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Tag Archive for: mental health

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Technology and Anxiety

Guest Blogger:  Susan Wang, MSc (OT)

Technology has increased access to information, entertainment, and connection with others.  However, it is not without consequences. With the rise of social media and the prevalence of smartphones, people are spending more and more of their lives looking at screens. Teenagers and young adults are particularly susceptible to the negative adverse effects of excessive technology use due to their developing brains and progression into adulthood.

Adolescence is a time of learning, growing, and challenges. Wanting to fit in, developing social relationships, and figuring out your identity are important pillars of adolescence. Social media provides a platform in which adolescents are able to satisfy their need for belonging and social interaction. However, excessive use of social media also increases the risk of several mental health symptoms, including depression and anxiety.

Staying in touch through technology has become a normalized way to connect with each other.  Data indicates that 88% of teens say they spend time with friends through texting, and 55% say they text their friends every day. The numbers are likely higher in 2020. There is increasing evidence supporting a link between social media use and higher levels of anxiety, depression, and low self-esteem amongst adolescents.  These findings can be attributed to a number of factors. For example, anxious adolescents tend to use social media more; this is consistent with previous findings in which adolescents higher in neuroticism prefer social uses of the internet. Furthermore, depressed adolescents may use social media more to regulate their low mood, causing a cyclic reaction that further exacerbates those symptoms. Other studies have found a linear association between the number of social media platforms used and depression and anxiety.  It has been found that individuals who used 7-11 social media platforms had substantially higher odds of having increased levels of depression and anxiety symptoms, compared to those who used 0-2 social media platforms.

Another factor contributing to poor mental health stems from the fact that many adolescents engage in nighttime use of their smartphones, resulting in later bedtimes and poorer sleep quality which also contributes to anxiety and depression.  It has been found that teenagers aged 15-19 who were regular users of mobile phones reported health symptoms such as tiredness, stress, headache, anxiety, concentration difficulties, and sleep disturbances more often than less frequent users.  Additionally, studies show that nighttime social media use was a predictor for poorer sleep quality.

There are several components of social media that cause stress and anxiety, including:

  • Seeing friends posting about events you weren’t invited to
  • Comparing your life/appearance to that of others you see on social media
  • Feeling pressured to post positive content about your life
  • Anxiety associated with getting comments and likes on your posts

FOMO

Fomo is defined as apprehension that others might be having rewarding experiences from which one is absent and a desire to stay continually connected with what others are doing. 

The term FOMO is associated with the first component of social-media induced stressors. For adolescents, being invited to events and having social interactions is extremely important to satisfy their sense of social connectedness and a sense of belonging. Seeing posts of their peers engaged in activities which they weren’t invited to causes FOMO. Why wasn’t I invited? Is it because they don’t consider me a good friend? What if everyone’s talking about this party on Monday and I can’t contribute?

Adolescents with predispositions of psychopathological problems (especially anxiety and depression) could develop higher FOMO because of their existing perceived social deficits. Individuals with poor emotional state and life satisfaction are also more likely to confront FOMO. Research has shown that social media users with high FOMO are more likely to spend more time on social media and suffer from depressive and anxious feelings. They may feel compelled to check their social media more often to keep up to date with their friends’ plans and activities, further feeding into a cyclic cycle of social media usage and symptom exacerbation.

“As being connected is of utmost importance in adolescents, young teens use social media prominently more in order to achieve greater levels of social involvement. By using social media, adolescents may satisfy their need to belong, but they also have greater risk of suffering from anxiety when they feel they are missing out on important shared experiences, or feel that they do not belong” (Oberst et al., 2017).

Common Symptoms of Social Media Anxiety

  • Interrupting conversations to check your social media accounts
  • Lying to others about how much time you spend on social media
  • Withdrawal from friends and family
  • Trying to stop or reduce your use of social media more than once before without being successful
  • Loss of interest in other activities
  • Neglecting work or school to comment on a social media account
  • Experiencing withdrawal symptoms when you are not able to access social media
  • Spending over six hours per day on social networking sites like Facebook, Twitter, or Instagram
  • An overwhelming need to share things with others on social media sites
  • Having your phone with you 24 hours a day to check your social media sites
  • Using social media more often than you planned
  • Severe nervousness or anxiety when you are not able to check your notifications
  • Negative impacts in your personal or professional life due to social media usage

Tips to Help With Social Media Anxiety: for Teens and Parents

  • Think critically about the accounts you choose to follow and unfollow accounts you are comparing yourself to, or that make you feel anxious or self-conscious
  • Recognize that everything on social media is highly orchestrated and not reflective of reality.
    • Think back to moments from your own life that you’ve omitted from social media
    • The “perfect” people you follow likely have the same negative experiences that they are not posting for everyone to see
  • Screen Time on your iPhone allows you to track how much time you are spending on your phone as well as on each app.
    • Set a limit on your phone to how much time you spend on each app.
    • When you reach the daily limit, your phone will automatically stop those apps and display a message indicating you have reached your daily limit
  • Set screen-free times where you put your phone away completely and spend time doing other activities.
    • This can be a goal set together as a family, for example, at night for an hour before bed, turn off all phones and spend time together as a family watching a movie.
  • When you start to feel anxious or experience negative thoughts about yourself, put your phone down.
    • Find another activity to keep your hands busy instead (adult colouring books, knitting, painting, exercising, etc)
  • Practice mindfulness to become aware of your surroundings
  • Spend more time outside with friends
  • Participate in a social anxiety group to relate to others with similar issues

References

Duggan, M., & Smith, A. (2013). Demographics of key social networking platforms. Pew Internet & American Life Project. Retrieved from http://www.pewinternet.org/2013/12/30/demographics-of-key-social-networking-platforms/

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.

Hamburger, Y.A., & Ben-Artzi, E. The relationship between extraversion and neuroticism and the different uses of the Internet. Computers in Human Behaviour, 16 (4), 441-449.

Van Der Goot, M., Beentjes, J. J., & Van Selm, M. (2012). Meanings of television in older adults’ lives: an analysis of change and continuity in television viewing. Ageing & Society, 32(1). 147-168

Primack, B,A., Shensa, A., Escobar-Veira, C.G., Barrett, E.L., Sidani, J,E,, Colditz, J,B,, & Everette-James, A. (2017) Use of multiple social media platforms and symptoms of depression and anxiety: A nationally-representative study among U.S. young adults. Computers in Human
Behavior, 69 , 1-9.

Woods, H.C., & Scott, H. (2016). #Sleepyteens: Social media use in adolescence is associated with poor sleep quality, anxiety, depression and low self-esteem. Journal of Adolescence, 51. 41-49.)

Jackson, ML, Sztendur, EM, Diamond, NT, Byles, JE, & Bruck, D. (2014). Sleep difficulties and the development of depression and anxiety: a longitudinal study of young Australian women. Arch Women’s Men Health, 17 (3), 189-198.

Dhir, A., Yossatorn, Y., Kaur, P., Chen, S. (2018). Online social media fatigue and psychological wellbeing—A study of compulsive use, fear of missing out, fatigue, anxiety and depression.  International Journal of Information Management, 40 , 141-152.

Desjarlais, M,, & Willoughby, T. (2010). A longitudinal study of the relation between adolescent boys and girls’ computer use with friends and friendship quality: Support for the social compensation or the rich-get-richer hypothesis? Computers in Human Behaviour, 26 (5), 896-905.

University of British Columbia (2019). Social Media Anxiety Disorder. Retrieved from http://etec.ctlt.ubc.ca/510wiki/Social_Media_Anxiety_Disorder

Fader, S. (2018) Anxiety and Depression Association of American – Social Media Obsession and Anxiety. Retrieved from https://adaa.org/social-media-obsession

Cuncic, A. (2019) Very Well Mind – Social Media and Social Anxiety Disorder. Retrieved from https://www.verywellmind.com/social-network-use-and-social-anxiety-disorder-4117143

Shafer, L. (2017). Harvard Graduate School of Education – Usable Research. Social Media and Teen Anxiety . Retrieved from https://www.gse.harvard.edu/news/uk/17/12/social-media-and-teen-anxiety

Soderqvist, F., Carlberg, M., & Hardell, L. (2008). Use of wireless telephones and self-reported health symptoms: a population-based study among Swedish adolescents aged 15–19 years.  Environ Health, 7: 18-10.1186/1476-069X-7-18.

Lenhart, A. (2015). Pew Research Center – Report: Teens, Technology and Friendships. Retrieved from  https://www.pewinternet.org/2015/08/06/teens-technology-and-friendships/

 

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COPING WITH COVID – Emotional Well-Being

COVID-19 has had a major impact on almost everyone. FunctionAbility, Solutions for Living and Social Work Consulting Group social work experts Wendy Gage, MSW, RSW, and Lynne Harford, MSW discuss practical strategies for coping with the new reality many of us face on a daily basis.

About the Experts:

Lynne Harford, BA, MSW, RSW, D.VATI is a Registered Social Worker, Director of Pediatrics and a Clinical Supervisor with The Social Work Consulting Group. She obtained a Master of Social Work degree from the University of Toronto and a Bachelor of Arts degree in Sociology from Glendon College-York University. Prior to her university studies, Lynne pursued a career in business and received a Marketing Administration Diploma from Seneca College of Applied Arts and Technology.  In 2013, Lynne achieved her designation of Art Therapist graduating with an advanced diploma in Art Therapy from the Vancouver Art Therapy Institute.

Lynne has had an extensive work history in both the private and public sectors. Prior to joining The Social Work Consulting Group in 2008, she was employed at The Hospital for Sick Children (SickKids) where she spent five years providing clinical social work services to children and their families in the Trauma Program. Throughout her career, Lynne has been an active member in the larger community participating in various committees as well as presenting at a number of community-based, insurance and legal conferences. Other areas of specialization in which Lynne has focused and devoted her practice to include, acquired brain injury in children and youth, acute and chronic illness, domestic violence, separation/divorce and issues related to grief and loss. Lynne is both a therapist and advocate who is committed to enriching the lives of children and adults in the aftermath of physical and emotional trauma.

Link to Canada’s economic plan: https://www.canada.ca/en/department-finance/economic-response-plan.html

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How Emotionally Intelligent Are You?

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

I have four daughters – three in high school and one in University.  That is a lot of estrogen in our house.  Yet it is an interesting time for our family – as our girls are navigating the perils of adolescence, I too am finding myself in a stage I am calling “adultescence” whereby my thoughts, feelings, and emotions are changing as theirs are.  This creates an interesting ebb and flow of all of us learning together what it all means as a teen girl to “grow up” and as an adult to start “letting go”.

I had one of those adultescent “aha” moments the other day with one of my teen daughters.  She is very socially driven and relationships are very important to her.  Over the last few months, as school has resumed, she has been struggling with some of her friendships.  One girl just suddenly stopped responding to messages, one takes pleasure in forwarding hurtful messages, and another treats my daughter as the weekend “last resort”.  In talking to my daughter about these events, my “aha” moment came when I realized that my daughter, already, is highly emotionally intelligent.  She has the ability to put herself in the position of others and regulates her own behavior (so far) on how she would feel as the recipient.  This is a gift for her but puts her at a relationship disadvantage as many of her peers are not there yet.   She “feels” in a relationship like she is 25, but is trying to rationalize the emotional behavior of kids 16 and 17.

According to psychology today, Emotional Intelligence includes three skills:

1. Emotional awareness, including the ability to identify your own emotions and those of others;

2. The ability to harness emotions and apply them to tasks like thinking and problem solving;

3. The ability to manage emotions, including the ability to regulate your own emotions, and the ability to cheer up or calm down another person.

Emotional intelligence then includes:  self-awareness, self-regulation, motivation, empathy, and social skills.  It can affect: personal relationships, workplace (or school) performance, physical and mental health, and how you deal with situations such as loss or disability.

The good news is that experts believe that emotional intelligence can be learned, even in adults.  How do you know if you are emotionally intelligent?  Perhaps reflect on your relationships – are you able to sustain positive and loving bonds with others?  Can you empathize and relate to people during their struggles, and do they know that you “get it” and are emotionally available to them?  Do you regulate your own behavior based on how others might feel if you act a certain way, or say certain things?  Before sending that text, email or calling someone in anger do you consider how you want them to “feel” following your interaction?  Do you take pleasure in being right even if that makes others feel bad?  If you want to test your level of emotional intelligence, or raise your emotional IQ, take a quiz to see where you’re at:  Emotional Intelligence Quotient Quiz.

Do you think you need to improve in this area?  Some suggestions include:

·    practice mindfulness – in social situations, at work, at home with family relationships.

·    Stay in touch with your feelings through journaling or meditation “check-ins”.

·    Connect your feelings to the situation and try to separate the person from their behavior.

·    Check your thoughts – how you think can become how you feel, and the good news is you can change how you think!

·    Communicate with others and don’t be afraid to be vulnerable to those close to you to help sort through feelings, thoughts and emotions.

·    And if you can, don’t take the comments of others personally.  Their thoughts about you do not need to become the thoughts you have about yourself.

 

Originally posted November 2016

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Tips to Survive the Winter Blues and Put a Stop to SAD

Julie Entwistle, C.Dir. (c), MBA, BHSc (OT), BSc (Health / Gerontology)

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.  If you feel this is you, talk to your doctor and have your symptoms investigated.

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 tips in our infographic below to make the winter bearable, or dare I say, even enjoyable?

 

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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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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

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How Anxiety and Depression Can Impact Cognition

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

As a student working with an Occupational Therapist in the community, I realized early in my placement that many clients struggle with anxiety and depression in combination with cognitive challenges like decreased attention, concentration and focus, difficulties with memory, and slower information processing abilities. This spiked my interest, as I was unaware of the possible impact anxiety and depression could have on cognition and how these symptoms could be related.  I decided to look into this further, and am sharing my findings below.

Occupational Therapists work in a wide variety of settings including the community. As the hospitals become less and less able to accommodate people long-term, community-based occupational therapy services are becoming more and more common. Working in the community allows occupational therapists to reach a wide variety of clients, and therapists utilize a strength-based approach to build on the client’s current strengths to promote wellness and productivity.

Depression and anxiety are the most common types of mental illness throughout the world, including Canada. From my community placement experience as a student Occupational Therapist, I have found that the majority of the clients I have seen are experiencing depression and/or anxiety, often in combination with other primary diagnoses.

Interestingly, depression and anxiety can negatively impact the way the brain thinks, learns, and processes information and thus how it functions.  However, the relationship is complicated as a decrease in cognition may also lead to an increase in depression and/or anxiety which can then perpetuate the cycle.

Research has highlighted how anxiety and depression can negatively impact several aspects of cognition including:

  • Psychomotor speed
  • Attention
  • Executive functioning
  • Problem-solving
  • Attentional switching
  • Cognitive flexibility
  • Visual learning
  • Memory

The result for most people tends to be poor functional outcomes in their daily lives. Additionally, the brain regions believed to be responsible for these functions have been shown to be abnormal in people that also suffer from anxiety and depression  (e.g. hippocampus, amygdala, temporal lobes, and prefrontal cortex). Decreased memory, slowed information processing, and issues with verbal communication can negatively impact multiple areas of people’s lives. This information demonstrates the importance of the need to detect and treat anxiety and depression as early as possible as well as the need for early cognitive interventions for clients with anxiety and depression.

As a student Occupational Therapist, I wanted to further investigate how Occupational Therapists can help. I found evidence that Occupational Therapists can help clients in reducing functional decline, while also reducing the probability of relapse by treating cognitive deficits. Occupational Therapist’s target these areas by teaching client’s cognitive remediation and compensation strategies during their interventions and treatment monitoring.

Examples of remediation interventions may include:

  • Retraining higher-level cognitive skills (e.g. strategy use, self-monitoring, self-correction, problem-solving, self-evaluation)
  • Education
  • Relaxation and stress management techniques to regain control
  • Divided attention training (e.g. learn tasks separately and then combine tasks)
  • Imagery
  • Rehearsal strategies

Examples of compensatory interventions may include:

  • Modifying the environment (e.g. dim lights, reduce distractions)
  • Altering the task, (e.g. use of rest breaks, breaking the task into smaller components, repetition of instructions)
  • Use of both internal and external cueing/reminders (e.g. use of mnemonics, post-it notes, organizers, applications)

With both, often, a cognitive behavioural approach is taken.  Cognitive behavioural therapy (CBT) works to change clients thought structure to allow positive mood change, enhance coping strategies/problem solving, and help challenge faulty beliefs.

Anxiety and depression are common and are known to negatively impact a person’s cognition.  Worsening cognition then can deteriorate anxiety and depression further.  Early intervention is key to break this cycle and to promote function and wellness.   Occupational therapists play a vital role in providing interventions for those with anxiety and/or depression by implementing interventions for these issues, as well as treating the common resulting cognitive deficits.  Both remediation and compensatory techniques are used, often through cognitive behavioral therapy.  If you, or someone you know, is struggling with anxiety or depression this may present as cognitive difficulty, or if cognitive issues are present, anxiety and depression may also surface.  Consider occupational therapy if you would like support and strategies to improve these symptoms and to reduce their effect on your daily life.

 

References:

1. Carrier, A., & Raymond, M. H. Community occupational therapy practice in Canada: A diverse and evolving practice.

2. McRae, L., O’Donnell, S., Loukine, L., Rancourt, N., & Pelletier, C. (2016). Report summary-Mood and Anxiety Disorders in Canada, 2016. Health promotion and chronic disease prevention in Canada: research, policy and practice, 36(12), 314.

3. Statistics Canada (2014) Survey on Living with Chronic Diseases in Canada (SLCDC). Retrieved from http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=5160

4. Lee, R. S., Hermens, D. F., Porter, M. A., & Redoblado-Hodge, M. A. (2012). A meta-analysis of cognitive deficits in first-episode major depressive disorder. Journal of affective disorders, 140(2), 113-124.

5. Jaeger, J., Berns, S., Uzelac, S., & Davis-Conway, S. (2006). Neurocognitive deficits and disability in major depressive disorder. Psychiatry research, 145(1), 39-48.

6. Bora, E., Fornito, A., Pantelis, C., & Yücel, M. (2012). Gray matter abnormalities in major depressive disorder: a meta-analysis of voxel based morphometry studies. Journal of affective disorders, 138(1), 9-18.

7. Femenía, T., Gómez-Galán, M., Lindskog, M., & Magara, S. (2012). Dysfunctional hippocampal activity affects emotion and cognition in mood disorders. Brain research, 1476, 58-70.

8. Lorenzetti, V., Allen, N. B., Fornito, A., & Yücel, M. (2009). Structural brain abnormalities in major depressive disorder: a selective review of recent MRI studies. Journal of affective disorders, 117(1), 1-17.

9. Fleming, J. (2017). An occupational approach to cognitive rehabilitation. Workshop presented through the Canadian Association of Occupational Therapists, Toronto, ON.

10. Grieve, J. I., & Gnanasekaran, L. (2008). Intervention for Cognitive Impairments. Grieve, JI, & Gnanasekaran, L.(3rd ed. ed.). Neuropsychology for occupational therapists: cognition in occupational performance. Oxford. Malden, Mass.: Blackwell.

11. Haran, D. (2009). Cognitive-behavioral therapy for depression. The Israel journal of psychiatry and related sciences, 46, 269.

12. Knapp, P., & Beck, A. T. (2008). Cognitive therapy: foundations, conceptual models,  applications and research. Revista Brasileira de Psiquiatria, 30, s54-s64.

 

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Youth Anxiety and Depression on the Rise

The Centre for Addiction and Mental Health (CAMH) has released the results of the latest Ontario Student Drug Use and Health Survey and the results are showing rising instances of anxiety and depression in grades 7-12 students.  Learn more about the results and how gender may play a role in the following care of CAMH.

The Centre for Addiction and Mental Health:  Half of female students in Ontario experience psychological distress, CAMH study shows