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.
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
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.
Today is Bell Let’s Talk Day in Canada. Again this year Bell will be raising funds to support mental health initiatives across Canada and to help put a stop to the stigma surrounding mental health.
Learn more about mental health and how you can make a difference by visiting The Bell Let’s Talk website.
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:
- 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.
- 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.
- 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.
- 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?
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
Tomorrow, November 11, is Remembrance Day, a day where Canadians pay respect to the men and women who have fought and continue to fight for our country’s freedom.
On this day we remember those who lost their lives and have suffered injury and/or illness fighting for our country. One of the largest illnesses afflicting our veterans is Post Traumatic Stress Disorder (PTSD). It is estimated that, in the military, one in six are reported to experience PTSD as a result of their service. The following article care of Global News discusses how for those who suffer from PTSD, Remembrance Day can be one of the most difficult.
Learn more about PTSD: its causes, symptoms and treatment strategies in our post PTSD and Occupational Therapy.
While minor accidents are common in the workplace and quickly addressed, higher instances of stress, mental illness, and workplace bullying are being seen across all industries. If you are suffering where do you go to get help? If you see signs of mental distress in a fellow employee, how can you help? The following from The Globe and Mail discusses how and where to seek help if you are concerned.
Learn more about strategies to improve mental health in the workplace in the following episode from our OT-V series:
Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)
Every generation is said to be shaped, influenced and molded by the major world events that they experience. These events hit us so deeply that most of us can remember where we were when we “heard the news”, how we felt in the moment, and the way the world changed following the event. Today is the anniversary of 9/11 and marks a day of mourning for those of us that still feel deeply connected to the senseless tragedy that remains the world’s worst terrorist attack. But the threats aren’t over and the connected world we live in exposes all of us, including our children, to these events in gory detail complete with photos, video and even the live streaming of things as they unfold. If parents are not careful, these events can have a negative, harmful and life-lasting impact on children especially if we don’t help them process what they are seeing or hearing.
So, in the spirit of both mourning and hope, today I wanted to try and provide some suggestions on ways we can talk to our children about events like 9/11, the bombing at the Ariana Grande concert, North Korea testing missiles, the terrorism in Paris and London, attacks on Parliament Hill, or even the recent suffering caused by hurricane Harvey and the wildfires in Western Canada. Despite the fact that I am a mom of four, I still struggle to have these conversations with my kids, and as such reached out to an Occupational Therapist friend and colleague skilled in mindfulness (Angie Kingma www.mindfulnessforhealth.ca) to get her take on how all parents can try and manage these conversations better. Here is what Angie had to say:
Some parents take the stance that they’d rather shield their kids from the disturbing events that continue to happen daily around the world. These parents are well-meaning, assuming that talking about these grim facts will not only upset their kids but perhaps also cause harm. However, literature shows quite the opposite. What happens is that these kids are denied the opportunity to develop the resilience that is necessary to become a healthy, fully functioning adult. There are other parents who would like to discuss these issues but just don’t know what to say or where to start.
Mindful parenting can greatly enhance our ability to be skillful when talking to our kids about the world’s hard truths. So, what exactly is mindful parenting? It involves the intention to bring a particular quality of attention to the interactions with our children, as they unfold moment-by-moment. To do this, we choose to consciously pay attention to what is arising in the present moment, becoming aware of what’s happening internally for both the parent and the child, as well as what’s happening externally. Mindful attention is enveloped by attitudes of non-judgment, gentle curiosity, open-heartedness (kindness and compassion), as well as acceptance. We are especially interested in the child’s thoughts, feelings and bodily sensations, as well as our own. We practice mindful listening, which just means listening with full attention, staying present, conveying to your child that you are truly listening and care about their experience. This quality of focused attention and awareness goes beyond just listening to the words, and includes awareness of facial expressions and body language.
Here are some mindful communication tips when talking to kids about life’s difficulties:
Don’t avoid the conversation. Depending on your own comfort level, let kids know that darkness, misfortune, evil, natural catastrophes and other unpleasant life pressures do exist.
Explain issues to kids in an honest and age-appropriate manner.
Keep it simple. Kids don’t need the gruesome details, just the gist of the event. Find out what they know about it first and then fill in the gaps with the basics of what happened.
Remind your child that you might not have all the answers but that you know it’s important to have these types of discussions. Sometimes they aren’t looking for answers, our kids just need to feel “seen” and “heard”, and to feel a sense of safety.
Stay level-headed when you’re discussing difficult news. Practice ‘radical acceptance’ of these realities, which simply means acknowledging the truth of things (radical acceptance doesn’t mean we that we have to like it or approve).
Pay attention to your own feelings. Since events like terrorist attacks evoke strong emotions in us and our kids, be aware of what feelings are coming up in you before the conversation and during. Pay attention to your feeling(s) and observe them, breathing with them, without having to act on or get overwhelmed by them. When we can regulate our own feelings, it can help your child to regulate their own feelings (a term called “co-regulation”).
Share with your child what strategies you use to deal with distressing situations.
Seek professional assistance if you’re having feelings that are too difficult to manage on your own or your coping strategies are unhealthy or ineffective.
Pay attention to your child’s feelings. Help them name what they are feeling, which tips us in the direction of emotional regulation. Ask them if they can describe where in their body they feel their emotion, ex. tightening in chest, butterflies in the tummy, tension around their head.
Listen open-heartedly to your child’s feelings about the situation. Ask open-ended questions such as “How does hearing about this make you feel?” or “Is there anything else that you’d like to talk about?”
Validate your child’s feelings, even if you don’t understand them yourself. Say “Of course you’d feel that way. That makes total sense to me”.
If you notice a significant increase in fear and anxiety in your child that begins to affect their daily functioning, report this to your family doctor as soon as possible and consider getting a referral to a children’s mental health specialist.
Respect it if your child will simply not talk about certain topics. Some children, particularly kids who already have anxiety, won’t be able to tolerate the conversation so don’t force it. Other kids will have a lot to say and want to discuss it at length. Neither response is better than the other.
Difficulty helps to build our resilience. Let your child know that the things that we go through in life make us stronger and teach us important lessons. Point out specific stories of heroism, survivors, first responders or people coming together to help one another during times of need.
Teach the concept of impermanence, meaning that while difficulties in the world do exist in the present moment, things are always changing. There is hope that things will change for the better. Practice modelling attitudes of hope and optimism and discuss the importance of these with your child.
Not only does mindful parenting and communication strengthen the parent-child bond and facilitate a strong attachment, it also cultivates emotional awareness and self-regulation, which our world so desperately needs.
“Your mindful presence is the most valuable and precious gift you can give to yourself and to your children.”
As the old adage goes, “you are what you eat,” and in this case what you eat may be affecting your mental health. Take a look at the following from Reader’s Digest which discusses the impact of certain foods on anxiety levels.
The new Netflix series 13 Reasons Why has become a popular topic of conversation for both adults and youth, both online and in person. Many kids will watch this before their parents even know that they have. Yet, parents beware because the content in this is apparently both graphic and at times, disturbing. In fact, the content is so concerning that school boards and even the Canadian Mental Health Association have issued statements cautioning viewers of this series: CMHA National Statement Responding to Netflix Series: 13 Reasons Why.
Personally, I take no pleasure in watching gory or graphic content of rape and suicide and do not see the value in sensationalizing this for the youth of today. However, others argue that this series aims to deter suicide by showing how disturbing this can be. At the least, know what your children are watching and heed the warnings. Mental Health and Suicide are very sensitive topics – not to be taken lightly.