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By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
Almost three years ago my partner committed suicide. He suffered from depression. We were only dating for a year, but I find his death still gets to me. It’s especially difficult now for me to date people. I used to be a very patient, happy, joking person. Since it happened, I feel as though it’s a charade I’m putting on so my friends and family don’t notice the change. How can I move on? The answer: The death of someone we love is one of the most difficult life experiences we will ever face . As a society, we are terrible at dealing with and talking about death. We are never taught in schools what to say to someone who loses a loved one, despite the fact that all of us will, at some point in our lives, have to deal with the inevitable losses of those we care about. Dealing with a death that occurs from suicide only adds more layers of complexity, confusion and, in some cases, self-blame that further amplifies what is often a difficult recovery to begin with. Those that are closest to someone who dies by suicide (partners, parents, children) are left with the biggest burden to carry. They are often left with myriad emotions: sadness, guilt, anger. Recreating past conversations, thinking you could have done or said something differently, questioning why you weren’t ‘enough’ for the person to not take their life – all are common thoughts for survivors. Unfortunately so much misinformation, stigma and shame continues to be associated with suicide, making it even more difficult for your support system to know what to do or say, which then further prolongs the grieving process for survivors who are struggling to make sense of the nonsensical. I’ve lost both an aunt and a cousin to suicide – and one of the things that stood out to me so strongly was how uncomfortable so many people were about their deaths. Friends and family that I knew to be caring and otherwise articulate stumbled through awkward conversations. Some avoided the topic altogether, others became visibly distressed, and others made well-meaning comments that were ultimately unhelpful. These are common themes I have heard again and again from patients and friends who have been affected by suicide. When we talk about “moving on” or “getting over” a loss, what we really mean to do is find effective ways to cope. This includes maintaining positive memories and thoughts of your partner, while still getting back to all of the elements that make life worth living – which, in your case, includes dating. It makes absolute sense that it’s difficult for you to date – you are in a self-protective mode, not wanting to make yourself vulnerable to another potential loss. There is no magic formula for how long or what the grief and recovery process looks like, as it is so individual. There is one thing I can say with certainty, however: Not processing your loss – having to present a facade to those that are close to you – will only prolong the ordeal. I would start by opening yourself up to the idea of speaking about your loss, as there is so much therapeutic value in simply talking through the thoughts and emotions you’ll have inevitably bottled up. Consider approaching those closest you: Tell them you don’t need them to say anything, that you just want to talk through what’s in your head. If you feel reticent to approach those you know, I would strongly suggest seeking the support of a psychologist or other registered mental health/grief professional that has expertise in suicide to help you move on. I would also seek support online. Some recommended websites are www.suicide.org, www.survivorsofsuicide.com and www.allianceofhope.org. Have faith that with time and with the support of someone you trust, you will be able to move forward in your life. 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  Coping with Suicidal Thoughts
If you’re thinking about suicide, you’re not alone. Many people have thoughts of suicide, for a number of reasons. Thoughts of suicide can be very scary and coping with suicidal thoughts may seem impossible. You probably feel hurt, confused, overwhelmed and hopeless about your future. You may feel sadness, grief, anger, guilt, shame, or emptiness. It’s easy to think that nothing can be done to change your situation. Your feelings may seem like they are just too much to handle right now. It’s important to know that thinking about suicide does not mean that you will lose control or act on these thoughts. Having thoughts of suicide does not mean you are weak, or ‘crazy’. Many people think about suicide because they are looking for a way to escape the pain they’re feeling. Even though your situation seems hopeless and you wonder if you can stand another minute of feeling this bad, there are ways to get through this and feel better. You don’t have to face this situation alone. Help is available. Coping with Suicidal Thoughts Right Now If you’re experiencing suicidal thoughts now and are possibly feeling unsafe, here are some things you can do right now.
Once you feel like you are out of immediate danger of harming yourself you can take the time to consider long term solutions to coping with suicidal thoughts. Make A Safety Plan Making a safety plan can be very helpful in getting you through those distressing times where you feel unsafe. Having a plan ahead of time ensures you know who you can call and have those people prepared to support you, as well as what activities and places can help you to get through the worst moments. One of the best people to make a safety plan with is a professional, as they are familiar with the process and can help you to brainstorm ideas for the plan when you’re feeling hopeless. If you’re not already connected with a registered psychologist or counsellor we suggest you do so. With the help of professionals and the support of family and friends, you can learn about what is causing your suffering and how you can change or manage it. If you or someone you love is at immediate risk of injury or death, call 911. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth  Breathing Exercises to Manage Stress
Breathing exercises can be very helpful tools for managing symptoms when our “fight-flight-freeze” stress response is triggered. And the great thing about breathing techniques is they’re easy – once we master the steps. One of my go-to breathing exercises, which we teach to many clients in our clinical practice group, is “four stage breathing”. This is a variant of the more common box breathing approach. Both can be equally effective approaches – it’s just about finding a style that works for you! What is Four Stage Breathing? Four stage breathing is a type of breathing technique that slows down our breathing actively and intentionally. It’s called four stage breathing as there are – surprise! – four stages to each full breath: two parts to the inhale, and two parts to the exhale. Why do breathing exercises work? And why is it important? Stress triggers our “fight-flight-freeze” response and when this response is triggered, we tend to shallow breathe. So why is shallow breathing a problem? Shallow breathing can lead to a whole host of physiological symptoms – including for example, changes in body temperature, lightheadedness or dizziness, or feelings of derealization or depersonalization (where distance/perception can be altered). These symptoms can mimic anxiety – and so shallow breathing can inadvertently make subjective feelings of anxiety or stress worse. Four stage breathing helps anxiety by providing control over the physiological symptoms – and this, in turn, helps calm the emotional symptoms. The Technique: How to do Four Stage Breathing First, ensure you are breathing in through your nose and out through your mouth. This naturally slows down the pace of our breathing. Second, make each full breath last at least 10 seconds – 5 seconds on the inhale, and 5 seconds on the exhale. Break each inhale and exhale into two parts: On the first inhale, fill up most of your lungs; on the second inhale, think about ‘topping up’ your lungs with air. On the first exhale, push out most of the air, and on the second exhale think about fully emptying your lungs. This helps to maximize our lung capacity. Repeat this cycle for 3-5 minutes. When you are first learning four stage breathing, it’s important to practice when you are already relatively calm or feeling low stress – this can help build mastery. Then, over time, use it as a tool when you feel your stress or anxiety increasing. How I incorporate Four Stage Breathing into my life
There is a very strong evidence-base on the benefits of breathing to reduce the frequency and intensity of the physiological symptoms associated with stress and anxiety-related. I encourage you to try four stage breathing regularly for a week – just a handful of times a day, for just a handful of minutes at a time and see how you feel. Remember: when we are experiencing stress, the best thing we can do is focus on the things within our domain of control and breathing is one of them. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth  Stress is a common and normal – and something we all experience on a day-to-day or certainly week-to-week basis. It’s our body’s innate defense mechanism against a perceived threat or danger. Our stress response – also known as the fight, flight, or freeze response – can be brought on by anything, such as change, an argument we had with our partner, or an upcoming work deadline that we need to meet.
While the way we experience and manage stress varies between individuals, stress can usually have both positive and negative effects. When it’s short in duration, it can keep us focused and motivated. But when we’re in a heightened state of arousal for a long period of time, stress can be harmful to our emotional and physical well-being. The connection between our physical & mental health Medicine – and society in general, for that matter – are increasingly recognizing the intertwined nature of our physical and emotional health. Gone are the beliefs of traditional medicine that purported that we could somehow separate our physical state from our psychological, emotional, and spiritual well-being. The experience of stress manifesting itself as physical symptoms is a common one: Most people who are dealing with chronic stressors experience some impact on how they feel physically. Research demonstrates the comorbidity rate between physical and emotional health conditions (those with psychological conditions who will also experience impairing physical symptoms) to be as high as 80 per cent, and vice-versa. How we experience stress The way our stress reveals itself depends on myriad factors, including our childhood history; personality and genetic predispositions; how we observed our parents dealing with stress; and whether or not overt emotional displays were viewed as ‘acceptable’ ways to communicate stress in our family. Individual differences exist in the degree and intensity to which emotional issues manifest physically, but the most common physical symptoms are stomach/gastrointestinal problems (tension, nausea, constipation, diarrhea), pain (headaches, back pain, chest tightness), appetite changes and sleep problems. What can we do about it? So how can we effectively manage stress when the physical symptoms become distressing and potentially damaging? A good first step is to consult with your medical doctor. They can offer objective input into the contributors of your physical symptoms and ensure that nothing more serious is going on. Next, get very structured and rigid about ‘the usual suspects’ – sleep, diet, and exercise. Aim for a minimum of 7 to 8 hours of sleep, ensure you are getting at least half an hour of movement in a few times a week, ensure you are eating healthy meals a few times a day (with an emphasis on plant-based and non-processed options), and reduce and ideally eliminate the use of substances, such as alcohol or smoking. Another way to effectively manage stress is to incorporate deep breathing and mindful practice into your daily routine. Even just five minutes at a time, a few times a day, can be extremely helpful. If you need help getting started, or a refresher on these techniques, we put together two short videos on mindfulness and 4 stage breathing for guidance. Finally, learn the basics of cognitive-behavioural therapy (CBT). CBT is an effective evidence-based stress-management approach, which helps you change unhelpful cognitions (thoughts, feelings, and beliefs) that contribute to your stress. CBT provides strategies for problem-solving to tackle primary stressors in your life (such as finances, relationships, or work-related challenges) and teaches behavioural strategies, like breathing and relaxation, to target the physiological manifestation of your stress. Stress is no match for a healthy body and mind Stress can be harmful to our physical and mental well-being when not managed accordingly. But with proper sleep, diet, exercise, and mindfulness and meditation practices, we ensure our body’s innate response is kept in check (and reserved for moments of real threat and danger!). 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 Emory Oakley. Emory is a writer and LGBTQ+ educator who regularly discusses the intersections of queer identities and mental health.  In the last several years there has been an increased focus on men’s mental health. With a focus on de-stigmatizing mental health in order to encourage men to seek support for their mental wellness. We know men are less likely to seek support for their mental health than women.
It’s common to believe this trend is a direct result of the perceived standards of masculinity. If you were to ask almost anyone what it means to be a man, you’d probably receive answers like strong, confident, brave, etc. These characteristics are seen to be in direct opposition to seeking mental health support which is perceived as weakness. Although this is something we’re slowly seeing change as more people are starting to question gender expectations and fight against the toxic ideals of masculinity. But we still have a long way to go. Facts About Men’s Mental Health Here are some specific facts about Canadian men’s mental health:
I’ve struggled with mental health to varying degrees my entire life, though I would probably say I started to notice it in my teenage years. By notice, I don’t mean I recognized I was experiencing symptoms of anxiety or depression. I was a late bloomer and experienced significant insecurity and discomfort in my body and I cared too much about what people thought of me. So, I tried desperately to fit in and to be ‘okay’ (whatever that means). At the same time, my mother was diagnosed with cancer and she passed away three years after I graduated from high school. So, on top of my own personal struggles, I was experiencing profound loss and grief I was unprepared to deal with at seventeen. Being The Tough GuyDespite everything I was going through I didn’t talk to anyone about it. I refused to admit I was struggling and put on a strong face. While simultaneously pouring my feelings into antsy poetry and contemplating why I should bother living. Of course, this made things worse, not better. I don’t recall anyone mentioning professional support even though I was perceived as a girl at the time. It wasn’t until I entered a community where it was common to talk about our struggles that I started to open up. At that point, I’d finished my degree in psychology and even though I could admit I had some struggles, I was also able to convince myself I was strong enough to manage it myself. What changed everything was that almost everyone in this new community space had an experience with going to therapy (and wasn’t afraid to talk about it). The impacts I experienced in therapy were profound. What Can We Do To Help Regardless of how we identify, we would all benefit from a more mentally healthy society. So, how can we support men’s mental health whether it be ourselves or the men in our lives? Here are some things I suggest:
Final Thoughts We all experience varying states of mental wellness regardless of whether or not our symptoms ever reach a point of being considered a diagnosable disorder. We all experience sadness, worry, and stress to some degree and many, if not all, of us, could benefit from support in developing our emotional resilience. It’s my hope that we are able to talk more about mental health and see the value of therapy for everyone. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
My wife is inconsolable after three miscarriages. What can I do? The answer: There are a number of things that may be help your wife through this difficult and understandably emotional time. First, resist the tendency to problem-solve. Let her know that you love and care about her, and that you want to support her as best as you can. Acknowledge that you don’t fully understand or appreciate what she is experiencing, but communicate that you want to understand. Then listen to her. Many men have a tendency to want to try to problem-solve or find a solution, but many women feel that they just need the opportunity to express what they are feeling. Being overly positive (e.g., “don’t worry, next time I know things will work out”) may feel invalidating to her. Ask her what you can do that would be helpful. We all cope in different ways and need different types of support from our loved ones. Ask her what you may be inadvertently doing or saying that is unhelpful. Ensure that you are present for any appointments that she is attending with respect to managing her health post-miscarriage, and also in terms of appointments moving forward to investigate causes of the miscarriages. Although the rates of having one miscarriage are quite high (15-20 per cent, with the bulk of these miscarriages occurring within the first seven weeks of pregnancy), the rates do increase with previous number of miscarriages and concerns your wife may be having about the viability of future pregnancies may be a realistic yet also saddening or frightening thought. Many women may experience a grief reaction, where they go through a number of emotional stages before they get to a stage of acceptance. These stages may include: denial that the loss has occurred; anger at having to deal with multiple losses; bargaining for the situation to be different; and sadness or depression. Keep in mind that you may be also experiencing your own emotional reactions to this, and ensure that you are getting the support you need as well. A number of factors impact the manner in which a woman copes with pregnancy loss: how early in the pregnancy the miscarriage occurs; the woman’s age; whether there are previous children; and the number of previous losses. These factors impact the bond a woman starts to make with her child (which is qualitatively different and often much stronger than the bond a father makes in early stages of pregnancy) and may amplify other worries, concerns or anxieties the woman has both about her fertility and the viability of having another child. At some point you both may benefit from speaking to a mental health professional, who can address if she is experiencing any clinical levels of depression or anxiety. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. |
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