|
By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth  Female Caregiver Stress: Tips to Take Care of Yourself
There is this idea that women are natural caregivers. Whether or not this is true, in our current society women tend to be responsible for most unpaid labour, such as caregiving for elderly family members and children as well as domestic responsibilities. Although caregiving can be incredibly rewarding, it can also be stressful – female caregiver stress is very common. It’s important for caregivers to remember to take care of themselves in order to be able to effectively care for others in their life. Signs of Female Caregiver Stress It’s easy for caregivers to neglect their own health when they’re focused on caring for others. But long-term stress can have a negative impact on a person’s physical and mental wellness. So, it’s important to pay attention to signs of stress, such as:
Tips to Take Care of Yourself – Managing Caregiver Stress
Remember that you’re not alone. It’s common for caregivers to have a challenging time asking for help which can lead to feeling further isolated, frustrated and even depressed. Final Thoughts While it can be rewarding to be a caregiver, it can also be incredibly challenging and cause a significant amount of stress, especially for female caregivers. This year has been particularly hard on everyone so it’s more important than ever to ensure that we prioritize our own needs so we are better able to support our loved ones. Remember it does not mean you have failed or that you’re weak if you need to reach out for support. We always manage things better as a community. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth  Feeling Suicidal? How to ask for help
Over the last decade, conversations about mental health and suicide prevention have become more prevalent. More people are becoming aware of the importance of mental health on our overall health. But unfortunately, we still have a long way to go and stigma is still affecting our ability to ask for help when we’re feeling suicidal or struggling at all. It’s important to remember that mental illness or thoughts of suicide are not a sign of weakness or a reflection on your character, and asking for help is an incredible show of strength. Know that you deserve support regardless of what in your brain is telling you otherwise. Also, know that help is available. Even if the first person you reach out to is not as helpful as you hoped, try again. Not everyone has the ability to be supportive and that is not a reflection on you. If you don’t have someone in your personal life you rely on, know that there are always crisis lines and professionals who have the training to provide you with the support you need. Don’t give up on support altogether, even if it takes some time to garner it. How to ask for help when you’re suicidal Many of us may struggle with asking for help when we’re suicidal because we don’t know what to say. We may not know how to express the feelings we are experiencing, and we may not know what we need or what type of support someone is able (or willing) to offer. These conversations are never going to be perfect, and we are never going to find the perfect words – but saying something is better than nothing. So, here are some suggestions on how to start these conversations and help to keep yourself safe. “I am really struggling and don’t feel safe right now, can you stay on the phone with me until I calm down?”
“I am feeling [depressed/suicidal] and I don’t know what to ask for, but I don’t want to be alone right now.” “I’m struggling right now, but I’m not ready to talk about it. Will you help to distract me?”
“I’ve been struggling with my mental health and what I’ve been trying isn’t working. Will you help me make a better plan?” (set a particular time and date to do it)
“Can you check in with me [at a particular time / every day] just to make sure I’m alright?”
“I’ve been really low. Can you remind me of something you like about me?”
Final Thoughts Asking for help when you’re suicidal can be challenging. Often it can be helpful to be blunt and say that you are feeling suicidal so the person you are reaching out to for support can better support you. It’s not easy to ask for help, but it is strong and it is brave and hopefully, the more we talk about suicide the easier it will be for people to ask for help. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
My husband has always been short-tempered, but he has become increasingly angry over the past few months. He takes it out on our pre-teen children – he has never gotten physical and does not swear or get otherwise verbally abusive. But he gets easily annoyed and frustrated, and will raise his voice and get upset with them to the point that they don’t want to be around him. His responses are out of proportion to the situations. How can I help him see the damage he is causing? The answer: Anger is a normal, healthy emotion that we all experience at times. Like any other emotion, anger exists on a continuum with varying degrees of severity. The range of emotions may include minor annoyance, irritation or frustration, all the way up to fury or rage. It is important to distinguish the emotional experience of anger (which can be appropriate in some circumstances) from the outward expression of anger (which is often inappropriate, and can lead to damaging, destructive or abusive situations). Anger can serve a useful function in some situations: namely when we are in situations where we are being disrespected, threatened/attacked, or when our boundaries are being crossed. Anger can become unhealthy and problematic when it is mismatched to the severity of a situation, or when it is inappropriately expressed or negatively impacting others – like the situation you seem to be describing with your husband. In these latter types of situations, anger often is a “secondary emotion” – meaning that it may be a sign of another underlying “primary emotion”. Insecurity, fear/anxiety, and depression can often manifest as anger, particularly for men. Given that you have described a recent change in your husband’s behaviour, it may be likely that his anger is reflective of some other emotional experience or stressor. Given that your husband’s behaviour is having a negative impact on your young children, you need to address this with him immediately. You may want to start by having a general discussion about changes you’ve observed over recent months. Be specific and objective in describing the behaviour you have seen, and avoid making assumptions or laying blame (as this will likely just lead to him feeling defensive). Let him know that you want to work with him as a family to create a more supportive and caring environment for your children. Describe the impact it’s having on your children. Ask if he’s noticed that things have felt different or ‘off’ recently, and if there are things that have been bothering him over recent months that you may be unaware of. Take a problem-solving approach where you work with your husband to identify factors that may be contributing to his anger (and work on solving those). Also, try to agree upon some immediate strategies to minimize the impact of his mood on your children (e.g., ask him to go for a short walk to relax before he comes home from work and sees the family). You should remain unapologetic in your expression of behaviours that need to change. Know that there are a range of effective strategies for managing anger, including: identifying trigger factors/situations (and working to reduce those); working to solve underlying issues (e.g., untreated depression or anxiety); learning and implementing relaxation strategies; reducing alcohol or other non-prescription substance use; changing thoughts/interpretations that lead to angry thoughts; and learning more effective/healthy communication styles (e.g., assertive, rather than aggressive communication styles). Note: If there is ever any indication of emotional, verbal or physical abuse – toward you or children – it is important first and foremost to ensure safety of everyone involved. Remove yourself and your children from any potentially dangerous or threatening situation and call The National Domestic Violence Hotline (1-800-799-7233) for resources in your area. There are a number of useful books on anger management that may be helpful for individuals that are dealing with anger problems, as well as for their loved ones to better understand anger patterns and triggers. 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:
I keep having work dreams. Or should I say, nightmares. How can I make them stop? The answer: Ah, the dreaded workmare. Unfortunately, I have no magic wand to make work-related nightmares stop. The key is to first understand what factors contribute to the types of dreams we all have, as well as the function they serve. The next step is to then work to alleviate the causal factors. Scientific understanding about dreams and their associated meaning is, on the whole, pretty poor. What we do know is that our most vivid and memorable dreams occur during our deepest stage of sleep, known as the REM (rapid eye movement) stage. We also know that there are differences from person to person on how much we dream, or whether we even recall our dreams. The frequency and content of our dreams can be influenced by factors such as what we have eaten on a given day, how much alcohol we have drunk and myriad other physiological factors (for example, nightmares can be a side effect of some medications). We also know – most importantly – that our day to-day life situations have a significant impact on the content and intensity of our dreams. Stressful and, in extreme cases, traumatic life situations are among the most significant psychosocial factors that affect our dreams. Studies that have examined dream content show that we tend to have and recall more negative dreams than positive ones, with the underlying theory being that there is an adaptive function to have threatening dreams. Namely, having nightmares can help us to simulate actual or perceived threatening situations in a safe environment, allowing us to be more psychologically and cognitively prepared for the threats when they come up in life. Pay attention to what stresses you at work but also in your personal life. High levels of stress, as well as perceptions that we are in situations that are unpredictable and over which we have little control, can play a role. Make a list of all the significant stressors in your life. Order these from most stressful to least. Then ask yourself the following questions: Do I have any control over this stressor? What specific action can I realistically take that may help alleviate my stress? Then make an action plan to reduce the stressors over which you have some control. Stress builds when we become passive and immobilized, and taking some action (even if it’s not the “perfect” one) can help tremendously. In addition, having a consistent pre-sleep ritual can help to reduce the intensity and frequency of your nightmares. First, minimize talking or thinking about stressful situations right before bed. Relaxation or meditation strategies can help to slow down both your mind and body. Have a warm bath or listen to soothing music to distract your mind. Avoid reading books or watching TV or movies with upsetting content. If you are woken by a nightmare, get out of bed (staying there will help associate the nightmare with your bed). Do deep, diaphragmatic breathing for five to 10 minutes and then do something relaxing, such as having a warm glass of milk, before you get back into bed. 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 mother criticizes my weight every time I see her. I am overweight, but am well aware. Her comments do not help! How can I deal with her? The answer: Our relationship with our mother can be one of the most complex bonds we have. When the relationship is strong, positive and loving it can be a source of tremendous happiness and validation. When the relationship (or elements of the relationship) are less than ideal it can be a source of sadness, anxiety or even anger. As children, we are of course reliant on our parental figures for food, caretaking, safety and security. As we become older and independent, we no longer rely on our parents for these basic needs. Despite this, our need for acceptance and validation often remains strong, even as adult children. As such it can often be difficult to speak directly or assertively to our mothers about difficult topics. A certain amount of “motherly critique” is a normal part of the mother/child relationship. However, repeat criticisms about weight are both unhelpful and disrespectful, and can be damaging to your self-esteem and confidence. The best advice is to address your mother’s criticisms directly and assertively. Let your mother know that her comments are unhelpful, unnecessary and hurtful. Clearly let her know that you would like her to stop making these comments. Respectfully state the consequences if her statements don’t stop. For example, you could let her know that you need to end your visit with her if she begins to criticize you unfairly. The difficult (but important) part will be for you to follow through with the consequences if her behaviour does not change. Here are some tips for speaking with your mother in an assertive way: – Clearly describe the statements she makes that you find hurtful. Be objective, specific, and avoid being judgmental or criticizing her back. – Express how her statements impact you. Don’t assume that she will necessarily understand what the effect has been on you until you tell her. – Directly state what you need to see in terms of her behaviour change. Tell her clearly that you would like her to stop making comments about your weight. – Assert the consequences if her behaviour does not stop. – Express how much you value your relationship with her, and let her know that you are hopeful that things can continue to improve between the two of you. Remember to be clear, direct and do not make any apologies for establishing boundaries in your relationship with her. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth  What is suicidal ideation? The signs one may be thinking about suicide
Suicidal ideation means thinking about or planning suicide or wanting to take your own life. This includes all thoughts from fleeting consideration to detailed planning. If you are thinking about suicide, you are not alone. Many people have thoughts of suicide for a number of reasons and the reasoning behind suicidal thoughts is not wrong. You may feel hopeless and think that nothing can be done to change the situation, but know that having these thoughts does not mean you are weak, or ‘crazy’. Often people think about suicide as a means of escape from their feelings, so just because you are thinking about suicide does not mean that you will act on those thoughts. Due to the stigma attached to mental health and suicidal ideation, those who experience these thoughts often feel as though they need to hide them from the people around them. Know that connecting to others when we are having these thoughts is extremely important and talking about mental health breaks down the stigma. Warning Signs of Suicidal Ideation Warning signs that you or a loved one may be thinking about suicide:
Causes of suicidal ideation Many people might think suicidal thoughts are attached to mental illnesses like depression or bipolar disorder but there are many causes of suicidal thoughts, some of which are circumstantial. As mentioned previously, suicidal thoughts often accompany thoughts of hopelessness, feeling out of control in life and/or feeling purposelessness. The circumstances that often cause these thoughts are relationship problems, trauma, substance use, a crisis of some sort, the pressure at work, a physical health issue, or financial difficulties. Taking Action If you are worried a loved one is thinking about suicide, ask. Asking will not make someone consider suicide if they weren’t already. If you are feeling suicidal, reach out for help. Know suicidal thoughts are common when one is feeling overwhelmed and hopeless, and when there seems to be no way out – but also know those suicidal thoughts won’t last forever, and that help exists. If you or someone you love is at immediate risk of suicide, call 9-1-1. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
I’m afraid of swallowing pills. The size and shape of the pills makes no difference; I either crush pills into food or some other suspension, or avoid taking them altogether. The avoidance strategies I have tended to use are getting harder to manage as I get older. What can I do? The answer: Dysphagia – or difficulties with swallowing – can be related to a range of causes including fear, pain, or some other cognitive, anatomical or physiological problem. Fear and avoidance of swallowing pills is not an uncommon source of anxiety for people. Although it seems like a very simple and easy task to do, many adults and children will struggle with swallowing pills. The gag reflex is a very powerful – and in true danger situations, a biologically adaptive – reflex. Even having one past experience where you felt as though you were going to gag/choke can reinforce that fear. Assuming that there is no physiological basis for your difficulties and that the cause is fully psychological, there are some effective strategies to manage your symptoms: 1. Work on relaxation strategies. The fear of swallowing pills (even in the absence of any physiological problem) can lead to the throat tightening up. Learning relaxation strategies can be very helpful, as reducing your overall level of body tension (and also specifically working on relaxing the throat muscles) can help to lessen the automatic response you get when swallowing. Deep breathing and progressive muscle relaxation skills practiced in the minutes before swallowing a pill can be very helpful. 2. Target your fears/thoughts about gagging/choking. You likely have a number of automatic thoughts related to gagging/choking that contribute to your fear, such as: “I can’t swallow pills”, “I’ll never be able to do this”, “I hate this”, “I will choke”. Increase your awareness to inaccurate/catastrophic thoughts and actively replace them with more realistic thoughts (e.g., “I don’t like swallowing pills, but my doctor has told me there is no physical reason I can’t, and it’s never as awful as I think it will be”). 3. Visualize success. Picture yourself calmly and easily swallowing the pill. Repeatedly visualizing success can have a very real beneficial impact. 4. Gradually build up your tolerance. Teaching yourself to swallow pills is like building up any other skill: you need to gradually build up your tolerance. Start with very small-sized “simulation pills” and gradually build up the size. Be creative here (e.g., using sprinkles, tic tacs). You want to of course ensure you are only practicing with digestible food that won’t cause any health problems (talk to a doctor if you are unsure). 5. Practice, practice, practice! Avoidance of things we fear counter-intuitively increases our fear of those things. So, you need to practice a lot, and not avoid swallowing pills! It can be helpful when you are first building up your tolerance to swallow the pills when someone is around you (e.g., if your worry is about choking). Many people also find eating some food immediately afterward can help with lessening the unpleasant sensation/taste of swallowing the pill. Drink a lot of water before and after (cool or room-temperature) and take the pill during a time of day when you feel more relaxed and can dedicate some time to implementing your relaxation and realistic thought-replacement strategies. Note: It would be important to ensure you do speak to your family physician about this to first rule out whether there is any other contribution, as dysphagia is more common in older adults and could be possibly related to some change in muscle or nerve function. 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  Recognizing that you are having emotional difficulties can be challenging to admit, but it’s the first step to getting effective treatment. So, good for you for getting there, but figuring out how to get the help you need can be another daunting step as there are so many different types of mental health professionals.
Psychologist vs Psychiatrist Psychologists and psychiatrists are both mental health specialists with expertise in assessing and treating emotional issues. They have approximately the same number of years of formal training. While there are some similarities between psychology and psychiatry, there are also some important differences in their type of training, focus and treatment approaches. We will address each of these topics below. Training
Focus
Treatment and Referral Process
Psychologists and psychiatrists have their own areas of expertise. Some individuals are matched with one or the other and see results, but you may also benefit from seeing both who work together to support you. Speak to your family physician to get some advice and guidance on who can best help you. Your provincial psychological association can also assist with answering questions about how to find a psychologist best suited to your needs. Editor’s Note: This post was originally published as part of a Globe and Mail “Ask the Psychologist” column authored by Dr. Samra, and has been edited and updated. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
I have a 17-year-old son who suffers from autism. It can be difficult at times. When he eats, he can unexpectedly start acting up and make awful sounds. He will randomly pick up and turn things over. You can give him instructions as a parent and he decides not to move an inch. I love him, but I find myself struggling not to be angry at him for his worst actions. How can I find ways to cope with behaviour that I understand he may not be able to control? The answer: Raising a child with a pervasive developmental disorder can be one of the most personally taxing and challenging life situations a parent can find themselves in. First and foremost, you need to be gentle with yourself – you are only human, and feeling upset or even angry toward your son is a natural reaction that most parents with a special-needs child will experience. Most parents, however, feel reluctant to verbalize their negative feelings due to fear that they will be reprimanded or judged by others; suppressing these feelings will do nothing but amplify them over time. What’s important is that you get the support you need as you deal with the daily challenges of parenting your son, while of course remaining mindful of not inappropriately displaying your frustration to your son. Autism spectrum disorder (ASD) has the hallmark feature of impaired social interaction and is characterized by impairments in communication and repetitive, stereotyped behavioural patterns. Although there is no “cure” in the traditional sense for autism, symptoms often improve with age and treatment, with Applied Behavioural Analysis (ABA, a skill-oriented behavioural intervention that is highly structured and intensive) being the most strongly supported by research. This would be an avenue I would suggest exploring if you have not already. It’s important to keep in mind that repetitive or perseverative behaviours are not unique to individuals with autism; particularly when under stressors, many people will engage in some element of repetitive behaviours (e.g., nail biting, pacing, obsessive cleaning). Given your son’s age, I would guess you have spent countless hours over the years trying to understand and manage as best as you can your son’s behaviours. Over time, however, and given the number of years your family has been dealing with his autism, it’s natural to lose objectivity in understanding patterns that may exist, and there may be value in revisiting this. Specifically, pay attention to the days when the repetitive/perseverative behaviours are less frequent: What elements that occurred earlier in the day – and particularly in the hours leading up to mealtime – could account for this? Try to replicate the elements that seem to be associated with a reduction in his repetitive behaviours, and reduce or eliminate those that seem to play a role in exacerbating his symptoms. Most importantly, actively work to manage other stressors in your life that you do have control over. Pay attention to the usual factors that may reduce our threshold for stress; get adequate amounts of sleep, regularly exercise, eat healthy and minimize alcohol use. You can also join a support group in your community where you can get the emotional and logistical support that other parents with autistic children can offer. And make sure you schedule some “non-parenting time.” Don’t be shy to ask for help from your partner or family members, or you can implement external caretaking support if you are financially in a position to do so. Take the time away from parenting to do things that you enjoy: Meet a friend, go for a run, watch a movie – anything that provides you with much-needed relief from your responsibilities, for a little while. 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: There’s a group of us who hang out, and we are pretty sure that one of our friends is gay. We don’t care, we just wish he wouldn’t hide it if that’s the case. Should we ask him outright? The answer: Coming out is a deeply personal process that can be immensely difficult and challenging. I’m happy to hear that among your group, your friend’s sexuality is irrelevant (in a good way) and a non-issue when it comes to how you view him. It sounds like you will accept and support him when he does choose to come out. Whether you should ask him outright is a tricky issue. On one hand, there’s something to be said for communicating to him that you accept him regardless of his sexuality. However, you need to balance that openness with the need to not put him in a position where he’s forced to come out when he’s not ready. Asking him outright may put him in awkward position, and you need to respect that he will come out when he feels he is personally ready to do so. He may also feel that it’s important that he first comes out to certain people in his life – like his family – before anyone else, even your group of friends. Consider the myriad challenges your friend may be facing. He may be going through the personal challenge of accepting his own sexuality before he comes out to others. He may be unsure how to tell those close to him. He may not be sure what reaction he will get from family and friends – those that he cares about and whose opinions matter to him. The best thing you and your friends can do is ensure that you are mindful of actions that may inadvertently create an unsupportive environment. Pay attention to the language you use and the jokes you make. It often stuns me how frequently people, just in day-to-day conversation, with no malicious intent, use words that can alienate someone who is gay. Also, take some time to learn more about the experiences people have when they first come out, so you can better understand what your friend may be going through. PFLAG Canada has links to a range of resources and support agencies that you may find helpful. Pay attention to your friend’s behaviour: It may be indirect communication he is giving about his sexuality. Think about your responses to him. Not uncommonly, people “test the waters” with those close to them before they come out, by observing how people react to seemingly neutral situations or stories. Whenever the opportunity arises, let your friend know what he means to you and what qualities you value in him. If it is appropriate and not awkward, try to convey that you would accept him no matter what. When he does come out, offer to support him however you best can in coming out to other friends, family or coworkers. And, most importantly, let him know how you feel – which is that his sexuality makes no difference to how you view him and your friendship. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. |
PH&S ClinicEnhancing psychological health, wellness and resilience Archives
April 2025
Mental Health
All
|
RSS Feed
