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Archive for category: Mental Health

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O-Tip of the Week: Take a Break!

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

For the month of September, a month of back to school and back to reality, our O-Tip series will provide you with OT-approved ways to put the focus back on you.  This week’s O-Tip can help to improve your mental health in a matter of a few minutes each day.

Though working through lunch or breaks sometimes seems like it could help you get more done, it actually is counterintuitive.  Breaks are necessary and can help to boost mental health and productivity, especially in the workplace.  However, breaks aren’t just for the office, but for household activities as well.  Some great ways to make the most of this break to boost your mood include:

  • Taking a walk
  • Heading outside for a breath of fresh air
  • Conversing with co-workers (non-work related)
  • Reading a book
  • Meditating
  • Stretching
  • Desk-ercising (try these fun ideas to work out at work)
  • Doing something artistic or creative (try bringing a relaxation colouring book and some pencil crayons in your work bag)

Remember it’s important that we take frequent breaks to reduce stress, improve focus and to take care of ourselves.

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Some Thoughts on Mindful Self-Compassion

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

For the last several weeks I have been enjoying a course in Mindfulness Self-Compassion.  Taught through the Program for Faculty Development at McMaster University, the course is for health professionals, but the strategies and teachings are very relatable to all of us in our daily lives.  While the course is not over, I wanted to share some of the main concepts I have found most helpful so far.

Here is the scenario:  you are heading home from work and you get a panicked call from a close friend or family member.  They are upset and really need your help.  How do you react?  Well, when I did this exercise I thought my reaction would probably include:  asking them what I could do that would be most helpful, clearing my evening schedule to go provide them with support, visiting with them to listen, offering support, helping to distract them through activity or fun if appropriate, assisting them to move through the situation, arranging for follow-up and checking in the next day.  Something like that.  But, what if the crisis is happening to me?  Would I react differently?  Well, historically, yes, I would.  In fact, I would probably treat myself very differently than I would my friend.  Or, more honestly, if I treated my friend the way I would treat myself, I wouldn’t have many friends.  My reaction to myself would be more like: “you don’t have time for this, get over it, there are bigger problems in the world”, or I would simply try to ignore the issue, bury the associated feelings and move on.  I probably would see my own name on the call display, roll my eyes, hit “decline” and wonder “why is she calling again”? Wow, what a difference.  Self-compassion then can be as simple as affording yourself the same compassion, love and respect that you afford to those around you.  Try it!

I also found it very helpful when the course addressed our “inner critic”.  This is the internal voice we all have that bully’s us into thinking we are not “good enough, smart enough, fit enough, competent enough” etc.  In truth, part of the reason I wanted to take the course in the first place was to try and sucker punch that bully and get her (mine is female) to leave me alone.  But when the course had me really evaluating the thoughts and feelings that my inner critic berates me with, I did come to realize that perhaps I should give her more credit.  Maybe it is my critic that ensures I complete 90% of my goals.  Maybe I need that critic for my willpower, drive and determination.  Perhaps some of my behavior is directed at proving her wrong (I am stubborn that way).  Because of the course I now have an increased appreciation for her and am now grateful that she keeps me in line.  By acknowledging that she exists and being open to her presence has actually diffused her, softened her approach, and now I find her voice more loving and supportive.  Go figure!

Lastly, I found the half-day silent retreat very refreshing.  While I had been on a silent retreat before, this time I was sure to be much more mindful throughout the process and the results were more enjoyable.  Not being pressured to talk or engage verbally with others really helped me to calm my thinking, slow my brain waves and see things that I usually ignore.  Nature, food and silence have never before been so enjoyable.  I left there with feelings equivalent to a restful nights’ sleep, a relaxing vacation, or a good meal with friend.  Soothing, comforting and rejuvenating.  Silence is definitely something I am going to work into my life more regularly.  My brain requires it.

While there have been other helpful and impactful parts of this course, I have highlighted my favorite three so far.  And though I am still learning the art of mindfulness (and am not yet “practicing” as much as I should), and I still struggle with meditation and working this into my day, the benefits of this course are many and the teachings important.  Mindfulness, self-compassion and human kindness are all pivotal concepts in this course that this world so desperately needs us all to embrace.  I am enjoying learning more about them all.

To close, here is one of my favorite poems from the course:

Allow

by: Danna Foulds

 

There is no controlling life.

Try corralling a lightening bolt,

containing a tornado. Dam a

stream and it will create a new

channel. Resist, and the tide

will sweep you off your feet.

 

Allow, and grace will carry

you to higher ground. The only

safety lies in letting it all in –

the wild and the weak; fear,

fantasies, failures and success.

 

When loss rips off the doors of

the heart, or sadness veils your

vision with despair, practice

becomes simply bearing the truth.

 

In the choice to let go of your

known way of being, the whole

world is revealed to your new eyes.

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One in Five Youth Struggle with Mental Health Problems – Do you Know the Signs?

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

I was recently reviewing my daughter’s school handbook and noticed the section on child and youth mental health.  According to this (and the Canadian Mental Association) 1 in 5 children and youth struggle with mental health problems.  While great strides have been made over the last several years to destigmatize and demystify mental health problems in both adults and kids, I feel this remains generally misunderstood.  In my practice, I still see the common misperceptions that people with anxiety don’t leave the house or appear nervous and anxious in public, or that people with depression sleep all day, don’t attend to their appearance, and sit around crying and feeling sorry for themselves.  The truth is that mental health is a spectrum, or a continuum if you will.  It can vary and no one’s experience will be the same.  In children, mental health problems can present differently.

As per the handbook I was reading, the signs might include:

·        Anxiety and fear that does not go away

·        Frequent crying and weepiness

·        Loss of interest in activities that were a source of pleasure in the past

·        Difficulty concentrating

·        Lack of energy or motivation

·        Problems at school with falling marks

·        Withdrawal from family, friends and school activities

·        Increased school absences

·        Loss or increase in appetite

·        Sleeping too much or too little

·        Increased irritability, anger or aggression

·        Neglect of personal appearance

·        Frequent stomach aches or headaches

·        Increased alcohol or drug use

In general, parents should be able to monitor most of these and overt changes might be obvious (suddenly disconnecting from friends, drastic changes in grades, behavior change at home, quitting enjoyed activities, not eating food or participating in meal times, etc).  But like with the continuum of mental health in adults, some of these might present some days and not others, or be so subtle that they deteriorate very slowly over time.   As parents of teens we need to be the barometer for our kids as they may lack the ability to relate some of these signs to mental health or internal struggle.

Luckily, in Southern Ontario anyway, I see the mental health problems of kids being taken seriously and there are publicly funded community supports available.  But getting your child connected with these can be the challenge.  It can be hard to convince a teen to do anything they don’t agree with, let alone getting them to the myriad of appointments with doctors and clinicians that can help.

Occupational therapy plays many roles in helping kids and teens address issues with mental health.  While some occupational therapists are trained to provide psychotherapy, others use meaningful and enjoyable tasks to help with mood elevation, reactivation and reengagement.  We are skilled at looking beyond the obvious to get a better sense of what might help at home, school or in the community to get your child or teen on track.  Sometimes it is as simple as helping them to reorganize their school work, create a process for managing assignments and tests, teaching them how to study in a way that works for them based on their learning style, or even looking at how their week is managed to make changes.  Occupational therapists tackle things like sleep / wake schedules, eating and diet, activity participation, grades and school success, managing friends and relationships, motivation through engagement, and dealing with negative pressures that create more stress and anxiety.

My advice if you are concerned about your child?  Start with your family doctor and discuss your concerns, even if your child won’t attend with you.  Involve the school in your concerns to get their support and guidance, after all your child spends several hours a day in their supervision and care.  Teachers can be a great resource and form of support as well, but you need to open those lines of communication.  Don’t expect the school to come to you – often they don’t.  If your child is in crisis, call your local Crisis Outreach and Support Team (COAST) and ask them for help.  They can (and should) also connect you and your child to other community programs.

If you have coverage for mental health treatment for your teen (extended benefits, other insurance funding, out-of-pocket), including occupational therapy, consider enlisting a private therapist.  Private therapy often provides a larger scope of service, is more specialized, and can be provided over a prolonged period if appropriate.  Any good private therapist will try to work themselves out of a job by getting your child on track as quickly as possible and they will want you to immediately feel the benefit of their involvement.  Also, if you have private dollars or insurance coverage, I would suggest a psycho-educational assessment.  These are extremely thorough “brain tests” that look at all aspects of how your child processes information, manages cognitive tasks and addresses the complicated relationship between our brain and our emotions.  The outcome of these assessments can be extremely helpful and will provide both you as a family, and the school, with suggestions for how to best help your child to succeed.

I have always said watching my kids grow up is the best and worst part of parenting.  It is especially heart-wrenching if your child is struggling.  Watch for the signs, talk to your child and get them (and you!) support if they need it.

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Can you “Catch” Stress Like you Catch a Cold?

The short answer… yes!  Science has proven that stress is contagious and that basically, being around people who are stressed can change your brain in the same way.  Learn the details of this incredibly interesting study in the following care of The National Post.

The National Post:  Your stress can actually change your partner’s brain, study suggests

Learn more about the effects of stress and ways to manage it from our popular post, How Stress is Affecting Your Health.

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Sexual Harassment and Sexual Abuse: OT Can Help

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

The pendulum has surely shifted on what society will and will not tolerate when it comes to sexual harassment and sexual abuse.  For those that remain confused on these two overlapping but very different concepts, here are simple definitions from Wikipedia:

Sexual Harassment:  bullying or coercion of a sexual nature, or the unwelcome or inappropriate promise of rewards in exchange for sexual favors.

Sexual Abuse:  undesired sexual behavior by one person upon another.

Sexual harassment has often been related to the workplace and women tend to be the most common recipients.  It also tends to involve a power imbalance whereby one person is in a position of authority over the other, but by definition, this does not have to be the case.  With the current societal shifts, it is now recognized that harassment can extend beyond the workplace, and is not gender specific.  Sexual abuse, on the other hand, has always been more of a global term, applying to anyone, anywhere, anytime, who is forced into sexual activity without their consent.  It has always been socially unacceptable, even when sexual harassment was more of a commonality.

Truth be told, I have been a victim of both.  I can say that harassment is easier to talk about but at the time I was being harassed it was not as socially unacceptable as it has become.  In fact, it almost seemed common that a young woman working (and in my case playing sports) who was exposed to men in more senior positions would be solicited, propositioned, flirted with or asked on dates or to social events.  I was fortunate in that none of these experiences turned into sexual abuse and I trust (hope) that men today behave much more professionally around women in general.  Sexual abuse, on the other hand, is much harder to talk about, and my experience with this is not one I am comfortable sharing publicly.  I do know though that victims of sexual abuse often need therapy to help them recover from their trauma, and I am hopeful that the recent media attention to this will encourage victims to come forward and seek help should they need it.

Occupational therapy can be one form of treatment for people who have suffered from sexual harassment or abuse.  When people are off work or struggling with work, our therapy helps people to discover functional barriers, develop solutions, proactively engage in problem solving, and then assists people to forward in their new chosen direction (albeit return to work, seeking new work, or addressing retraining).  With sexual abuse some occupational therapists are trained in psychotherapy and work with people directly to address the results of their trauma.  Occupational therapy also helps people to rebuild the elements of their life that have been lost because of their trauma.  Sometimes victims of sexual abuse develop maladaptive ways to cope (addictive behaviors, inactivity, social isolation to name a few) and these can be addressed in treatment.  It is also common that depression and anxiety surface following sexual abuse, and these too can be tackled through activation at home and in the community.  Occupational therapists work very well with other providers who may also be involved – social workers, psychologists, and the medical team, helping to create a cohesive and impactful approach to recovery.

If the media attention to these problems results in positive societal and behavioral change, then we all need to be thankful and grateful to the people that have come forward and for the stories that have been shared.  And if sexual harassment or abuse have caused problems for you and impact how you manage your day-to-day activities including work, taking care of yourself, enjoying leisure, or managing important elements of how you want to spend your time, consider occupational therapy as one element of your recovery team.

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What Does a Psychologist Do?

February is Psychology Month.  Psychologists, often confused with Psychiatrists, are valuable health practitioners who assist people with how they feel, act and behave.  Learn more about psychology, its benefits, and how a Psychologist may be able to assist you or someone you love in the following care of the Canadian Psychological Association.

Canadian Psychological Association: What is a Psychologist?

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Overcoming Eating Disorders: OT Can Help

Guest Blogger:  Carolyn Rocca, Occupational Therapist

According to Statistics Canada, in 2012 over 130,000 Canadians over the age of 15 years old reported that they have been diagnosed by a health professional as having an eating disorder. Considering these high rates, and the likely underestimation of reported diagnoses, eating disorders remain a form of mental illness that are not openly talked about.

Eating disorder is an umbrella term for several categories of diagnoses, with anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorders not otherwise specified being the most common. Although symptoms vary based on the diagnosis, some overall symptoms experienced with eating disorders include a pre-occupation with body weight, body dissatisfaction, behaviours to prevent weight gain, perfectionism, emotional dysregulation, depressed mood (including suicidality), anxiety, and low self-esteem. Naturally, these symptoms can lead to secondary impacts such as physical adverse effects, social isolation, and a compromise of occupation in the areas of self-care, daily living, leisure, and productivity (NCCMH, 2004).

The treatment and recovery of adolescents with eating disorders involves the collective work of many healthcare professionals including physicians, dietitians, nurses, psychiatrists, psychologists, social workers, teachers, child and youth counselors, and, yes, occupational therapists(Norris et al., 2013). Each of these team members works collaboratively to deliver the best practice approaches of pharmacotherapy, nutritional rehabilitation, and psychosocial interventions, including cognitive behavioural, dialectical behavioural, interpersonal, and family based therapies, among others (APA, 2006; NCCMH, 2004). Several of the healthcare professionals working with adolescents with eating disorders can deliver these therapies, including occupational therapists.

This means that occupational therapists work effectively with several disciplines to deliver best practice approaches, while also integrating their unique focus on occupational functioning to the team. Occupational therapists’ unique contribution is their ability to holistically address the physical, cognitive, behavioural, and psychosocial aspects of adolescent eating disorders through occupation-based approaches to improve adolescents’ self-worth and self-esteem (Kloczko & Ikiugu, 2006). As mentioned previously, eating disorders commonly have a substantial impact on adolescents’ function in the areas of leisure, self-care, daily living, and productivity (NCCMH, 2004), meaning many youth have difficulty balancing their family and social lives, education, employment, extra-curricular participation, ability to regulate their own activities, and thus overall health.

Occupational therapists have the expertise to work closely with adolescents and their family to help them with their goals around succeeding in school, work, leisure, and overall re-engagement in meaningful activities. In fact, Occupational Therapists are skilled at using meaningful activities as a vessel to get to the underlying problem of the eating disorder.  Sessions don’t focus on eating, food or binging behavior, but on being productive, enjoying life, and accomplishing things that matter.  The indirect influence is better choices in other areas (including diet) and recognizing the link between mental and physical health, quality of life and wellness.

If you know a teen (or adult for that matter) that may be dealing with an eating disorder, encourage them get help.  There is a team of professionals, including occupational therapy, that are skilled at assisting teens to recover from these, and other mental health issues.

 

References & Resources:

American Psychiatric Association (APA). (2006). Practice guideline for the treatment of patients with eating disorders (3rd ed). Retrieved from https://www.guideline.gov/summaries/summary/9318/practice-guideline-for-the-treatment-of-patients-with-eating-disorders

Kloczko, E., & Ikiugu, M. N. (2006). The role of occupational therapy in the treatment of adolescents with eating disorders as perceived by mental health therapists. Occupational Therapy in Mental Health, 22(1), 63-83. doi:10.1300/J004v22n01_05

National Collaborating Centre for Mental Health (NCCMH). (2004). Eating disorders: Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders. Retrieved from https://www.nice.org.uk/guidance/cg9/evidence

Norris, M., Strike, M., Pinhas, L., Gomez, R., Elliott, A., Ferguson, P., & Gusella, J. (2013). The Canadian eating disorder program survey–exploring intensive treatment programs for youth with eating disorders. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 22(4), 310.

Statistics Canada: http://www.statcan.gc.ca/pub/82-619-m/2012004/sections/sectiond-eng.htm

 

previously posted March 2017

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Ecotherapy: Harness Nature’s Healing Power

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

Of all the ways I take care of myself, my daily walk outdoors with my dogs is one of the most therapeutic.  The only things that keep me from being outside daily would be a horrible rainstorm or temperatures that are too cold for my dogs to endure.

Not only does seeing my dogs enjoying the scents of nature lift my spirits, but the fresh air, sunshine, sounds of nature (or my music, depends on the day), sights of the birds (the hawks are my favorite), trees (and sometimes deer, bunnies and even coyotes) distracts me from the stress of the world, even if just for precious mindful moments.

The below article highlights the concept of Nature Therapy and outlines how sometimes we should consider using the sights and sounds of the outdoor world around us for valuable healing opportunities.

The Hamilton Spectator:  Nature might be the prescription for what ails you

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Blue Monday and Beyond — How to Beat the Winter Blues

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

I made a comment after the Holidays that I was slowly recovering from Christmas Affective Disorder.  For me, Christmas is stressful, hectic and challenging.  I struggle with it every year.  After the seasonal rush, it takes me days, or even weeks, to get back to my normal equilibrium.  However, really, winter despair is not a joke and for some, can be debilitating.

In fact, some research suggests that up to 15% of people in Ontario experience the “winter blues”. These leave you feeling tired, groggy, and maybe even sad or irritable.  While this causes discomfort, it is not incapacitating.  However, a more serious form of the winter blues, known as Seasonal Affective Disorder (SAD), can be.  While occurring less frequently at 2-3% of the population, the symptoms can prevent individuals from leading a normal life.  Symptoms of SAD include decreased energy, changes in appetite, especially leading to cravings for starchy or sweet foods, oversleeping and weight gain, among other things.  If you feel this is you, talk to your doctor and have your symptoms investigated.

The problem is not always the blues, but how these create a negative behavior cycle.  When you feel down, you revert, avoid, or change habits.  This leads to feeling worse and the cycle continues.  Occupational therapists (OTs) recognize the importance of being engaged in activities that are meaningful, active and productive, and understand how these contribute to health and well-being. In fact, one of the best treatments for beating the winter blues involves just “keep on keeping on” by doing what you normally do every day.  Some tips include:

  1. Use behavioral activation to keep your normal routine.  Make the bed, have a shower, prepare a decent breakfast, walk to the mail box.  Don’t change habits that are ingrained just because it is winter.  Never underestimate how damaging it can be if you avoid even small things that ultimately add up to a productive day.  Gradually try to get back to those important tasks if you have found that your daily behaviors have become unproductive.
  2. Stay active. Those that love the winter do so because they get outdoors.  Walk, ski, skate, toboggan – something to help you appreciate how wonderful a change of seasons can be.  This is best facilitated by proper clothing that will keep you warm.  If exercise is tough for you, build it into your day by default – park farther from the door, use the stairs, make a few trips from the car with the groceries to get the blood flowing.
  3. Consider light therapy. Sit by the window at lunch, get some fresh air when the sun is out, or consider purchasing an artificial light for your use at home.
  4. Up the nutrients. When some bad eating habits creep into your winter these can be hard to break come spring, and only contribute to further mood declines.  Shop in the fruit and veggie isles, and avoid the isles that house the bad foods you seem to be eating too much of.

Finding ways to help you do the things you want to, need to, or enjoy, is at the heart of occupational therapy. While the winter months can be long, dark, and cold, ultimately how we adapt to the seasonal change is up to us.  If moving or going south is not an option, consider some of the above tips to make the winter bearable, or dare I say, even enjoyable?

 

Resources:

Seasonal Affective Disorder. (Canadian Mental Health Association, 2013) http://www.cmha.ca/mental_health/seasonal-affective-disorder-sad/
Beat The Winter Blues (Readers Digest, no date) http://www.readersdigest.ca/health/healthy-living/beat-winter-blues
Kurlansik, SL & Ibay, AD. (2012).
Seasonal Affective Disorder. Am Fam Physician. 2012 Dec 1;86(11):1037-1041.
10 Winter Depression Busters for Seasonal Affective Disorder (Borchard, no date) http://psychcentral.com/blog/archives/2012/12/30/10-winter-depression-busters-for-seasonal-affective-disorder/

 

Previously Posted January 2017