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By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
My husband’s family keeps psychological illness in the closet. How do I discuss openly with my children their cousin’s illness without antagonizing my in-laws? The answer: Unfortunately, there continues to be a significant degree of stigma around psychological health issues. Statistics indicate that 1 out of 4 Canadian adults will struggle with one of the more common psychological health conditions (depression or anxiety) at some point in their life. There are two distinct issues you are raising: how to discuss the illness of a family member with your children, and how to not antagonize your in-laws. Separate these issues out and deal with them independently: First, I would suggest that you and your husband have an open and candid discussion about where you stand as individuals and as parents with respect to this issue. What are your respective beliefs about psychological illnesses? What are your values about what and how you speak to your children about this and other sensitive topics? What discussions are each of you comfortable in having with your children? If your husband holds some of the beliefs that his family does, this may be a challenging conversation. The goal is to agree on how to approach discussions with your children. There are a few things to keep in mind. First, my strong belief is that speaking openly with children about even difficult or sensitive topics is almost always the best approach to take. Conversations should always be age appropriate in terms of both the amount of information given and the language used to describe what someone is experiencing. Having open conversations about difficult topics with kids can open the door for them to communicate with their parents about difficult topics when need be. Discussing psychological health issues openly and respectfully with your kids also gives them a very powerful message: that you would accept them if they ever struggled. This keeps the door open for them to speak to you if they were to ever struggle at some point in their life. The second issue you raise relates to you not antagonizing your in-laws. In-law relationships can be tricky to navigate around in the best of times. Although being sensitive to this is important, to both maintain peace in the family and out of respect for your husband, ultimately you need to decide what values and behaviours you will model in your family and you need to stand behind this as a couple. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
My friend’s boyfriend came on to me. She has no idea. I shut him down, but I think I’m hot for him too. What should I do? The answer: Stop and ask yourself one question: If the roles were reversed and you were in your friend’s shoes, what you would want her to do? Think long and hard about the answer to this question. Romantic relationships will come and go, but true friendships can be lifelong, so I would not even consider temptation. That being said, you have a few options: do nothing (always an option); pursue the relationship with your friend’s boyfriend (bad idea); or set some boundaries and ensure you do not betray your friend in any way (best plan). Think about how would you friend react if she knew that not only had her boyfriend disrespected her by coming on to someone else, but that her friend also entertained thoughts of getting involved with him. Being “hot” for someone can be the result of a number of factors. It can be pure physical attraction, which is totally normal. It can be the secrecy of the attraction and the fact that it would be taboo. It can also be alcohol induced. See the attraction for what it most likely is: nothing more than a fleeting sensation. If you find yourself fantasizing about a possible relationship you could have with this guy, ask yourself whether you would want to be in a relationship with someone who hits on his girlfriend’s friends? The best predictor of future behaviour is past behaviour, and likely his pattern would continue. In terms of how to approach this, I would suggest one of two things. Since you already shut him down, you could ignore the boyfriend’s behaviour altogether and just ensure that you establish very direct boundaries moving forward. Do not give him any direct or inadvertent verbal or non-verbal clues that you are interested in him – and then wait and see. Perhaps it was an isolated event or other factors such as alcohol contributed to his behaviour, and he realized what a mistake he made. If, however, he continues to hit on you, I would speak to him assertively. Let him know in no uncertain terms that you are not interested, that you do not appreciate him disrespecting your friend and that if his behaviour continues, you will tell her. The issue of speaking to your friend about the situation is a more complicated one, and you really need to navigate this matter carefully. Whether you speak to her is going depend upon a number of factors: your relationship with her, the amount of trust you have in each other, how long she has been with this guy and whether she has any sense of his behaviour or doubts about his trustworthiness. It is also going to depend on what he did. Was he simply being friendlier than normal without crossing any real line? Was he flirtatious, but not overtly inappropriate? Did he directly proposition you? If it was a one-time situation, if he his behaviour fell in a grey zone and if he has regret and changes his behaviour, it may be best to not hurt her feelings by bringing this up. On the other hand, if his behaviour continues or if it clearly was in a category that surpassed certain boundaries, you may need to speak to her directly. Ultimately, you need to act in a way that is consistent with your values and make decisions you will not regret. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. By Xavier Mercader Psychological Impacts of Taking Care of a Child with a Heart Condition
I’m sure anyone who’s had a child, will agree that the birth of your first, is one of the most blissful moments in life. As new parents, you spent time reading about how to take care of a child (as if there was an actual manual for it). You prepare your future child’s bedroom, make lists of what they’ll need, buy clothes and attend prenatal classes. All in preparation for the day that will change your life. But no matter how well you think you’re prepared, whether or not you’re a first-time parent or if it’s your fourth child, I don’t believe anyone is ever fully ready for it. In my case, my wife and I were lucky – she had a really easy pregnancy. She felt great the entire time and was even going to the gym three days before her due date. Even the delivery felt easier than I thought it would – not that I was going to do the hard part – but men are usually more afraid than their pregnant counterparts; even if they won’t admit it. Our daughter was taking her time, so my wife was induced. The epidural shot worked great, and my wife was even able to take a nap before showtime. After forty-five minutes of active labour, we met our daughter and I even cut the cord without fainting! The first month felt like it went by in the wink of an eye. We were tired and obviously sleep-deprived, but we couldn’t be happier to have welcomed our daughter into our lives. The News During one of our regular check-ups, the doctor told us she noticed our little one had an odd way of breathing. So, we were referred to a pediatrician. The pediatrician didn’t see anything odd with her breathing but told us he could hear a murmur. He said it was probably just a murmur, but suggested it might be good to go to the ER to get it checked out. I don’t remember how many hours we spent at the ER or how many tests they ran. All I remember is hearing a doctor, at 2 AM, telling us “we are going to admit you” to the hospital. Our one-month-old daughter had a heart condition called Ventricular Septal Defect (VSD), that was causing her ventricular hypertrophy and as a result, was filling up her lungs with fluid. In one day, all that happiness and bliss turned into fear, uncertainty and doubt. We felt powerless, unable to do anything but sit and wait for the doctors to tell us the plan. How everything changedAfter a week, we were cleared from the hospital and given prescriptions to give to our daughter. Captopril to help her heart work better, and two diuretics – one to get rid of captopril once it had its effect as it has a certain level of toxicity, and the other one to reduce the fluid in her lungs. So as new parents, that a month before didn’t even know how to change a diaper, now had to cope with administering three different medications. Giving a child that young medication is extremely challenging; we had to ensure she swallowed them, without spitting them out or choking. Most times, we were lucky if she swallowed half. We were unprepared for this. One morning when giving her her medication, before leaving for work, I thought she was swallowing them just fine. Until she started to turn red. She was unable to breathe for a few seconds. I turned her over and patted her back till she finally spat it all out. I’ve never been more scared in my life. The thought that I could’ve lost her, had me shaking and as a result, I was unable to go to work. The days I did go to work were weird. Some days, it felt like everything was ok and other days, I could barely hold back tears. But most days when I came home I would find my wife crying. Typically I’m good at cheering her up, but this was different, there was nothing I could say or do to help. I worried about that a lot. I felt useless, unable to ease my wife’s pain. At times, being able to leave my place for a few hours, felt like a mental break from everything. But at the same time, I couldn’t stop worrying about my wife and daughter at home. It was tense 24/7. We would put our baby to bed, try to relax, watch some tv, but we couldn’t. Our Next Steps In another check-up, the cardiologist told us our daughter would likely need open-heart surgery. But all we could do is wait and see how everything goes. It would all depend on how well she was gaining weight. If she started to gain weight normally, it was possible she wouldn’t need the surgery. But if she continued below the growth charts, it would mean her heart condition was keeping her from growing normally (this is what they call failure to thrive). So, we tried our best to get her to eat better. But how would she gain any weight if she was taking two diuretics three times a day and she wasn’t finishing her bottles? Every time we went to her check-ups, she was below the growth charts. And every time we were told the same thing. “It’s too early to decide, let’s see how everything goes”. This made every feeding time tense. All we could think was “I hope she eats a bit more now”. After a few months of stress, we went from not wanting our baby to have surgery, to wanting her to have it. We didn’t actually want our baby to have to go through surgery, but we did want her heart fixed and to be able to leave the stress behind us. With time, our little one started to gain weight. We were told she was doing well but still needed to wait to decide about the surgery. Our, now toddler, was able to play and do all the things other children do, so we started to relax slightly. We couldn’t stop worrying completely, but at last, we received some good news. At her last check-up, we were told she won’t need surgery after all. She will be able to live a normal life. The Connection with Mental HealthTaking care of a child with any health condition is sure to take a toll on the mental health of their parents. In my experience, parents feel stressed, depressed, helpless and a sense of unfairness asking themselves “why does this have to happen to OUR baby?” This feeling of unfairness, also makes us feel alone and isolated. I remember going to one last prenatal class to meet with the group of parents after all our babies were born, to share our experiences about giving birth. There were approximately 13 couples and most of them shared bad experiences: they had either during the final stages of pregnancy or during labour, but all of their babies were healthy. They had the ability to look back to those difficult experiences with a smile. When it was finally our turn, we didn’t have a bad labour experience to share, only our baby’s heart problem. And that made us feel very alone. What I Learned About Managing Mental Wellness Although everyone’s experience is different, the following are my personal tips for a parent dealing with a similar issue.
Conclusion Caring for a child with a heart condition or other illness is a situation that no parent is prepared for. It can be physically and emotionally taxing to not only manage the realities of a child’s illness, like giving my young daughter medication, but also the fears associated with the illness and the unknowns that can come with that. Even though during this time you likely want to spend all of your energy taking care of your child, it’s also important to take time for your own mental health. Overall, you will be better able to take care of your child and manage the illness if you’re also taken care of. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
My boyfriend wants to take erectile dysfunction medication to enhance his performance. Why would he want to do that? I think our sex life is great, and I don’t want medication to make it unnatural and weird. The answer: There may be a number of reasons as to why your boyfriend feels the need to take erectile dysfunction medication – getting to the root is key. Relationships thrive on communication and that includes speaking to our partners openly about our sex lives. Erectile dysfunction is the inability to develop and/or maintain penile erection during sexual performance. It certainly affects a percentage of the male population. Psychological impotence (complication with erection due to stress or performance anxiety, rather than physical impossibility) is the most common contributor to erectile difficulties. The issue often gets resolved when a man’s anxiety dissipates. Most men will experience this at some point in their life, especially when they are highly stressed or are in the early stages of a relationship. But the difficulties are often short-lived and do not create continuing problems in a relationship. In these circumstances, pharmaceutical intervention is not necessarily successful and I would not recommend it. Erectile dysfunction caused by physiological or medical reasons – such as a health condition or side effect from other medications – is less common. In this scenario, age is a primary contributor. The National Institutes of Health estimate that about 5 per cent of 40-year-old men will experience erectile dysfunction on an ongoing basis, whereas the number rises to 15 to 25 per cent among 65-year-olds. Your partner does not have a medical reason for taking this medication as you have alluded, which means he’s part of a growing number of men who use erectile dysfunction medication in a recreational manner. There could be a number of contributing factors for this. Your partner may be curious about the extent to which his performance will be enhanced; he may be experiencing peer pressure; or if he has had too much to drink, he may take the medication to combat the negative impacts of alcohol on performance. I have two main concerns with recreational usage. For one, erectile medications have side effects. They place stress on the major organs – in particular the heart, liver and kidneys – and the long-term effects are unknown. Second, there is some emerging evidence that men may experience adverse impacts on their sexual function and become psychologically reliant on the medications. Start by explaining these concerns to your boyfriend – especially the latter as it may serve to be the strongest deterrent. Then try and understand where your boyfriend is coming from. Perhaps he has some insecurities about his performance that he’s been reticent to share. Having an open conversation about your perceptions and feelings surrounding your sex life may serve to ease his mind. Tell him how great you feel about your sex life and suggest ways to add spontaneity and excitement to your intimate relationship without the use of medications. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. |
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