Getting Help & Talking to your Mental Healthcare Provider

Do you think you suffer from a mental illness?

While being diagnosed with a mental illness can be frightening, many people say that being able to put a name to the symptoms you are feeling can be comforting. Understanding your illness will help you and your care providers to take the steps required for recovery. But if a television personality is the only therapist you have ever heard of, sorting out who to talk to and how to get help can be very confusing and overwhelming. Here are some tips to help you get started on your road to recovery.

There are as many different types of care providers as there are types of problems. Talk to your family doctor, they may be able to refer you to an appropriate care provider.
Remember that your care providers are actually working for you. Before you begin make sure that you know what it is that you want. If you’re not sure, then ask your primary care provider for information, education and their recommendations.
There are lots of people who provide treatment, counseling and therapy. Some have formal training and credentials, and others do not. It can be client beware so it’s important you know the differences to make the best choices for yourself. When you are making your first phone calls to a provider, consider these questions for them.

•What's your education and professional/clinical training?
•Have you got experience in treating your particular condition or disorder?
•Are you a member of a professional association or college?
•How long have you been practicing?
•Do you have experience with my specific problem?
•Did someone you trust and respect refer you?

Your 'gut' feelings about the person on the other end of the phone shouldn't be ignored. If a provider refuses to provide any information, try to find someone else to talk to. Most conditions have recommended evidence based treatments that have been shown to help. Ask your mental health provider if they are aware of these and able to provide the recommended treatment. You may be able to do your own research and find out what the recommended treatments are from a treatment guideline, professional association, university, government public health agency or consumer association.
How to talk to your health care provider

There are several different ways to communicate with your care provider. Here are three styles of interacting and communicating with your provider. Each style offers quality based care. It is important that you choose a style that you are comfortable with.

Active-Passive Style
• When your care provider actively makes most care decisions for you. Some people find this comforting.
Guidance-Cooperation Style
• When your care provider guides you through your options, points outs the pro’s and con’s of each, advises you of what they think is best for you, and you often go along with the advice and recommendations as you trust their judgment.
Mutual Decision Making Style
• You are an equal partner in all decisions. You may decide differently from your providers recommendations and you accept a great deal of responsibility and accountability for your care decisions. Your provider is comfortable in working with you and your decisions, even if it’s not their first choice. Your provider may still refuse to go along with care decisions they feel are harmful or inappropriate.

In identifying your preferred style of interaction it is important that you try to develop a good fit between your style and your provider’s. Be aware that any one provider will also have their own preferred style or styles of how they deliver care. And you can’t tell them what style of care to practice. That’s their choice and out of your control.

Tell your provider your preferred style and way of participating and discuss it with them so that they know how to best meet your care needs. All styles of care can be of high or low quality despite your personal style preference and perceived level of satisfaction.

In an emergency safety comes first. You might not obtain your preferred style of care and may benefit from tolerating a variety of styles. There may be emergency situations when it’s in your interest for care providers to take over, and for you to take their advice and direction. In emergency situations there are laws and legislation that guide and oversee the provider’s action, intended to protect your civil rights and freedoms balanced with the need for emergency care.

Before your care visit

•Write down the most important things you want to discuss or ask so you don’t forget
•Educate yourself about your condition using quality evidence based information
•Ask your provider what you can expect at your care visit (e.g. time, cost, insurance coverage)
•Ask a trusted friend/family member to go with you
•Send your questions or concerns to your provider ahead of your visit so they have a chance to review and be clear about your concerns.

During your care visit
•Ask if it’s ok for a trusted friend/family to accompany you -they can help remind you what was discussed or speak for you. It’s easy to forget or misinterpret when you’re feeling unwell.
•Write things down if needed or ask the provider to write things down for you
•Ask for take away information or recommended information sources
•Communicate using the first person “I” statements in sentences - e.g. “I feel unclear about” it’s more effective than “you didn’t tell me” and more likely to get you a better response

After and between care visits
•Review your notes
•If accompanied by a friend or family then discuss what was said to clarify and synthesize your understanding and concerns.
•Educate yourself with quality information
•Write down and prepare the next most important things you want to discuss
•If something doesn’t seem right, contact a professional regulatory authority to inquire about standards of care and report any inappropriate behavior

Questions to ask yourself after the first few sessions:
•Am I beginning to trust this care provider?
•Does the provider seem to understand me?
•Do I feel at ease with the therapist even though it's a difficult situation?
•Are the fees okay and in keeping with the standard or appropriate range?
•Is the location as good as possible?
•Do I feel comfortable in the care provider’s office?
•Can the therapist accommodate my schedule needs as much as possible?
•Do I feel that we make a good team?
•Do I feel heard?
•Do I feel supported?
•Do I need a second opinion?
•How long will I need treatment? What’s the end point?

Make sure that you feel comfortable. Remember, this is an important and courageous step that you have taken and you need to be on the journey with someone that you know you can count on and feel is appropriately knowledgeable and skilled to help you.
The goal of treatment is recovery if possible. Ideally therapy and care will make you more able to function independently and at some point no longer need treatment. Therapies and treatments that make you more and more dependent should be questioned and need a clear and convincing reason. Sometimes mental health conditions are chronic and may require ongoing monitoring and treatment to help you maintain your best possible health, ease suffering and help functioning.
If you don't feel that you and the provider are a good fit, let them know. Some problems can be resolved but sometimes it's just a matter of 'mismatched or poor fit between you and the care provider. This is no one's fault but will require you to find a different provider if possible and available.

If you need to find a new provider ask your current one to help you by providing some recommended names. They should be able to accommodate this request. You can also check with your local professional organizations, health care centers, or speak to your primary care physician or provider. Getting a name of a provider by word of mouth from someone who’s had a positive experience is another good approach.
Mental health care providers are dedicated, caring, concerned and understanding people. They’ve chosen helping others as their career and life’s work. Most of them will be helpful or at least steer you in the right direction. And they know you may be uncomfortable or ashamed at first. They’re used to that, and will work to help put you at east. They’ll explain and remind you that mental health conditions are not your fault. Their knowledge, skills and training will help you understand your condition and experiences, and help you work towards recovery.

The most important step is that you seek out help and talk to someone. It can be life saving.

Suggested resources include:

http://www.ccmhi.ca/
http://www.nnmh.ca/
http://www.cmha.ca/bins/index.asp
http://www.mooddisorders.on.ca/therapist.html

Postpartum Depression

What is postpartum depression?

They say having a baby is supposed to be the happiest event of your life. Everyone gets excited about the idea but having a baby is not always what you expect. Even if your baby is the cutest one ever born! Having a baby is challenging, both physically and emotionally. It is natural for many new mothers to have mood swings after delivery, feeling happy one minute and depressed the next. These feelings are sometimes known as the “baby blues” and usually start within three days of giving birth and lasting up to 14 days. Up to 80% of mothers experience these blues. Symptoms include sadness, crying spells, poor concentration, and irritability. Reassurance and understanding of what’s going on, taking care of yourself and getting support will help you to feel better. These feelings usually pass without treatment.

Some women, however, may experience a deep and ongoing depression which lasts much longer. This is called postpartum depression. This depression can begin at any time within four weeks post-birth, and may last up to several months or even a year. Postpartum depression is a common illness that can be effectively treated and prevented. The sooner the condition is diagnosed, the more effective the treatment.

Symptoms

Below are some typical symptoms. If you have been feeling any of these symptoms for more than two weeks you may have a postpartum depression.

• Sad and tearful mood
• Worn out, but unable to sleep
• Changes in appetite
• Overwhelmed and can't concentrate or make decisions
• No interest or pleasure in activities you used to enjoy
• Restless, irritable or angry
• Anxiety, you may feel this as aches, chest pain, shortness of breath, numbness, tingling or "lump" in the throat
• Not yourself
• Ashamed, hopeless or frustrated
• A bad mother
• Feelings of inadequacy, guilt, worthlessness
• Not bonding with the baby, afraid to be alone with the baby
• Have repeated scary thoughts about the baby, or of harming the baby
• Suicidal thoughts

How common is it?

Almost 15% of women will suffer from some degree of postpartum depression and other postpartum mood disorders after the birth of a baby. Postpartum depression is the most common complication of child-bearing. Despite the sensational stories in the media, postpartum depression it is not unusual or scary. It is actually quite common.

What causes it?

It is not your fault. It is not a sign of weakness and you don’t have to suffer and tough it out. The exact cause of this disorder is not known but physical, hormonal, social, psychological and emotional factors may all play a part in triggering this illness. It is important to understand that this is a medical condition and you did not bring it on yourself.

Some women are more likely to develop this disorder. You are more at risk if you have:

• Been depressed or anxious during your pregnancy
• A history of depression and/or other mood disorders
• Family members with mood disorders
• Had a recent stressful life event such as a move or a loss in the family, or complicated pregnancy, labour or delivery
• Little social support
• Relationship difficulties with close family members
• Severe premenstrual syndrome (PMS)

How is postpartum depression treated?

There are many safe treatments. As with any medical condition speak with your health care provider to consider risks and benefits to decide what is best for you. Therapy, support networks and medicines such as antidepressants are used to treat postpartum depression. Counseling and psychotherapy has been shown to be an effective treatment and an acceptable choice for women who wish to avoid taking medications while breastfeeding. And social supports by a public health nurse, friends and family can help.

How can family help?

Family can best help by assisting with meals, laundry, shopping etc. Trying to help by taking care of the baby may be more fun but can undermine a new mother’s confidence in her parenting and interfere with the new bond between mother and child. If you are concerned about a family member developing postpartum depression, encourage them to seek out support and to get checked out by their health care provider. If invited, you can offer to accompany them to their initial appointment and convey your concerns.

Coping with postpartum depression

First, remember that you are not alone and you are not to blame. Here are some suggestions for coping:

• Focus on short-term, rather than long-term goals. Build something to look forward to into every day, such as a walk, a bath, a chat with a friend
• Look for free or inexpensive activities; check with your local library, community centre or place of worship
• Take care of yourself. Try to rest, eat healthy foods and get some fresh air and exercise.
• Getting as good nights sleep as possible is important and sleep assisting medications might be helpful.
• Take time for yourself. Accept offers for help with household chores and brief baby-sitting so you can have a break.
• Spend time with your partner and/or close friends
• Share your feelings and ask for help
• Consult your doctor and look for a local support group
• Go to your local emergency room anytime if in crisis (thoughts/plans to hurt yourself, others or baby).

More information

For further information about postpartum depression contact a community organization, health care provider or your family doctor to find out about support and resources available in your community.

Related Web Sites:

Centre for Addiction and Mental Health

Canadian Mental Health Association

Pacific Postpartum Support Society

Postpartum Support International

Depression After Delivery

Online PPD Support Group

mentalhealthminute.com

Loss and Grief

Losing a loved one is something that many of us fear and is among the most stressful events you will experience. It may feel like you are going crazy but remember, there is no right or wrong way to feel and it is natural to experience lots of different emotions.
Understanding grief

Grief is the normal response to the loss of someone or something important to you. It is the emotions you feel as you cope and learn to live with this loss. You may experience grief due to a death, a divorce or a job loss. Grief can be difficult but it is not an illness. It’s part of normal human experience, and the natural cycle of life.

What does grief feel like?
Everyone grieves differently. Grief is one of the most personal experiences you will go through, and people from different cultural backgrounds may have very different customs and practices.
Contrary to popular belief, there are no stages of grief that you must go through. Grief is personal, and the feelings, thoughts, behaviors that effect you are yours alone and very personal. Nevertheless there may be some similarities in experience that you may find helpful.
Following a death or loss, you may feel empty or numb, as if you are in shock. You may notice physical changes such as trembling, nausea, trouble breathing, muscle weakness, dry mouth, or trouble sleeping and eating.

After the initial shock starts to wear off you may begin to feel things again. You may feel sadness, anger, guilt, loneliness, bitterness, fear, and nervousness. This is a painful time, but a normal part of grieving. Most people will find that with time they adapt but it can take weeks, months or even years to adjust to the loss.
Eventually you will begin to focus on daily tasks again. You do not need to feel guilty about this! It is healthy for your life to move forward. And your relationship with your lost loved one is never completely forgotten. It is normal to continue to feel strong feelings of loss from time to time. Humans are capable of more then one feeling at a time. You can get on with enjoying your life while still being sad and grieving your loss. It doesn’t have to be one or the other.

Grieving is not a weakness; it is necessary. We need time to understand that the loss has actually occurred, to deal with the emotions that follow and to balance moving our lives forward again. Refusing to grieve may at times be temporarily protective but hopefully you feel permission to experience and express your feelings in whatever way feels right for you.

Grief can challenge your assumptions about the world, and it may take time to find meaning and purpose in life again. Loss can be a stimulus and for some a gift to finding new meaning and purpose to your life and future.

How to cope with your own grief:

• Stay connected with other people. Spend time with family, friends, community, and perhaps members of a self-help group, who have been through the experience of loss and grief.

• Take enough time. Everyone reacts differently to a loss. It will probably take longer than you expect and at times catch you off guard.

• Acknowledge your emotions. Let yourself feel sadness, anger and other feelings.

• Give yourself permission to choose where, when and with whom to express your feelings.

It’s allowed and part of a healthy grief experience.

• Recognize that you may be less attentive to your work and personal relationships for some time.

• Reach out for help. Don't always rely on others to make the first move; they may be concerned about allowing you your privacy.

• Take care of your physical health. Be sure to eat well, exercise and get enough sleep. Speak with your doctor if you feel your grief is affecting your health.

• Return to interests and activities you may have stopped doing.

• Be thoughtful about major life changes. Consider waiting before making big decisions, such as moving, remarrying or having another child.

Sometimes our grief becomes too much for us to handle on our own. In such cases speaking to a professional may help to re-establish a normal or healthy grief process. Some signs that you may benefit from speaking to a care provider include:

• Extreme avoidance or downplaying of the process of mourning (quickly returning to normal life, keep extra busy, not dealing with the emotions)

• Feeling stuck in the extreme feelings (overwhelmed by constant anger, sadness or guilt)

• Relying on drugs or alcohol to help you cope

• Finding yourself unable to function in various parts of your life

• Developing symptoms of a clinical depression, constant sadness, and lack of interest

• Thoughts or plans of ending your life/suicide to join your loved one or ease the pain. Seek emergency help if suicidal.

How to help a friend who is grieving

It can be difficult to watch a friend grieve. You may feel guilty and helpless, or feel there is little you can do to comfort your friend. This is a natural feeling. But there are some ways that you can help.

• Consider offering to provide meals and assist with funeral details, and other tasks that follow death

• Accept your friend's need to tell repeated stories about the life and death of their loved one, and recognize your healthy limits and availability to listen

• Encourage involvement in social activities, special interest groups, and hobbies

• If reactions are extreme, encourage professional help and provide the support necessary to assist your friend to take this step

More information

For further information about grief contact a community organization or your family doctor to find out about support and resources available in your community.

Related Websites:
Canadian Mental Health Association

Mother’s Against Drunk Driving

Caring Connections

Regional Palliative Care Program

mentalhealthminute.com

What is ADHD?

In today’s fast paced world of video games and high speed internet it seems as though everyone is having trouble paying attention to anything for more than a split second. But for some kids this restlessness actually indicates a mental health problem. Attention Deficit Hyperactivity Disorder (ADHD) is a term used to describe patterns of behaviour that appear most often in school-aged children but can sometimes linger in to adulthood. Children with these disorders are inattentive, overly impulsive and, in the case of ADHD, hyperactive. They have difficulty sitting still, attending to one thing for a long period of time, and may seem overactive. It is hard for these children to control their behaviour and/or pay attention. They sometimes get into trouble at school as they can’t easily sit still or focus on what’s being taught. For some people it’s the attentional deficit that predominates (ADD) and for others it’s the hyperactivity-impulsivity that predominates. For many it is a combination of both the inattention and hyperactivity-impulsivity.

This disorder interferes with the learning process because it reduces the child's ability to pay attention. It is important to understand that ADHD is not a learning disability, a condition that affects the child’s ability to learn, but it may be present in addition to a learning disability.

How common is it?

ADHD is the most common mental health problem that affects children. Approximately 3-5% of children around the world have ADHD. This means that in a classroom of 25 to 30 children, it is likely that at least one will have ADHD. Also approximately 8-10% of males and 3-4 % of females under the age of 18 years have ADHD.

The Cause of ADHD

Unfortunately the specifics of this disorder are unknown but ADHD is likely a problem related to the hard wiring of circuits within the brain. Like other psychiatric disorders, there is most likely a chemical imbalance in the brain. ADHD has nothing to do with how smart or intelligent you are. It’s the brains ability to filter all the outside stimuli and internal thoughts and select and stay focused on the appropriate thing that’s compromised.

Symptoms of ADHD

All children can be restless, fidgety or daydream the time away. But when the child's hyperactivity, distractibility, poor concentration, or impulsivity begin to significantly affect performance in school, relationships with other children, or behaviour at home, ADHD may be suspected. But because the symptoms vary so much across settings, ADHD is not easy to diagnose. This is especially true when distraction is the biggest symptom.

Other common symptoms are:
• Impulsive, aggressive or violent behaviour
• withdrawal, anxiety and depression
• Low self-esteem
• Physical symptoms such as headaches, stomach or back aches, or pains in the hands or legs.
• Becoming the "class clown" or the "class bully,"
• Avoiding or refusing to become involved in activities where he/she is unsure of success.

Symptoms of ADHD will appear over the course of many months, often with the symptoms of impulsiveness and hyperactivity preceding those of inattention, which may not emerge for a year or more.

The behaviours must appear early in life, before age 7, and continue for at least 6 months. Above all, the behaviours must create a real difficulty in at least two areas of a child's life, at school, on the playground, at home, in the community, or in social settings.

Diagnosis

ADHD may be suspected by a parent or caregiver or may go unnoticed until the child runs into problems at school. Given that ADHD tends to affect functioning in school, sometimes the teacher is the first to recognize that a child is hyperactive or inattentive and may point it out to the parents and/or consult with the school psychologist. If your child’s teacher has any concern you may want to speak with your child's pediatrician or family doctor.

With the right kind of help, most children with ADHD overcome their disabilities, and their emotional problems usually disappear. They do better at school, improve their relationships with family and friends, and will be more likely to achieve their full potential. With help from family, school and other professional people, children with ADHD have more than a good chance to grow up to be healthy, happy and productive adults.

Adult ADHD
Adults can also suffer from ADHD. It’s often that when a child is being assessed for symptoms of ADHD that a parent sometimes notices that “those symptoms sound just like me” or some other adult in the family. In adults it’s often the distraction and inattention (ADD) that lingers, and they may be thought of as visionary dreamers with great ideas but all over the place, with difficulty sticking to one thing. They may be in careers that fall below their potential or can be very successful in their careers despite being scattered at times. Often in adults it is the inattention that persists even though they outgrow some of the hyperactivity. The good news is that with the right kind of help adults can improve functioning at work and home and improve their relationships and quality of life. Often adults wish they had known about their ADHD earlier in their lives as it can explain some things in their past and make for a happier and more satisfying future.

More information

For further information about ADHD contact a community organization, health care provider or your family doctor to find out about support and resources available in your community.

Related Web Sites:

Canadian Mental Health Association

National Institute of Mental Health

Canadian ADHD Resource Alliance

mentalhealthminute.com

What is Alzheimer’s?

Alzheimer's disease is a progressive, degenerative disease of the brain, which causes thinking and memory to become seriously impaired.

How common is alzheimer’s?
1 in 20 Canadians over age 65 is affected by Alzheimer's disease and more women are affected by the disease than men.

What are the symptoms?
• Memory loss that affects day-to-day function
• Difficulty performing familiar tasks
• Problems with language
• Disorientation of time and place
• Poor or decreased judgment
• Problems with abstract thinking
• Misplacing things
• Changes in mood and behaviour
• Changes in personality
• Loss of initiative

People may think these symptoms are part of normal aging but they aren't. It is important to see a doctor when you notice any of these symptoms because they might be due to other condition that can mimic Alzheimer’s such as depression, drug interactions, a dietary deficiency of a vitamin or an infection. If you notice problems with memory in you or a family member don’t jump to conclusions about the cause because there are several possibilities that can explain the symptoms.

Causes
The cause of Alzheimer’s disease remains unknown but researchers believe it is caused by a combination of factors that muck up nerve cells in the brain so they don’t work properly. Current research is focusing on family history and genetics and the internal/external environment.

Researchers have discovered that Alzheimer's disease is:
• Not a part of normal aging
• Affects both men and women
• More common in people as they age -- most people with the disease are over 65
• Not caused by hardening of the arteries
• Not caused by stress

Diagnosis
At specialized centers, doctors can diagnose Alzheimer’s correctly up to 90 percent of the time.

Doctors use several tools to diagnose "probable" Alzheimer’s, including:
• questions about the person's general health, past medical problems, and ability to carry out daily activities;
• tests to measure memory, problem solving, attention, counting, and language;
• medical tests - such as tests of blood, urine, or spinal fluid; and brain scans.

Treatments
At present there is no cure for Alzheimer’s disease, but there are medications and other approaches that can successfully help with some of the symptoms, delay the effects and improve quality of life, in some people. The good news is that researchers have made great strides and there are a number of drugs in clinical trials that act directly against the disease process. They’re even testing vaccines against the disease.

Living with Alzheimer's or a related disease can be challenging. Whether you have the disease or you are caring for someone who does, it is important to take steps to be as healthy as you can be. Research shows that there are many things that you can do to enhance health and quality of life when living with Alzheimer's disease including:

• Eating well
• Remaining active
• Staying connected with friends and family
• Keeping your brain active
• Taking charge of your own health
• Reducing your stress
• Finding help

Caring for someone with Alzheimer’s

When you’re taking care of a loved one, you may forget to take good care of yourself. Your are at risk for caregiver burnout. Alzheimer’s is one of the most emotionally draining and traumatic conditions for both the individual and their family. It can be hard on your body and cause a lot of stress. A lot of caregivers have times when they feel tired and overwhelmed. In fact, caregivers themselves have a high risk of depression and other sickness. Those with little or no help from family and friends are at the highest risk.

When you need to, it may be necessary to reach out to others. Family members, friends, and neighbours may want to help. They need you to tell them what kind of help they can give. Try to make specific requests when you can. It may be hard to ask, but getting help when you need it may be beneficial. Your doctor should be part of your support network; they may see signs of depression or illness that you don't notice. Other health care team providers can also be invaluable for support, information and resources. Peer support groups and societies are available in some communities and help you know you’re not alone and not the only one going through the challenges the disease can bring.

More information

For further information about Alzheimer’s disease contact a community organization or your family doctor to find out about support and resources available in your community.

Related Websites:
Alzheimer’s Society of Canada

Alzheimer’s Association

Alzheimer’s Disease International

National Institute on Aging

Alzheimer Knowledge Exchange

mentalhealthminute.com

Aging and Retirement

Retirement can be a time of freedom and reward after a lengthy career of service. For many it’s a chance to get to things they’ve always wanted to and finally are able. Most people live active fulfilling lives in their retirement years. But it’s also a time of change that can catch some people off guard. At first the time away from work can be a relief, like an extended vacation. But retirement may mean a loss of your work role and authority, and you no longer have the routine of getting up and going in to the social atmosphere of most workplaces. With time you may feel unproductive with no purpose or contribution from yourself. Some people start to feel like they’ve gone from a somebody to a nobody without a job or work to help define them. And it’s easy to get isolated from social contacts. With time this can be unhealthy for your mental and physical health.

It’s best to think ahead and prepare for the changes. Before retiring think of activities you enjoy or find meaningful. Participating in these social activities before you retire can ease the transition and give you a network to tap in to later on if you choose. Find interests and activities that stimulate you and give you a sense of purpose and make you feel you’re contributing to the world in some way. And try to stay connected to social networks and community. For some people this is more time with family. For others it’s volunteer work, or involvement in their religious organizations. Some people feel they want to be productive by starting a new business, or contribute to the next generation with their time and experience.
Despite the ads for Freedom 65 describing retirement as the best time of your life, growing older is not something everyone looks forward to. As we age, we face many changes and sources of stress - we are not as strong as we used to be, illness is more of a problem, children move away from home, we retire from work, and we may become lonely.

These changes may contribute to an increased level of sadness and sometimes clinical depression. In Canada about 6% of the over-65 age group suffers mild to severe depression. Retirement and isolation also increases the risks for developing problems with alcohol.
Coping with all these changes is difficult, but it can be done, and your retirement years can become some of your best!

Dealing with retirement

Retirement can be a major source of stress because your job may have been a very important part of your life. This stress may be even greater if you have been forced to retire because of your employer's retirement policies. You may lose your sense of identity and feel worthless. You will probably miss the daily contact with friends from work.

However, retirement does not have to be a sad time, and there are things you can do to meet the challenges facing you, such as:

• Make a list of your abilities and skills. Your work experiences may help you succeed in a small business or do valuable volunteer work for a favourite charity.

• Renew your interest in the hobbies and activities you enjoy. You now have time to play - enjoy!

• If you can afford it, travel. There are probably places you have wanted to see all your life. The early years of your retirement can be the ideal time to become a nomad for a while.

• Stay socially connected in whatever way works for you.

• Review your finances and living costs for the peace of mind that you can sustain your living needs. Get help from someone to plan if needed.

Dealing with loneliness
Everyone needs some time alone, but being alone against your will is very painful. You risk losing your sense of purpose and self-worth. Being retired changes your social life but there are things to do to avoid loneliness:

• Stay active, and look for new social contacts. Most communities have a number of programs.

• Try to make friends with people of different ages. You may be pleasantly surprised to find how much you have in common!

• Spend time with grandchildren or other young family members.

• Volunteer to help part-time in a local school or day-care centre. Very young children can brighten up your life with their enthusiasm and energy.

• Learn to recognize and deal with the signs of depression. Your family doctor can refer you to a mental health professional for treatment if needed.

Staying Physically Healthy

The physical changes you undergo throughout your retirement years can also be a source of stress. Here are some things you can do to stay as physically active and fit as possible:

• Accommodate to your physical changes. Get the things that will help you - eyeglasses or hearing aids for example.

• Keep a positive attitude. Chances are you will still be able to do almost all the things you used to; you may just need to take a little more time and learn to pace yourself.

• See your family doctor or health and wellness providers regularly.

• Be careful about your medications, they may begin to affect you differently than before. Make sure your doctor and health care providers know about all your medications. Keep an up to date list in your wallet.

• Take responsibility for your own health. Do not hesitate to ask your health provider questions.

• Adopt a balanced nutritious diet, and try not to over-eat.

• Drink less alcohol. Your body will have more difficulty coping with it as you grow older.

• Regular exercise and physical activity can be both healthy and enjoyable like walking, swimming, dance classes etc.

Although your body and lifestyle are changing, your personality remains the same. You are still you! Remaining active and with a positive outlook can allow for many more years of enjoying life.

More information

For further information about retirement and aging contact a community organization, health care provider or your family doctor to find out about support and resources available in your community.

Related Web Sites:
Centre for Addiction and Mental Health

Canadian Mental Health Association

Aging in Canada

Here to Help

mentalhealthminute.com

What is Schizophrenia?

Schizophrenia is a mental health condition caused by a disorder of the brain's functioning. It can seriously disturb the way people think, feel and relate to others. People with schizophrenia are often misunderstood and blamed for their behaviour. It is important to understand that this is a medical disorder and it is not the person’s fault. It’s not due to lack of effort, intelligence, or anything a parent, family or friends did or didn’t say or do.

How common is schizophrenia?
About one person in 100 develops schizophrenia. Men and women are affected equally; however, men tend to have their first episode of schizophrenia in their late teens or early 20s. With women, it is usually a few years later.

What are the symptoms?
The symptoms of schizophrenia vary greatly from person to person, from mild to severe. A specialist is needed to make the diagnosis, especially because there is no such thing as a simple schizophrenia test.
Making it even harder to diagnose, schizophrenia often starts slowly. When the symptoms first appear, usually in adolescence or early adulthood, they may seem more confusing than serious.

In the early stages, people with schizophrenia may find themselves losing the ability to relax, concentrate or sleep. They may start to shut their friends and family out of their lives. Work or school begins to suffer; so does their personal appearance. During this time they may talk in ways that could be difficult to understand and they may start to perceive things in an unusual way.

Once it has taken hold, schizophrenia tends to come and go.

Other symptoms may include include:

•delusions (false beliefs that are not consistent with the person's culture, and have no basis in fact, maybe weird or paranoid)

•hallucinations (people hear, see, taste, smell or feel something that does not actually exist)

•disorganized thought (unconnected thoughts that make it impossible to communicate clearly with other people)

•disorganized mood (finding it hard to express feelings; feeling inappropriate or intense bursts of emotion; feeling empty of any emotions)

•disorganized behaviour (odd behavior or cannot complete everyday tasks such as bathing, dressing appropriately and preparing simple meals)

•changes in sensitivity (more sensitive and aware of other people; or withdrawn and seeming to pay no attention to others).
Causes

No single cause has been found for schizophrenia, although there is a clear genetic link.

Treatments
Treatment usually consists of medication and counseling. Antipsychotic medications are the main class of drugs used to treat schizophrenia. Psychotherapy can offer understanding, reassurance and suggestions for handling the emotional aspects of the disorder and providing less stressful living situations. Social supports for housing, finances and employment or daily activity are important for treatment and recovery. Families, friends and coworkers can benefit from education and support.

Recovery
It is impossible to predict how well a person will recover after the onset of the disorder. Some will recover almost totally. Some people will need medication and support for the rest of their lives.

More information

For further information about schizophrenia contact a community organization or your family doctor to find out about support and resources available in your community.

Websites:

National Network for Mental Health

Schizophrenia Society of Canada

Canadian Mental Health Association

Centre for Addiction and Mental Health

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What is Psychosis?

What is psychosis?

Psychosis is a loss of contact with reality due to an interruption in how the brain works. When people can't tell the difference between what is real and what is not, it is called a psychotic episode. A first episode of psychosis is often very frightening, confusing and distressing, particularly because it is an unfamiliar experience.

Sometimes psychosis emerges gradually over time, so that symptoms might be ignored in the early stages. Other times, symptoms appear suddenly and are very obvious to the individual and those around them. Symptoms vary from person to person and can change over time.

Who gets psychosis?
Psychosis can affect anyone; however, people with a family history of serious mental illness are at increased risk of developing psychosis.
Psychosis usually first appears in a person's late teens or early 20s. Approximately three out of every 100 people will have a psychotic episode in their lifetime. Psychosis occurs in men and women and across all cultures and socioeconomic groups.

A number of mental illnesses can include psychosis as a symptom, including schizophrenia

What are the symptoms of psychosis?

Symptoms of psychosis can vary from person to person and may change over time. Some common symptoms are:

•changes in thinking patterns (difficulty concentrating; loss of memory; disconnected thoughts)

•delusions (fixed, false beliefs that are not consistent with the person's culture, and have no basis in fact, sometimes weird or paranoid)

•hallucinations (people hear, see, taste, smell or feel something that does not actually exist)

•changes in mood (finding it hard to express feelings; feeling inappropriate or intense bursts of emotion; feeling empty of any emotions; depression)

•very disorganized behaviour (strange behaviours, or cannot complete everyday tasks such as bathing, dressing appropriately and preparing simple meals)

•thoughts of death or suicide

•feeling their thoughts have sped up or slowed down

•feeling preoccupied with unusual ideas

•belief that others can manipulate their thoughts; or that they can manipulate the thoughts of others

What causes psychosis?

There can be many causes for the brain to not work properly and start imagining things. Sometimes psychosis is secondary to a toxic substance like drugs, alcohol, supplements or medications. Sometimes it’s due to a medical disturbance like an infection, hormone abnormality, seizure disorder, or other medical illness. Sometimes it’s secondary to a severe mood disorder like depression or bipolar disorder. Often it’s a primary psychosis due to reasons that we do not entirely know the cause of.

In some cases, we do not know what causes a first episode of psychosis. Current research shows that biological and genetic factors raise the risk of having psychosis. Brain chemistry may effect psychosis. What’s clear is that it’s not due to a person being weak, or unintelligent or anything they or their family did or didn’t do or say.

When psychosis occurs for the first time it is difficult to know the cause. Psychosis is associated with a number of medical conditions including schizophrenia, depression, bipolar (manic-depressive) disorder and substance abuse, among others. Because the first episode of psychosis can signal a variety of conditions, it is important to seek a thorough medical assessment.

Can psychosis be treated?
Psychosis can be treated, and many people make a good recovery, especially if they get help early. Treatment usually consists of medication and counseling.
Throughout treatment, families can receive support and education during sessions with the treatment team.

Medication called antipsychotic medication is usually essential. It relieves symptoms of psychosis and may prevent further episodes of illness. With proper treatment, most people recover fully from the first episode of psychosis. For many, the first episode is also the last. Antipsychotic medications have many benefits, and as with all medication some risks and side effects. It’s important to discuss these with your care provider. And research and newer treatments are being developed.
Sometimes people with psychosis benefit from hospitalization for safety, support and stabilization at some point in their treatment and recovery path.

Recovery
Recovery from a first episode of psychosis varies from person to person. Sometimes symptoms go away quickly and people are able to resume their regular life right away. Other people may need several weeks or months to recover. Some people will need medication and support for the rest of their lives.

More information

For further information about psychosis contact a community organization or your family doctor to find out about support and resources available in your community.
Websites:

National Network for Mental Health

Schizophrenia Society of Canada

Canadian Mental Health Association

Early Psychosis Prevention and Intervention Centre (EPPIC) in Melbourne, Australia

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What is Obsessive Compulsive Disorder? (OCD)

What is obsessive compulsive disorder?

Everyone experiences concern and uneasiness from time to time. We may worry about a problem at work or school, about money, health, or if the Leafs are going to win the Stanley Cup. But if you can’t stop worrying and it’s interfering with your life you may be experiencing obsessions as part of obsessive compulsive disorder (OCD). Sometimes you know the thing you’re worrying about is ridiculous and makes little sense, but it bothers you anyway. For example, someone with OCD may have a constant worry that they have left the stove on, or not locked the door, even though you know you had. Or maybe you have to repetitively check, clean or organize things way beyond what’s reasonable, but you feel compelled to anyhow. It often annoys people around you and can cause problems for you at work, or in your relationships.
When worries overwhelm someone, we call them "obsessions." Obsessions are uninvited thoughts that surface in the mind over and over again. People with OCD know their obsessions are unrealistic, but they can't get rid of them, they can't control them, and they can't ignore them.

To relieve the feelings of distress and anxiety, people with OCD often try to reduce their anxiety by acting out certain rituals, or compulsive behaviours, over and over again. These rituals may include repeated washing, checking and arranging things, and counting. Performing these actions give people only temporary relief from their anxiety.

Who suffers from OCD?
OCD afflicts about one adult in 40, making it twice as common as schizophrenia and bipolar disorder, and the fourth most common psychiatric disorder. OCD is believed to be a disorder that is related to family history and how someone’s brain works. OCD can occur in people of all ages, but it generally begins before age 40. Studies show that the disorder usually begins during adolescence or early childhood. It affects men and women equally.

How to treat OCD
While a complete cure for OCD is rare, specialized treatment can bring many people long-term relief from their symptoms.
Two effective treatments for OCD have been developed: medication and a type of psychotherapy called cognitive-behavioural therapy (CBT). Used together, these treatments can be effective.
Psychotherapy techniques used to combat OCD symptoms involve encouraging a person to stay in contact with the object or situation that forms the obsession, and to not perform the ritual to ease the pressure of that obsession. Depending on the intensity of the therapy, improvement may be seen within 2 or more months. Yes, the best thing to help is to purposely expose yourself to the feared thought or situation and not be allowed to engage in the compulsive safety activity that’s become an unnecessary compulsive habit. Technically therapists refer to this as “exposure and response prevention”.

Coping with OCD
With early diagnosis and the right treatment, people can avoid the suffering that comes with OCD. They also have a greater chance of avoiding depression and relationship problems that often exist with OCD. Families, friends and coworkers can benefit by understanding what’s going on in OCD. Family, friends and coworkers often get pulled in to someone’s OCD demands in an effort to try and be helpful. But before long they feel hostage to the OCD demands and can become resentful. It’s best if they don’t participate in another person’s OCD demands, even though the person with OCD may protest.

More information

For further information about OCD contact a community organization, health care provider or your family doctor to find out about support and resources available in your community.

Websites:

Centre for Addiction and Mental Health

Obsessive Compulsive Foundation

Anxieties.com

Canadian Network for Mood and Anxiety Treatments

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What is Depression?

It’s part of normal human existence to feel down, depressed and sad at times. We have all said ‘I’m so depressed’ after being dumped or failing an exam, or when your favorite team loses the game. But when a health care provider talks about Depression they’re referring to something different. Clinical depression, medical depression or a Major Depressive Episode is more than being sad or feeling down. Clinical Depression is a condition which can affect your thoughts, feelings, physical health and behaviors. The people who called named the condition Depression must not have been very wise, as naming a clinical condition with the same name as a normal mood feeling creates confusion.

The main symptom of depression includes a sad, hopeless mood that:
•is present most days and lasts most of the day
•lasts for more than two weeks
•interferes with your ability to perform at work, at school or in social relationships.

For some the main symptom of depression is not as much their mood as much as
•a loss of interest or pleasure in things they usually are interested in or enjoy

Other symptoms of major depression may include:
•Changes in appetite or weight loss or gain
•Trouble falling asleep, staying asleep or sleeping too much
•Loss of interest in work, hobbies, people or sex
•Withdrawal from family members and friends
•Irritability
•Loss of energy, feeling very tired
•Trouble concentrating, remembering and making decisions-you might fear you’re developing Alzheimer’s disease
•Crying easily, or feeling like crying but being not able to
•Thoughts of suicide (which should always be taken seriously)
•A loss of touch with reality, hearing voices (hallucinations) or having strange ideas (delusions).
•Feeling worthless, helpless or hopeless
•Overwhelming feelings of sadness or grief

Who gets depression?
At any given time, almost three million Canadians have serious depression. It occurs in 10-15% of men and 15-25% of women

What causes depression?
There is no one cause of depression, neither is it fully understood, however several factors may play a part. These include a family history of depression, problems with brain chemistry, or a major stress in a person's life.

Types of depression

Different types of depression have different symptoms. These include:

•Seasonal depression or seasonal affective disorder
Usually affected by the weather and time of the year.

•Postpartum depression
Occurs in women, following the birth of a child. About 13 per cent of women will experience this type of depression.

•Depression with psychosis
Depression may become so severe that a person loses touch with reality and experiences hallucinations (hearing voices or seeing people or objects that are not really there) or delusions (beliefs that have no basis in reality).

•Dysthymia
A chronically low mood with moderate symptoms of depression.
Depression is not a weakness or character flaw. It’s not your fault. It is a clinical condition. If you think you may be suffering from depression, don’t be embarrassed. This is not something you can fix alone, but a health professional can help!

How to treat depression
Depression is the most treatable of mental illnesses. Between 80-90% of all depressed people respond to treatment and nearly all depressed people who receive treatment see at least some relief from their symptoms.
The most commonly used treatments are medication, psychological, lifestyle and relationship counseling and sometimes electroconvulsive therapy. These treatments may be used individually or in combination. Support from family, friends and self-help groups can also make a big difference.

More information

For further information about depression contact a community organization, health care provider or your family doctor to find out about support and resources available in your community.

To see if you might be suffering from clinical Depression try a self test at http://www.checkupfromtheneckup.ca/

Web Sites:

National Institute of Mental Health
http:www//nimh.nih.gov

Depression is a Treatable Illness: A Patient's Guide http://mentalhealth.com/bookah/p44-dp.html

Understanding Depression
http://www.camh.net/about_addiction_mental_health/depression.html

Online Depression Screening
Sponsored by the National Mental Health Association
http://www.depression-screening.org/screeningtest/screeningtest.htm

Mood Disorders Association
http://www.mooddisorders.on.ca/dep.html

Canadian Mental Health Association http://www.cmha.ca/bins/content_page.asp?cid=3-86-87〈=1

Canadian Network for Mood and Anxiety Treatments
http://www.canmat.org

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What is Anxiety Disorder?

Anxiety is the body’s natural response to a stressful or dangerous situation. In these situations the body reacts by causing the heart to beat faster, the palms to sweat and the mind to race. These are normal responses to stress and danger that we have all experienced when public speaking or walking down a dark alley alone. The physical symptoms are the result of stress hormones like adrenaline activating your body. They’re not generally dangerous but they can be uncomfortable when you don’t know why they’re occurring.

An anxiety disorder is when one's body reacts to a situation as though it is highly stressful but in fact the situation is not at all dangerous. In many cases the person recognizes these fears as irrational, yet they are unable to control how their body is reacting.

If you have broken into a cold sweat with your heart pounding while waiting in line at the supermarket, you may be suffering from an anxiety disorder. Reacting this way is not your fault. These conditions are medical disorders and help is available.
What are the symptoms of an anxiety disorder?
After experiencing such panic attacks, individuals with anxiety disorder often begin to avoid certain things, like road trips and airplanes, only entering situations if there is a chance of escape.

Agoraphobia, a type of anxiety disorder, is the fear of being in places or situations which would be difficult to escape from, or in which it would be difficult to find help, should a person suffer a panic attack. People with agoraphobia often avoid public transport or shopping malls; others refuse to leave their homes, sometimes for years at a time.

Social anxiety disorder, or social phobia is another form of anxiety where people suffer from extreme shyness and fear social interactions like meeting new people, speaking to others or social events. The focus of the fear is on being judged or scrutinized by others about how you look, what you say or what you assume people are thinking about you. It results in avoiding social situations or tolerating them with great distress, or abusing alcohol or substances to try and tolerate the fear.

Generalized anxiety disorder is an ongoing feeling of worry and physical anxiety that is there most all of the time. It may never build up to a panic attack. The worry is usually about normal things like family, finances, health etc.

Many individuals with anxiety disorders have difficulty with relationships, school, work and social activities.

Who gets anxiety disorders?

Anxiety disorders, including phobias and panic disorder, are among the most common of mental health problems. It is estimated that 2 million Canadians suffer from panic disorders. Women are roughly twice as likely as men to be diagnosed with panic disorder.

How can anxiety disorders be treated?

Treatment exists to help people with phobias and panic disorder, and research into new therapies and techniques continues.
Currently, the best evidenced ways to treat an anxiety disorder include medication, cognitive-behaviour therapy (CBT) or a combination of the two. Treatment choice will depend on the type of anxiety disorder as well as any additional illnesses such as depression or alcohol abuse. Another useful technique includes relaxation training.
More information

For further information about anxiety disorder and agoraphobia contact a community organization or your family doctor to find out about support and resources available in your community.

Web Sites:

Mood Disorders Association of Ontario
http://www.mooddisorders.ca

National Network for Mental Health
http://www.nnmh.ca

Anxieties.com
http://www.anxieties.com/home.htm

NIMH Anxiety Disorders Education Program
http://www.nimh.nih.gov/anxiety

Canadian Mental Health Association
http://www.cmha.ca/bins/index.asp

Anxiety Disorders Association of Ontario
http://www.anxietyontario.com

Psych Direct (McMaster University)
http://www.fhs.mcmaster.ca/direct

Canadian Network for Mood and Anxiety Treatments
http://www.canmat.org

Social Phobia/social anxiety Association
http://www.socialphobia.org

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What is Bipolar Disorder?

Everyone has ups and downs; feeling happy, sad and angry is normal. But if you are experiencing extreme mood swings, laughing more than you normally would or crying at the smallest thing, you may be suffering from bipolar disorder. It used to be called Manic Depression.

Bipolar disorder is no one’s fault. It does not come from a “weak” or unstable personality. It’s got nothing to do with being smart or with your intelligence. It is a condition that can be treated.

Bipolar disorder typically consists of three states:
1. a high state, called “mania”, or hypomania when part way high
2. a low state, called “depression”
3. a well state, during which many people feel normal and function well.

Typically a person with Bipolar disorder will have episodes throughout their life in which they’re mood may be high, low or regular. Low mood depressed states are more common than high typically lasting for months. Low periods usually last longer than high periods, which typically last days, weeks or a few months. There are well periods of regular mood as well.

Signs and symptoms of mania include but are not limited to:
•Extreme happiness
•Extreme irritability
•Rapid, unpredictable emotional changes
•Racing thoughts
•Overreacting, misinterpreting events
•Increased interest in activities
•Overspending
•Feeling invincible or all powerful, inflated self-esteem
•Excessve energy
•Decreased need for sleep
•Increased sexual drive, sexual indiscretions
•Poor judgment

Signs and symptoms of depression include but are not limited to:
•Sad mood
•Preoccupation with failures or inadequacies and a loss of self-esteem
•Feelings of uselessness, hopelessness, excessive guilt
•Slowed thinking, forgetfulness, difficulty in concentrating and in making decisions
•Loss of interest in work, hobbies, people
•Social isolation
•Abnormal drowsiness
•Agitation
•Changes in appetite or weight - eating too little or too much
•Oversleeping or insomnia
•Decreased sexual drive
•Suicidal thoughts

Prevalence

You or someone you care about may have been diagnosed with bipolar disorder. You may now feel alone in facing the problems of the illness, but you are not alone. About one to two per cent of adults worldwide suffer from bipolar disorder. Men and women are affected equally.

What causes bipolar disorder?
Unfortunately we do not know the answer to this question! However, research shows that genes play a strong role. Stress or difficult family relationships do not cause the illness but these factors may "trigger" an episode in someone who already has the illness. In some women, bipolar disorder may appear during pregnancy or shortly after it. There are medical clues to the brain’s mood regulation system not working as it should and allowing the normal ups and downs to swing too far and for too long.

How can bipolar disorder be treated?
The most common treatments are medication and counselling/psychotherapy. These can be used alone or in combination with other treatments. Approximately one in three people with bipolar disorder will remain completely free of symptoms just by taking mood stabilizing medication. These mood stabilizers return mood to their normal state and try to prevent illness episodes and keep moods in a healthy range. Like other medical disorders such as high blood pressure or diabetes, bipolar disorder can be effectively managed and controlled by combining treatment and a healthy lifestyle. Unfortunately people sometimes get so unwell that they require hospitalization for support and to protect them from their illness.

More information

For further information about bipolar disorder contact a community organization or your family doctor to find out about support and resources available in your community.

Websites:
"Bipolar Screening Tool"
http://www.fhma.com/bipolar_02.html

Treatment of Bipolar Disorder: A Guide for Patients and Families, Kahn/Ross/Printz/Sachs, 2000.
http://www.psychguides.com/Bipolar_2000_Guide.pdf

Bipolar Disorder: A Summary of Clinical Issues and Treatment Options, Canadian Network for Mood and Anxiety Treatments, 1997
http://www.canmat.org/psychs/index.html

Mood Disorders Association
http://www.mooddisorders.on.ca/bipolar.html

Canadian Mental Health Association
http://download.cmha.ab.ca/Edmonton/Bipolar%20Disorder.pdf

National Network for Mental Health
http://www.nnmh.ca

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Feelings

Listening to your heart and understanding your feelings is one of the most important sources of information we have about our mental health. In this section you can explore information about feelings like worry, sadness, anger, laughter and guilt. Gain information about what's normal and when feelings might indicate problems or signs of illness. Explore topics on strong feelings like tragedy, loss, abuse, war, and even road rage. Feeling stressed is a normal and common part of our lives. Please come back soon to learn about how to better identify and better handle stress.

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