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Archive for category: Mental Health

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Giving Back this Holiday Season

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

Tis the season for me to carefully balance my dislike for the Holiday season with my desire to not bring those around me down with my “baa-hum-bug” attitude.  My hate-on for Christmas started in my late 20’s probably around the time I had four kids under age 5 and through some lack of communication among my family, my kids had like 15 presents to unwrap EACH.  No, I am not complaining that my kids have access to such “abundance” by some very loving and well-meaning people, but with this display of affection comes a parent’s concern that their child will love Christmas because of the stuff.  And the more stuff they get, the more they want.  The more they want, the more they miss the point on the difference between want and need and the more they expect the “bar” to be raised with each passing year.

So, in my search to not pass on my “hate-on for the holidays” gene to my children, I landed on charity and acts of service to balance the fact that they, like most of their friends, live in abundance but still need to be mindful and grateful that they get a lot of what they want, while “needing” nothing.  After all, most of us can give something and there are so many options for this.  This new approach has been helping me to beat the Holiday Blues for the last few years.  It helps me to slow down, reflect, and be mindful and grateful for the things I have and can provide others, and for the pleasures of my own life. 

But in stepping out and getting my girls involved in local charities over the holidays, I have realized that there is an art to “giving” that can have the most impact.

Here are my Top 5 Things to Consider when Giving Back This Holiday Season:

Donate Money – good and responsible charities are appreciative of every dollar.  From the Salvation Army Bell Ringers to putting in a payment online or in the mail.  Money does help.  Search online with your kids to find a charity close to your heart, and have every member of the family donate.

Donate Items – some charities collect food, clothing, toys, or housewares to provide to those in need.  Time to purge those things you don’t need or use.  But before you donate items, ASK the charity what they need and HOW they want the items provided.  If they want new toys, these need to be packaged and un-used.  If they want them unwrapped then don’t take the time to wrap them – it only adds cost and time for you, and cost and time for the charity to unwrap the item before distributing.  Also, ASK what age groups they have a hard time providing for.  I was volunteering at the Good Shepherd recently and they had an abundance of items for small children, but very few for teens.  If you ask them, they will tell you the age categories they struggle to provide for.  Lastly, be sensitive.  If the charity is serving refugees or people immigrating from war-torn countries, toys that involve violence or war (i.e. guns or tanks) might not be appropriate and will need to be screened out by the charity before providing it to the recipient, again adding time and administration during a busy season.

Purchase Charity Goods – some charities sell “goods” that provide an item with a donation.  World Wildlife Federation sells small stuffed animals to represent an “endangered species” and most of the cost of the animal goes to the charity.  So, for $40.00 my child gets an “endangered stuffie” with a certificate about the animal they have adopted, and the charity gets $32.00 as a donation to their cause.  This is also true of other charities that aim to sell farm animals or agriculture supplies that are provided to third world countries.

Support Events – many charities offer dinners, auctions, or other seasonal events to raise money.  This is a great way to donate while engaging in an “experience” with a friend, partner or as a family.

Donate Time – sometimes donating your time reaps the best reward for you and the charity.  Not only does it provide you with an opportunity to see how the organization operates and allow you to be “hands on” in making a difference, it saves the charity from needing to fund staffing to manage the busy holiday season.  I have been at the Good Shepherd three times this month doing anything from sorting clothing donations, food donations, stocking housewares on the shelves in their store, and sorting toys for their Christmas hampers.  There are many organizations that just need some extra hands during the holiday season and sometimes our time is our most impactful gift.

Next week on our blog we begin our annual tradition of giving back to our readers with the 12 Days of Inspiration.  We hope you find these uplifting stories a source of inspiration and hope this Holiday Season.  

Previously Posted December 2016

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“The Cost of Caring” — Coping with Compassion Fatigue

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

Co-written with Kayla Colling, Student Occupational Therapist

There are many reasons we become health care providers.  Sometimes it is a passion for helping a certain population, a desire to help people achieve specific goals, or the recognition that people are needed to fill gaps in health care delivery.  Whatever the reason, there are physical and emotional risks that come with “helping” work.

If you are a helping or social professional who uses compassion and empathy with your clients who have experienced trauma and suffering, you may already be familiar with compassion fatigue.  Nurses, physicians, trauma therapists, social workers, workers in child protective services, and military healthcare teams are recognized to be at risk of exposure to second hand trauma through their work and may benefit from understanding and recognizing compassion fatigue.  Other health care providers, such as occupational therapists, advanced practice registered nurses (APRNs), respiratory therapists and physical therapists may also suffer the consequences of compassion fatigue in their work with people and their families that are experiencing a health crisis.

What is compassion fatigue?

Compassion fatigue is often described as the “cost of caring”.  It can also be called “secondary traumatic stress”, which is a more clinical term, but it is generally agreed that these terms are interchangeable.

Compassion fatigue occurs when providers are exposed to another person’s trauma and suffering.  This could be through routine interactions at our workplaces, when we provide compassion and empathy to clients or patients who have experienced trauma.

Symptoms

Compassion fatigue impacts individuals physically, emotionally and spiritually, and tends to have a rapid onset of symptoms.  The symptoms listed below are not exhaustive and not exclusive to compassion fatigue, so they should not be used to diagnose.  If you are concerned, consider making an appointment with your physician or other mental health worker to discuss your concerns.

Physical:  chronic fatigue, frequent headaches, gastrointestinal complaints, sleep disturbances, muscle tension, aches and pains, and anxiety.

Emotional and Spiritual:  heavy heart, emptiness, decreased sense of purpose, low self-esteem, high self-expectations, helplessness and hopelessness, numbness, apathy, depression, anger, irritability.

Behaviour Changes: avoiding or dreading work, calling in sick frequently, inability to maintain empathy, chronic lateness, overworking, and difficulty focusing and concentrating.

So it’s like burnout?

Burnout has a more gradual onset and results from an accumulation of ongoing, daily stressors at work that wear us down if we do not take proper care of ourselves and try to address the contributing workplace issues.  Symptoms of burnout tend to be more subtle and are sometimes misinterpreted.  It is still very important that we try to both address and prevent burnout, but this is clinically different from compassion fatigue.

Building Resiliency/Prevention

Although we cannot entirely prevent compassion fatigue from happening, we can take steps to reduce the risk, recognize warning signs and seek support early in order to reduce the impact on ourselves, our coworkers, our clients and our friends and families. 

By reading this blog, you have already taken a step toward learning more about it.  If we can normalize these emotions after exposure to these types of situations, it might help us to seek and accept support when we need it.

If your workplace permits, it can be helpful to have regular debriefings, even if a specific incident or crisis has not occurred.

Self-care strategies have been shown to help prevent compassion fatigue.  These strategies will likely include enhancing your boundaries to separate your work life from your home life as much as possible.  It also often involves balancing your activities outside of work as well, including engaging in a variety of relaxing, pleasurable and productive activities throughout the week.  Importantly, getting enough sleep at night and eating healthy and regular meals are also parts of self-care.  Avoiding maladaptive coping mechanisms (such as turning to alcohol, increasing smoking, eating or spending) is also important, including recognizing when things are deteriorating to get help quickly.

Practicing self-compassion can also help us to build resilience against compassion fatigue.  You can find meditations to help cultivate self-compassion, or it might be something you explore through reading, watching TedTalks, attending a course or workshop, or talking to your therapist about.  Having a regular mindfulness or meditation practice may also help you build resilience, along with other positive and adaptive outlets like exercise and social time.

Resources

If you are interested in learning more about compassion fatigue, check out the references below.

If you want to “check in” with yourself, you may be interested in looking at the Professional Quality of Life Scale (ProQOL) available here.  This scale will allow you to calculate scores on scales that consider compassion satisfaction, burnout and secondary traumatic stress (compassion fatigue).  I am not suggesting using this scale for self-diagnosis but it can sometimes be helpful to indicate if there is a concern you might want to speak to a professional about.

The symptoms of compassion fatigue can be severe – if you are concerned for your safety, please call your local crisis/distress line for support.  Find a crisis line near you.

References

Sorenson, C., Bolick, B., Wright, K. & Hamilton, R.  (2016).  Understanding compassion fatigue in healthcare providers: A review of current literature.  Journal of Nursing Scholarship, 48(5), 456-465.  doi: 10.1111/jnu.12229

Sorenson, C., Bolick, B., Wright, K. & Hamilton, R.  (2017).  An evolutionary concept analysis of compassion fatigue.  Journal of Nursing Scholarship, 49(5), 557-563.  doi: 10.1111/jnu.12312

Vu, P. &Bodenmann, P.  (2017).  Preventing, managing and treating compassion fatigue.  Swiss Archives of Neurology, Psychiatry and Psychotherapy, 168(8), 224-231.  doi: 10.4414/sanp.2017.00525

 

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“MO”-Tip of the Week: Learn the Male-Specific Symptoms of Depression

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 Movember, a month dedicated to Men’s Health, our “MO”-Tip series will provide you with OT-approved ways to take care of the men in your life.  

According to Movember Canada, across the world, one man takes his own life every one minute.  By learning some of the less-recognized symptoms of depression that are more prominently seen in men we may be able to prevent this.  These include:

  • Being irritable, short-tempered, or inappropriately angry
  • Spending a lot of time on work (they may be trying to escape their feelings by keeping busy)
  • Reckless driving, extreme sports, or other risky behaviours
  • Excessive controlling behavior
  • Alcohol or substance abuse (men are far more likely to abuse substances)

These behaviours are untraditional of typical depressive symptoms but mean that men who may benefit from emotional aid are often slipping under the radar for health professionals, and this can lead to disastrous consequences including poor quality of life and higher rates of suicide.  If you, or a man you know, is experiencing these symptoms speak to a healthcare professional.

This Movember, commit to walking or running 60 km in recognition of the 60 men we lose each hour to suicide.  Learn more here.

Learn more in our post, Stressed or Depressed” – Man Therapy

 

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The A to Z of OT: W is For… Workplace Wellbeing

There are many ways that Occupational Therapists promote wellness and wellbeing for those in the workplace.  From ergonomics to accessibility; injury prevention to return to work programs, OTs assist in the workplaces in many facets.  We are going to focus on an important way that Occupational Therapists can assist employees and employers at work – by improving mental health.  Learn more about how OT’s can provide essential information and assistance to enable the support of mental wellness at work in our OT-V video below, or in our post,  Promoting Mental Wellness at Work.

 

October is Occupational Therapy Month and to celebrate we will be sharing a new series called the A to Z of OT.  In our attempts to further educate the public about what Occupational Therapists do we will be highlighting twenty-six of the awesome ways OTs provide Solutions for Living.  

We encourage you to follow along and to add to the discussion by highlighting other awesome things OTs help with for each corresponding letter!

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The A to Z of OT: S is For… Stress Management

In 2013, Statistics Canada reported that 6.6 million Canadians (ages 15 and older) reported that most days were ‘quite a bit’ or ‘extremely stressful’.  Stress can negatively affect many aspects of your physical and emotional health and can have long-term repercussions.  Occupational Therapists can help people manage their stress with a variety of strategies.  Learn more about Occupational Therapy and stress reduction in our post, How Stress is Affecting Your Health.

 

October is Occupational Therapy Month and to celebrate we will be sharing a new series called the A to Z of OT.  In our attempts to further educate the public about what Occupational Therapists do we will be highlighting twenty-six of the awesome ways OTs provide Solutions for Living.  

We encourage you to follow along and to add to the discussion by highlighting other awesome things OTs help with for each corresponding letter!

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Technology – Why it’s Important to Unplug

Our relationships with our smartphones and other devices are bittersweet.  Though these devices seem to enrich our lives in many ways, they also have created numerous problems for our mental and physical health.  Excessive use of technology can lead to serious health problems including addiction, vision difficulties, sleep disturbances and more.  It’s important to try to be mindful of our technology use in order to avoid dependencies.  Check out this infographic, created by Psychologist Barbara Markway, with some great tips to help you unplug regularly for the sake of your health.

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O-Tip of the Week: Let it Go

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 you learn to put the past behind you in order to have a bright future.

Remember this:  “You can’t start the next chapter of your life if you keep re-reading the last one.” (author unknown.)  Check out these 40 Ways to Let go of the Past and Leave it Behind You care of Self Development Secrets.

 

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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.