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Archive for category: Mental Health

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Keeping Up Appearances: Social Media and Self-Esteem

Guest Blogger:  Susan Wang, Occupational Therapist

In the current age of media, the internet and social media sites (especially Instagram) contribute heavily towards bombarding young girls with images and videos of models. Approx. 90% of adolescents use social media daily, frequently for more than 2 hours a day.  Girls are more exposed in higher rates to media than boys which make females much more vulnerable to the negative impacts of media than boys. With the rise of social media use for marketing and advertising, content creators and models can interact heavily with their viewers through comments and live videos. They create heavily curated profiles and document intimate moments of their lives that thousands (sometimes millions) of individuals follow and keep up with. This, in addition to the popularity of Instagram use by celebrities, can create the illusion of forming authentic relationships with their audience. The interactive nature of social networking also provides opportunities for girls to compare their appearance with their peers. For example, taking selfies may cause women to scrutinize their own image from an observer’s perspective, which is then further reinforced by instant feedback on their appearance through the form of comments and ‘likes.’

Social media presents unique pressures on body dissatisfaction and disordered eating. It is a highly visual environment in which appearance ideals and the pursuit of thinness are promoted. Indeed, the interactive nature of social media appears to contribute to increases in disordered eating. As social media marketing and advertising continues to grow, competition amongst content creators and “influencers” also rises. There is a need to create a persona and create images/videos that stand out amongst the thousands of other marketers competing for the same sponsorships. This results in models utilizing photo editing apps to alter their images. With the rise of “FaceTune” and other photo editing apps, it is increasingly easier for individuals to alter their images, without needing to consult professionals or develop skills in photo editing. This has resulted in girls comparing themselves to unrealistic beauty standards.

In addition, celebrities such as Kim Kardashian have normalized the usage of surgical enhancements. Lip injections, breast augmentations, “fillers”, and other cosmetic surgery has been on the rise in recent years.  Cosmetic doctors have reported an increase in teens seeking lip injections, citing photos of Kylie Jenner as an inspiration. Studies have shown that women who rated their self-esteem, life-satisfaction, and attractiveness as low, were more likely to undergo cosmetic surgery.  This study also indicated that women with high social media exposure were more likely to undergo plastic surgery.  There is also an increase in the number of teenagers seeking plastic surgery. In 2017, approximately 220,000 cosmetic procedures were performed on patients aged 13-19 and social media plays a large part in this trend.  The average Millenial takes over 25,000 selfies in their lifetime, which is one of the major reasons for the self-esteem issues in this age group. In a recent American Academy of Facial Plastic and Reconstructive Surgery survey, more than 40% of surgeons said looking better in selfies on Instagram, Snapchat, and Facebook was an incentive for patients of all ages getting surgery. This is magnified for teens, who use social media more often.

Instagram vs. Reality

There are existing efforts to combat the rise in unrealistic beauty standards by raising awareness about the increasing use of photo editing apps. One such example is a community on the forum “Reddit” that posts side-by-side comparisons of edited images posted by models and celebrities and non-edited photos or videos depicting what they actually look like. While some of the posts contain borderline offensive/body-shaming comments, the concept can be helpful, especially for young girls, in highlighting the efforts and altering (posing, editing) that goes into celebrities’ images.

Some additional helpful resources we came across include:

References:

Brown, A., Furnham, A., Glanville, L., & Swami, V. (2007). Factors that affect the likelihood of undergoing cosmetic surgery. Aesthet Surg J, 27 (5). 501-508.

Paul, K. (2018, October 10). Do Instagram and Snapchat distort how teenagers see themselves? MarketWatch. Retrieved from
https://www.marketwatch.com/story/the-unsettling-relationship-between-selfie-filters-and-plasticsurgery-2018-08-02

Paul, K. (2018, September 30). More than 200,000 teens had plastic surgery last year, and social media had a lot to do with it. MarketWatch. Retrieved from https://www.marketwatch.com/story/should-you-let-your-teenager-get-plastic-surgery-2018-08-29

Fardouly, J., Diedrichs, P. C., Vartanian, L. R., & Halliwell, E. (2015). The mediating role of appearance comparisons in the relationship between media usage and self-objectification in young women. Psychology of Women Quarterly, 39, 447–457.

Oberst, U., Wegmann, E., Stoft, B., Brand, M., & Chamarro, A. (2017). Negative consequences from heavy social networking in adolescents: The mediating role of fear of missing out. Journal of Adolescence, 55, 51-60.

Costa, L. D. C. F., de Vasconcelos, F. D. A. G., & Peres, K. G. (2010). Influence of biological, social and psychological factors on abnormal eating attitudes among female university students in Brazil.

Journal of Facial Plastic Surgery (2014). Selfie trend increases demand for facial plastic surgery. Retrieved from https://www.aafprs.org/media/press_release/20140311.html

Salmela-Aro, K,, Upadyaya, K., Hakkarainen, K,, & Lonka, K. (2016). The Dark Side of Internet Use: Two Longitudinal Studies of Excessive Internet Use, Depressive Symptoms, School Burnout and Engagement Among Finnish Early and Late Adolescents. Journal of Youth and
Adolescence, 46 (2). DO – 10.1007/s10964-016-0494-2

de Vries, D. A., & Peter, J. (2013). Women on display: The effect of portraying the self online on women’s self-objectification. Computers in Human Behavior, 29, 1483e1489. https://doi.org/10.1016/j.chb.2013.01.015 .

Spettigue, W., & Henderson, K.A. (2004). Eating disorders and the role of the media. The Canadian Child and Adolescent Psychiatry Review, 13 (1), 16-19.

 

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Mental Health Services for Youth

Nicole Kelday, Student Occupational Therapist (University of Toronto)

Cowritten by:  Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

 

It is staggering to realize that 39% of Ontario high school students show active symptoms of anxiety and depression. And while there are a multitude of resources available to help students that may require mental health services, only 40% of Canadians aged 15-19 reported they have not accessed these when needed. This begs the question…why are these youths not seeking services?

Reaching out for help can be daunting and many report stigma related to mental health concerns, especially in high schools. So, how do we encourage youth to access the services available to them and talk to those who may be experiencing similar concerns? A new emerging trend in mental health care is the concept of youth-led groups. Youth-led groups involve a shift in thinking, instead of viewing youth as our clients; they are viewed as partners and leaders to improve the practice of youth engagement in the mental healthcare system.

Across the province, community agencies have begun to initiate youth-led groups by involving youth with mental health illness in leading each other to raise mental health awareness and fight existing stigma. With support from a clinical adult ally, youth have participated in the creation of youth-friendly services by designing waiting rooms in clinical environments to encompass the interests of this group.

It is known that participation in meaningful activities and roles can enhance emotional well-being and social competence. Occupational therapists (OTs) have the unique ability to evaluate and facilitate supportive environments in order to promote mental health amongst children and youth. By involving all key stakeholders, OTs are able to determine factors that influence the ability of a youth to fulfill their primary roles and occupations and provide interventions to promote maximal functional participation in such.

As a student occupational therapist, I could immediately recognize how this concept strongly resonated with the core beliefs of client-centredness. Youth-led groups truly highlight the client as not only an active partner but also a leader, in their healthcare experience. Youth are equipped with vast knowledge and perspectives that we as healthcare professionals may not immediately recognize, which may help to explain why youth are not seeking available services in the first place.

 

References

1. Centre for Addiction and Mental Health (2018). Transforming mental health for children and youth. Retrieved from https://www.camh.ca/en/camh-news-and-stories/transforming-mental-health-for-children-and-youth

2. Hartman, L., Michel, N., Winter, A., Young, R., Flett, G. & Goldberg, J. (2013). Self-Stigma of Mental Illness in High School Youth. Canadian Journal of School Psychology, 28(1), 28-42.

3. The New Mentality (2016). TNM Groups. Retrieved from https://www.thenewmentality.ca/what/tnmgroups/

4. The American Occupational Therapy Association, Inc. Mental health in children and youth: the benefit and role of occupational therapy. Retrieved from https://www.aota.org/~/media/Corporate/Files/AboutOT/Professionals/WhatIsOT/MH/Facts/MH%20in%20Children%20and%20Youth%20fact%20sheet.pdf

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The Relationship Between Physical Activity and Depression

We have talked a lot on our blog about the benefits of regular physical activity for your physical, cognitive and mental health.  Why?  Because quite simply, other than laughter, physical activity is the best medicine!  A study recently published in The Journal of the American Medical Association (JAMA) Psychiatry looks at the relationship between regular exercise and depression.  Learn more about this study here care of the New York Times.

The New York Times:  Exercise May Help to Fend Off Depression

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Occupational Therapy Approaches for Substance Use in Clients with Brain Injuries

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)
Co-written by Ashley Best, Student Occupational Therapist

In our previous blog post titled “Brain Injury and Substance Use”, we discussed how the cognitive and emotional changes associated with brain injury can overlap with substance use.  But what wasn’t covered was the role of the Occupational Therapist when working with clients who have these challenges.  While our role is complex in cases like these, we have tried to simplify how we use function and meaningful activity in combination with direct treatment to address some common themes as outlined below.

1. Harm Reduction

Arguably the most important strategy of any professional working with someone who uses substances is Harm Reduction. An Occupational Therapist can work with a client to better understand the process of using a substance with the same skill used for analyzing other daily activities. By breaking down what a client’s substance use looks like, from the trigger to being under the influence, the OT can identify areas of potential harm or danger. Some common concerns with substance use, and some OT intervention examples are:

 

 

 

 

 

 

 

 

 

 

It is important to recognize that the above strategies are not meant to encourage substance use but ensure the safety of the client when they are not willing or able to stop.  Sometimes just reducing the harm is all we can offer until the harm can be eliminated.

Clinical Example: A man with previous regular alcohol use prior to an accident, now has seizures when he does not have alcohol in his system. Thus, it is actually more harmful to ask this client to not use alcohol. Instead, monitoring the amount he drinks and ensuring he has regular supports at home are two strategies that can reduce the harm that alcohol may cause.

2. Recognizing Substance Use as a Barrier to Goals

The financial, behavioural, and health effects of substance use often negatively impact a client’s ability to reach their goals. An occupational therapist can help a client to understand and hopefully address the gap between substance use and being able/unable to move forward in other areas of life. An OT may also strategize ways to achieve goals despite substance use by planning use around occupations and this, in turn, may help decrease use over time.

Clinical Example: An individual with a brain injury has a goal to return to work but does not have the insight to recognize how using narcotics would impact their success on the job. Thus, helping the client break down the requirements of a job, recognize poor fits, and then implementing strategies to change substance use behaviour so that it doesn’t impact work (in the case that abstaining from use is not an option) could be an intervention focus.

3. Using Activity to Avoid Triggers

Often, substance use is time-consuming between acquiring, using, and coming down from the influence. This becomes a major challenge when people stop using because there is a lot of free time that may lead to boredom and relapse. This is an important place for occupational therapists to intervene by helping the client identify meaningful activities to engage in when they are feeling an urge to use. This could involve interests and values, or just discussing past activities that the client would like to resume.

In the case of someone with a brain injury, more guidance may be required to identify triggers (if the client has low insight what is triggering). In addition, activities that the client can perform may be different following a brain injury, and thus they may need support in finding new meaningful activities to fill the time that was previously taken up with substance use.

What is the take-home message?

As the above indicates, implementing any of these strategies will require the client to exercise a high level of control over their addiction. Thus, an OT can help support and accommodate each client’s unique situation by providing remedial and compensatory strategies to help clients transition from the occupation of substance use, to other, ideally more meaningful and healthy alternatives.

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Brain Injury and Substance Use

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)
Co-written with Ashley Best, Student Occupational Therapist

As clinicians working in the community with clients who have a brain injury, we all too often see the challenges of recovery impacted by the use of illicit drugs and alcohol.  And while we treat both the brain injury and substance use as they impact function and the ability to participate in life roles, we often wonder, which came first? 

Statistics show that individuals with brain injuries have higher rates of substance use than the general population. However, statistics also show that individuals with brain injuries have higher pre-injury rates of substance use.  While this does not explain a “causal relationship” or answer the “which came first” question, we know the interplay is complicated and that acquiring a brain injury can change the way the brain processes information which may influence substance use behaviours and patterns.

Here are some examples of how this can happen:

  1. Cognitive Changes: Having a brain injury can result in cognitive changes from mild to severe difficulties with memory and concentration, communication, processing speed, problem-solving, and more.
  2. Emotional and Personality Changes: A brain injury can also result in emotional and personality changes such as impulsivity, irritability, and lack of insight.

The changes and symptoms mentioned above occur as a result of injury to the brain’s frontal lobe. The frontal lobe is responsible for more complicated cognitive processes. It helps us to problem solve everyday challenges and consider the positive and negative impacts of our decisions. When a person hits their head or is jolted quickly, the frontal lobe will often impact against the skull – bruising, damaging, and disrupting the connections between the brain cells in this region.

So how does this relate to substance use?

Well, there are reward pathways in the brain which react and process substance use triggers and the associated emotional response. These pathways respond to the positive feelings associated with substance use and strengthen the more the substance is used, telling the brain to seek more. These pathways recognize triggers of substance use and respond by sending the “craving” to the frontal lobe. The frontal lobe determines whether or not the substance will be sought after, and if so, how the substance will be obtained and used.

When we think about individuals with brain injuries and associated cognitive and emotional challenges, we can see how if a person has difficulty with impulsivity, for example, then ignoring a craving may be more difficult than it would be pre-accident. In addition, when a person with a brain injury decides to engage in substance use, challenges such as poor planning and problem-solving may make the use even more unsafe.

Though we may not have evidence to connect brain injury to substance use directly, the cognitive changes in the brain are likely to make managing, using and even recovering from substance use much more difficult.

So now that we have talked about how substance use behaviours and patterns may change after acquiring a brain injury, the question remains, What can be done to help an individual who has both a brain injury and problems with substance use?  This question will be answered in part 2 of our blog post: The Comorbidity of Substances and ABI – the Role of the OT…stay tuned!

 

References:

Bjork, J. M. & Grant, S. J. (2009). Does traumatic brain injury increase risk for substance abuse. Journal of Neurotrauma, 26, 1077 – 1082.

Ilie, G., Adlaf, E. M., Mann, R. E., Ialomiteanu, A., Hamilton, H., Rehm, J.,… Cusimano, M. D. (2015). Associations between a history of traumatic brain injuries and current cigarette smoking, substance use, and elevated psychological distress in a population sample of Canadian adults. Journal of Neurotrauma, 32, 1130 – 1134.

West, S. L. (2011). Substance use among persons with traumatic brain injury: A review. Neurorehabilitation, 29, 1 – 8.

WETA. (2017). Facts about concussion and brain injury. Retrieved from https://www.brainline.org/article/facts-about-concussion-and-brain-injury

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What is Hygge and How Can it Help You Survive Winter?

Hygge (pronounced hue-guh) defined as, a quality of coziness and comfortable conviviality that engenders a feeling of contentment or well-being (regarded as a defining characteristic of Danish culture), is becoming very popular.  Its basic principles revolve around creating an environment that is comfortable, full of love, warm, and cozy – sounds like a great way to make it through a cold Canadian winter if you ask me!  Learn more about Hygge and its benefits in the following care of HealthLine.

HealthLine:  What the Heck Is Hygge and Why Do You Need Some This Winter?

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O-Tip of the Week: Give Yourself a Pat on the Back

Our O-Tip of the week series we will be providing valuable “OT-Approved Life Hacks” to provide you with simple and helpful solutions for living. 

For the month of February, our O-Tip of the week series will talk about Self-Esteem, which is defined as confidence or belief in one’s own worth or abilities.  Self-esteem issues affect more than just teenagers and encompass more than physical insecurities.  Follow along this February to learn more about self-esteem, its importance and some simple ways give yourself a boost! 

This week we invite you to reflect on and record your accomplishments.  Big or small, past or present, make a list of all the things you have achieved and refer to this when you are feeling down or need a boost. 

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What’s Your Love Language… And Why Does it Matter?

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

I have a few online Goddesses I follow.  Women entrepreneurs who have built an empire educating other women on how to be successful.  Much like my own blog, they are comfortable sharing their stories of success and failure and want others to benefit from the knowledge they have.

In watching my online videos I will occasionally stumble upon a gem.  A piece of knowledge, a book to read, a way of thinking, or an exercise that truly moves me forward.  I recently had one of those experiences.

The video, by my career-crush and woman with the best hair in the world Marie Forleo (www.marieforleo.com), was on ways to appreciate and be appreciated.  Be it your spouse, children, parents or colleagues at work, we all strive to be loved and appreciated by those that matter to us, and to demonstrate this in return.  Marie was suggesting that in work and life it is helpful to understand how people experience and interpret love and appreciation so the efforts you make towards them can truly have an impact.  While a bit unorthodox, her suggestion was to engage people in the test of their Love Language.  She mentioned that this really helped her and her team know how to work together and ultimately appreciate each other best.  So, I took the test.  And my husband took the test.  And my children.  And my team.  The results were fascinating and helpful.

In my own family, our languages are different.  Personally, I appreciate it most when people take things off my plate.  My mind is a web of things to do so one less thing to think about is hugely valuable and appreciated by me.  Be it “I grabbed the kitty litter, put that envelope in the mail, or will send that email” – it resonates and helps me feel loved.  And call me cold, but I don’t resonate with physical touch (recall MC Hammer “Can’t Touch This”).

My girls are all different.  While most of them ranked “quality time” as their # 1, some prefer “words of affirmation” and one “physical touch”.  Not surprising, my physical touch kid is the one that is always asking for hugs and snuggling up to me on the couch.  Of great interest to me was that the one whose highest score was “words of affirmation” is also the kid that has a really hard time with conversations about things she did wrong or ways she let us down.  That makes sense now as people with this love language “thrive on hearing kind and encouraging words” and can be “shattered by insults”.  While we would never intentionally insult her, indicating that her school work is sloppy will make her feel unloved.  Good to know.  After we took the test and talked about it as a family, I took all of our ratings and put these in a chart by the door where we come and go.  I wanted these to be in plain sight and a regular reminder that our Love Languages are different and this matters when we want or need to be loved and appreciated by one another.  In a chaotic family of 6, this understanding is essential.

So I then took this experience a step further.  I asked the very important women I work with to also take this test.  The results again were interesting.  While my business partner and I tend to use small gifts as a way to show them appreciation, none of them ranked this as important.  Most would rather have unsolicited compliments (“words of affirmation”) then a surprise Edible Arrangement.  Some also prefer “acts of service” or being given “quality time” to feel valued.  At work, we can easily implement appreciation actions by offering to help them complete a burdensome task, providing unsolicited compliments, or making sure they have our undivided attention when they need it.

I consider the masterpiece that is myself to be always “under construction” and as such, I am repeatedly interested in ways to be better, do better, and spread love.  Love does not need to be considered romantic and according to 5 Love Languages, can be cast over all we meet with through simple gestures, kind words, a pat on the back, a small token of appreciation, or by sparing some time from a packed schedule.  Take the test here and see how you interpret love and appreciation and share that knowledge with those around you.

 

Originally posted July 2015

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O-Tip of the Week: Life’s too Short to Keep Up with the Jones

Our O-Tip of the week series we will be providing valuable “OT-Approved Life Hacks” to provide you with simple and helpful solutions for living. 

For the month of February, our O-Tip of the week series will talk about Self-Esteem, which is defined as confidence or belief in one’s own worth or abilities.  Self-esteem issues affect more than just teenagers and encompass more than physical insecurities.  Follow along this February to learn more about self-esteem, its importance and some simple ways give your self a boost! 

One way you can harm your self-esteem is through constant comparison of yourself to others.  However, putting a stop to this is, in fact, a difficult ask – magazines, tv shows, movies, social media… all of these things serve as channels to fill your mind with false images of how you “should be.”  Check out this great article care of Psychology Today which provides some great ways to get you to stop comparing yourself to others and see the amazingness within!

Psychology Today:  How to Stop Comparing Yourself to Others