you. You’ll enter into the healing process with insight and begin to develop definitions to build self-worth and self-esteem.You will see how you fit into the world, your contributions, and understand how and why you matter.
- As you recover, you will begin to recognize warning signs that indicate you may be moving backwards or reverting to previous harmful actions and behaviours. Identify your behaviours and moods that signal a shift in how you are thinking. With time, you will learn to see and acknowledge signs that you need to seek help and guidance, which will allow you to avoid risks that may result in a crisis.

Here’s a small list of common warning signs that many people experience when faced with mounting mental health challenges. It’s important to note that warning signs will differ between individuals. The signs noted below may also be attributed to physical health concerns. If you notice things starting to break down, you may want to consult your primary care physician or a counsellor: (4)

Being angry at people who you care about
Confusion, forgetfulness or thinking that is not clear
Crying and not being able to stop
Experiencing physical symptoms that are not usually present (excessive tiredness, lack of appetite, heart palpitations)
Feeling overwhelmed and that you can’t go on
Lack of motivation
Wanting to withdraw and avoid people

Recovery doesn’t happen without your input and involvement

Your involvement in defining your recovery journey is key because it is so personalized. The professionals who are supporting you are only one element. Your mental and physical health are often affected in some capacity, and treatment options will look at all aspects of your health. A combination of mental and physical treatments are the best approach to securing and maintaining achievements during recovery. That means your care may involve pharmacological treatment, psychological therapy and physical care (exercise and diet).

As you acquire knowledge and an understanding of the help being provided, you will contribute to the creation of how you want to define what feeling well means to you, which, in turn, allows you to offer insights and choices about your care.
- Think about the kinds of activities you enjoy when you are well. Do you like to cook, read or exercise?
- Determine what feels meaningful with respect to the activities you feel comfortable participating in during your recovery.
- You may want to work with your caregivers to create a personal plan for mental health to help your caregivers understand when they should intervene, what your care preferences are during a crisis, and how and when to recognize that you feel comfortable in resuming full control. Having a documented plan can make things more transparent for everyone involved and ensure your wishes are articulated during times when you may need more help.
During recovery, it’s import to have the right attitude towards sharing information, communicating and embracing care partnerships.
- There may be some hesitation; however, sharing relevant information will help the people who are caring for you understand what your wants and needs are during recovery and will ensure synchronized and well executed transitions of your care requirements.
- Be willing to learn more about yourself, your strengths and vulnerabilities, your family relationships and your friendships. Observe and identify how these interactions relate to your mental health when you are well and when you are in need of more support or are ill. This knowledge creates valuable meaning that can help you address your past and can help you define and reinforce positive choices in your care plan.
Another important action is your willingness to regularly re-evaluate where you are within your recovery journey with honesty and courage.
- There are many tools you can explore to help you with this aspect of recovery. Review questions and contemplate scenarios that help you assess how you are feeling and set goals for yourself that allow you to track your progress.
- Realize that your recovery effort is ongoing. The work needed may diminish with time, however it will never finish. Recognize this is a positive thing. Looking at your adversities through a recovery lens will help you find balance and a fulfilling life. As you gain more insight and the ability to recognize your signs of crisis, you will learn when you need to invoke a different degree of care. You can regain control of and manage your mental health.

Some questions you may ask yourself to assess your current mental health and help set goals(3)

What keeps you going?
How would you like your life to be different?
What are your dreams now? How have they changed?
How have you previously moved through tough times in your life? What was helpful? What would you have done differently?
What positive ways have you changed or grown as a person?
What things have you done or how have you behaved that made you feel really proud of yourself?
What would give your life more meaning and make it more enjoyable?
When did you last have fun?
What would someone who knew you really well say about you? What would you like them to say?

The Principles of Recovery

There aren’t a prescribed set of steps to follow for mental health recovery. Instead, it’s based on self-discovery, acceptance, personal growth, working through occasional setbacks and learning from all of these experiences. Having a “holistic, person- centered approach to mental health care,” where recovery focusses on every aspect of your life is crucial. (5) That means looking at you (both mind and body), your spirit, and your community. Knowing that “It is possible to recover from a mental health condition and the most effective recovery is patient-directed”5 helps provide a framework for how you can live your life fully and successfully. Working to build upon your strengths and define your purpose with respectful, responsible and supportive care, plus receiving positive reinforcement through social relationships, support groups, family and friends will help you develop confidence and become more comfortable over time. Don’t rush and don’t look at repeating steps as defeat. It’s all part of a healthy recovery experience.

References:

Jacobson and Greenley, 2001, p.482 (as cited in Principles of recovery oriented mental health practice) Government of Australia Health website. Retrieved on May 6, 2019 from https://www.health.gov.au/internet/main/publishing…
Mental Health Commission of Canada (n.d.) What is Recovery? Retrieved on May 6, 2019 from https://www.mentalhealthcommission.ca/English/what…
Slade. M. Dr., (2009). 100 ways to support recovery. Rethink Report – Canadian Mental Healh Association (CMHA). Retrieved on May 6, 2019 from https://toronto.cmha.ca/ wp-content/uploads/2016/07/100-ways-to-support-recovery-Rethink.pdf
Copeland, M.E. (n.d) Webinar: Avoiding a crisis – When Things are Breaking Down. Wellness Recovery Action Plan (WRAP) Mental Health Recovery (website). Retrieved on May 6, 2019 from https://mentalhealthrecovery.com/webinar-avoiding-…
Lyon, S. (2018, May 7). The Recovery Model. very well mind. Retrieved on May 18, 2019 from https://www.verywellmind.com/what-is-the-recovery-…

by admin

June is National Post-Traumatic Stress Disorder Month

PTSD does not discriminate; it can affect anyone regardless of their age, gender, or race.

Recent statistics from the Ministry of Veterans Affairs indicate PTSD as the second leading mental health disorder within the Canadian Armed Forces, with incident rates doubling between 2002 and 2013. However, PTSD is not limited to our military and soldiers. It can affect anyone who has experienced or witnessed a traumatic event.

Trauma is the Greek word for “wound”. While the Greeks used the term for physical injuries, trauma can also mean emotional and psychological wounds.

Trauma can refer to the traumatic event and the subsequent emotional and psychological injury. PTSD refers to a set of symptoms, which can be diagnosed as the condition of PTSD when the after effects of the trauma don’t go away within a specific time period.

What is PTSD?

Post-traumatic stress disorder (PTSD) is the psychological reaction to emotional trauma. This could include responses to powerful one-time incidents or chronic/repetitive experiences.

Examples of One Time Experiences:

Accidents, natural disasters, crimes, surgeries, death, other violent events

Examples of Chronic/Repetitive Experiences:

Child abuse, neglect, military combat, urban or domestic violence

Who is at risk?

PTSD does not discriminate; it can affect anyone regardless of their age, gender or race. PTSD is brought on by experiencing or witnessing a traumatic, often life-threatening event. At particular risk are individuals who work in occupations where they are repeatedly exposed to trauma under high levels of stress. Also at risk are people who experience trauma in childhood and people with a family history of mental illness and addictions.

Symptoms of PTSD

The ramifications of a traumatic event may be felt immediately, but PTSD is not diagnosed unless the symptoms last more than one month. Symptoms include:

Re-experiencing Symptoms

Often, people who suffer from PTSD will relive the traumatic event. This can present in different ways, including upsetting memories which can be triggered by a reminder. For instance, when a combat officer hears a car backfire and it reminds them of gunshots, or when an assault victim sees a news report and is reminded of their own experience. Once triggered, memories can cause the sufferer to react in physical and emotional ways similar to those experienced during the original event.

Avoidance and Numbing Symptoms

Individuals with PTSD may go out of their way to avoid certain triggers. They may not want to return to the site of the experience, and there might be sights, sounds or smells they will avoid. They may even stop watching TV programs that remind them of their experience.

In order to numb themselves, people with PTSD may have a hard time getting in touch with their feelings or expressing them. They may isolate themselves from others, and stop taking part in activities they once enjoyed.

Arousal Symptoms

People suffering with PTSD may feel they are in a constant state of emotional arousal. This can cause them to feel abnormally alert, resulting in difficulty sleeping, irritability and difficulty concentrating. They may feel as though they are “on guard” and searching for signs of danger at all times. This can lead to substance abuse to either heighten or dull their arousal.

Changes in Mood and Cognition

A traumatic event can result in people altering their beliefs about themselves or the world around them. People suffering from PTSD may start blaming themselves or others, and saying things such as “I should have done more” or

“People in authority can’t be trusted.” They will have a persistent low mood and decreased enjoyment of things they once enjoyed.

How can I support my loved one who suffers from PTSD?

When a family member or close friend suffers from PTSD, it can be overwhelming for family, friends and others close to the individual. It’s hard to understand the changes in behaviour, and it may feel like the individual is less affectionate or angry with you. In turn, you may be frustrated taking on more responsibilities, when the individual suffering is unable to do things they use to do. Try not to take it personally, and remember these do’s and don’ts for living with someone who suffers from PTSD:

DO

Be patient
Educate yourself on PTSD
Be a good listener
Express your commitment to your relationship
Minimize stress at home
Anticipate triggers and try to avoid them
Watch for signs that your loved one is getting stressed
Ask how you can help
Give them space, if they need it
Let your loved one guide you as to how they are feeling, what they can handle, and how they would like to handle their stress
Call 911 if you feel you or your loved one is in danger of being hurt
Make time for yourself
Build a support system of trusted family and friends
Set boundaries, know your limits and communicate them to your loved one, family and support team

DON’T

Pressure your loved one to talk about their experience
Stop your loved one from talking about their feelings or fears
Trivialize or deny your loved one’s traumatic experience
Tell your loved one they are weak because they aren’t coping well
Offer advice, if you aren’t asked for it
Take their outbursts or need to isolate personally
Get upset with yourself if you sometimes have negative feelings towards your loved one

by admin

PTSD in the Workplace: Solutions and Support

Post-traumatic stress disorder (PTSD) is most often linked to combat occupations and first responders. So you wouldn’t think of your everyday co-workers as prime candidates to encounter PTSD related symptoms.In most instances, our co-workers have always lived an ocean away, and then some, from an armed conflict. As day to day employees, we may never witness a crime scene or a deadly car crash.

So what could or does happen?

Although research has mainly focused on combat, rape and other types of assaultive violence as causes of PTSD, the sudden, unexpected death of someone you care about is often a leading cause of PTSD within the community, accounting for nearly one third of all PTSD cases.(1) So yes, there is more to each of us as employees than meets the eye. Maybe someone has lost their
mother, their best friend, or their partner / spouse. Or maybe it’s something else they have lost, such as a work and/or occupation related event. Trauma can manifest and surface in very different ways. The mind can become a conflict zone. How can one escape? In this article, we’ll be looking at:

What is PTSD and what are its symptoms and signs?

What are the occupational effects of PTSD?

What solutions and supports have proven most effective?

To help shed some light on those issues, we’ve asked the expert advice of Dr. Sandra Primiano, a psychologist who serves as Homewood Health’s Senior Director for the Homewood Clinics.

Redefining trauma

In terms of high-risk occupations, we immediately think of the military and first responders such as police, firefighters and paramedics. But, even if less frequent, many public facing positions are vulnerable to potential trauma. Assaults are not uncommon for occupations such as retail or bank clerks and taxi drivers, for example, PTSD occurs in response to the direct experience of extremely traumatic/stressful events or being witness to people involved in them. The very concept of traumahas expanded drastically since being first introduced in the DSM-III in 1980. To meet the criteria, people no longer need to be survivors of life- threatening events or even be present on the scene. The clerk who hears about a colleague being held at gunpoint on the night shift can qualify as a trauma survivor just as much as the victim whose life was at risk.(2) Vastly more people qualify for the PTSD diagnosis than in the past.(3)

For example, 60% of participants in a study on causes of PTSD in the Detroit community experienced the sudden death of someone they cared about. More than 14% of the participants developed PTSD. The conditional risk of PTSD following exposure to trauma, independently from the source, was 9.2%. In comparison, the highest risk of PTSD prevalence resulted from a person being physically assaulted (20.9%).(1)

PTSD is to mental illness what concussion is to physical health

The vast majority of people subjected to trauma will not develop PTSD. Depending on sources, it can be said that between three and five percent of the population is affected by PTSD, and approximately nine percent of people will be diagnosed with PTSD in their lifetime. Women are significantly more at risk of developing the disorder than men, by a two-to-one ratio.(4)

“What makes people more vulnerable than others? We know that one factor is having a childhood with a history of adversive experiences, like abuse (psychological, physical or neglect)”, says Dr. Primiano, whose area of expertise is trauma and stress-related disorders and anxiety disorders. “When you exercise, you feel pain at first but your body gets stronger, with PTSD it’s the reverse. The more trauma you experience, the more vulnerable you become. The more you’ve experienced, the more susceptible you are to experience even more, as you’ve been primed to experience the world in certain ways, and then it accumulates. When you experience early trauma, you become more vulnerable towards developing trauma,stress and anxiety related disorders as you are pre-conditioned to similar triggers or traumatic events.”

PTSD is a mental illness that needs the fulfillment of certain criteria for a minimum duration of one month before being diagnosed. It is not associated only with feelings of sadness, anxiety or shock after the traumatic events.

The list of symptoms fall under four categories:

Intrusive memories: Can include recurring, unwanted, distressing memories of traumatic events. “The person is reliving the trauma event like it’s happening right now through flashbacks or nightmares. There can also be emotional or physical distress reactions when something triggers the recollection of the events.”

Avoidance: One tries not to think about the events by avoiding certain places, persons or activities that bring the traumatic event to mind. “Some will also forget really important parts of the events.”

Hyperarousal: It involves being on guard, feeling angry, irritable, aggressive and impulsive. “It can lead to self- destructive behaviours, trouble to concentrate or being easily startled.”

Negative thoughts and moods: Self-blame, fear, guilt and distorted negative feelings about oneself, others and the world. “People will also tell you they don’t feel anything anymore or that they’re hopeless about the future. Some can socially withdraw and lose interest. It becomes hard to connect with people.”

The disorder can develop immediately after experiencing or witnessing the event, or surge months, and in some cases even years, after the event.

Occupational effects of PTSD

When PTSD develops, it can become very difficult for employees to engage in work. “Getting to or being at the workplace for the employee could be a trigger, says Dr. Primiano. It becomes too disturbing, stressing. Employees may call in sick often, or just not show up and no one knows why.” In situations where an employee manages to make it into work, she says, co-workers maybe witness to occupational effects, such as:

Having trouble concentrating or remembering things they’re supposed to be doing because they’re anxious and hyper-aroused.

Taking more time to complete tasks than before. Managing time and scheduling can be an issue.

Looking very tired. PTSD often comes with certain sleep-related issues, such as insomnia, because of nightmares and hyper vigilance.

Coming to work under the influence, as nearly half of individuals with PTSD use substance abuse as a coping mechanism and more than one-in-five also meet criteria for substance addiction.(5)

Having angry outbursts because they’re on edge and are easily startled, which can cause the amicable co-worker you knew to easily get into arguments.

Having increased difficulty coping with stress.

When the red flag behaviours listed above manage to somehow stay under the radar, they most often come with a decrease in performance that, in many cases, will be noticed.

Solutions and support

What kind of help?

Talking about how you’re feeling simply might not be enough. Depending upon the severity of the disorder, Dr. Primiano advises to seek evidence-based psychotherapy for PTSD, essentially meaning any therapy that uses cognitive, emotional, or behavioral techniques to facilitate processing a traumatic experience and in which the trauma focus is a central component of the therapy.(6)

“The reality is, some employees get better on their own with the passage of time, while other employees will not. It can be very difficult to return to your previous level of functioning, more so than with depressive episodes or having panic disorder, because PTSD really does change the perception of one’s self, of the world, and of others including your co-workers.”

Dr. Primiano, adds that the prognosis is more complex for employees who have experienced many traumatic events and/or have suffered from PTSD for a long time. “It changes things about who you are, the way you think and interpret things. It’s really hard to change that.”

But trauma-focused (TF) psychotherapies do work. TF therapies are almost three times as effective as medication in treating the severity of PTSD.(7) For every 100 individuals with PTSD, only nine percent will no longer have the disorder after three months without treatment but this figure rises to anywhere from 42% to 53% with TF treatment depending on the approach.(8)

She concludes by saying that, with proper care, one can really hope to return to a good level of functioning. Sometimes talking to a professional can help you regain a healthy perspective regarding your ability to cope with the aftermath of the traumatic event you have experienced.

References:

Bresleau N, Kessler RC et al Trauma and posttraumatic stress disorder in the community:The Detroit Area Survey of Trauma. Arch.Gen.Psychiatry.1998;55(7);626-32. Link to abstract https://www.ncbi.nlm.nih.gov/pubmed/9672053#
(McNally, 2009; McNally & Breslau, 2008).
(Breslau & Kessler, 2001).
American Psychiatric Association’s website. Link: https://www.psychiatry.org/ patients-families/ptsd/what-is-ptsd
Pietrzak RH, Goldstein RB, Southwick SM, Grant BF. Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Anxiety Disorders. 2011;25:456–465. doi:10.1016/j.janxdis.2010.11.010.
Jessica Hamblen. The 2017 Revised Clinical Practice Guideline for PTSD: Recommendations for Psychotherapy. National Center of PTSD, U.S.Department for Veterans Affairs.
Watts BV, Schnurr PP et al (2013). Meta-analysis of the efficacy of treatment for post-traumatic stress disorder. Journal of Clinical Psychiatry, 74(6), e551-e557. Link: http://dx.doi.org/10.4088/JCP.12r08225
Harik JM, Hamblen JL, Grubbs K. G. & Schnurr PP. Will it work for me? A meta-analysis of loss of PTSD diagnosis after evidence-based treatment.

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