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By Emory Oakley. Emory is a writer and LGBTQ+ educator who regularly discusses the intersections of queer identities and mental health. On the morning of February 1st, my mother would smile and like a giddy teenager as she lined up the cereal boxes and state: “it’s only twenty-seven days until my birthday.” As if we hadn’t performed this ritual for as long as we could remember. She was always enthusiastic to celebrate regardless of whether or not she had an actual birthday that year. In reality, the entire last week of the month was all about her. Of course, the leap years were the biggest, but every other year was almost the same. Since there was no actual day to celebrate, “why not celebrate on February 28th and March 1st?” You might think this would be incredibly annoying, and while it was to some extent, it was impossible to be annoyed for long.
A lot of things from my childhood have been forgotten but not those birthday celebrations. I couldn’t tell you which events happened which year or what years were the biggest parties, but I do remember my mother’s enthusiasm. And everyone would have said she was the life of the party. She would inevitably be found in the kitchen – wine glass in hand, small ice cubes clinking against the glass as she danced lazy circles around the furniture or other party-goers. If you could really call what she did dancing. When she really got into it she would do this thing that can only be described as a jump-shuffle-dance. With her feet together, knees bent and ass sticking out, she shuffled backwards, sort of like a reverse bunny hop or maybe a two-footed moonwalk. It was impossible not to watch her when she danced, not only because it was quite funny to watch, but the way her face shone with joy demanded attention. When Everything Changed My mother died just before I turned eighteen years old and three weeks after I graduated from high school. That was more than ten years ago now, but as February 29th approaches I feel heavy. It’s a heaviness that even now as I write this I am having a difficult time describing. It feels almost like something’s missing in my life but not in a way that feels tangible to me. This is because my mother has never been a part of my adult life. Since graduating from high school I’ve come out as queer and transgender. I’ve legally changed my name and have grown into an entirely different version of myself. One that my mother never got to meet. So, while she’s missing from my life now and that burdens my heart significantly, I also don’t know what her being in my life would look like anymore. This is a completely different type of sadness. Does grief last ten years or more?For the last handful of years, I had a hard time describing the feelings I’ve had about my mother as grief. The way I feel now feels nothing like the first few years did. My mother had been sick for a long time before she died and I was lucky enough to have the opportunity to say goodbye. Unfortunately, these things did little to actually prepare me for her absence. The last year, maybe more, was spent making trips back and forth from the hospital. Picking mom up and bringing her home for dinner, or for weekend visits, when she was healthy enough. Then suddenly everything changed. My family home turned into nothing more than a few two by fours and a roof- a place to sleep and eat but it no longer felt like a home. That first year, grief pooled under my tongue, it felt like I couldn’t speak or swallow. I became well acquainted with the feeling of tears welling in my cheekbones, learned to lock jaw keep them out when I could. I told myself to be strong. That my younger sibling needed me to be strong. But as I look back now I realize how much this prevented me from healing. I needed to feel my feelings in order to let them go. Everything was a challenge that year and it felt like I was doing everything alone. The first Christmas felt hollow, I didn’t want to celebrate as there was no reason to anymore, and when we got to the first February I was barely able to function. I somehow managed to maintain my grades in university and show up at work but I was just going through the motions. Doing just enough to exist but nothing more. The First Leap Year The first leap year was 2012, almost three years after my mother passed. I was twenty years old and by then I felt like things had changed, that I’d grown up enough. I was able to look back on the amazing things about my mother and smile rather than just seeing hospital beds and blue gowns. But something about that February broke me open. I felt the hole in my life again and I was completely unprepared to deal with it. The Second Leap Year The next leap year was 2016, and this time everything was different. I’d come out as queer, been through years of therapy and was coming to terms with my gender identity. This time I felt like a new person. It had been years since grief had taken hold of me and I finally felt like I was figuring out how to be an adult. But when February rolled around I felt guilty. It felt like I was forgetting and that made me feel nauseous. It took more effort than I would have liked to conjure the image of my mothers’ smile and I could barely remember the sound of her laughter. It felt like everything was fading and I spent weeks angry at myself for letting go. I didn’t want to forget but I also didn’t want to cling to the sadness that had burdened me so significantly years before. So, I made the decision to write. I’ve been a writer for as long as I can remember, and there is something cathartic about having a place to put your feelings outside of yourself. But this time instead of writing into the sadness – I chose another path. That month I created a chapbook of poems that I titled Unsent Letters. It contained eight poems written as if they were letters to my mother describing my life and how things had changed. In those poems, I was able to come out to her and tell her I wasn’t her little girl anymore. It provided me with healing I never could have anticipated. Of course, I wish I could have spoken those words to her and that she could have met this version of me, but it was the closest I was ever going to get. Grief After 10 Years Now, things continue to change when it comes to my grief. I have casual depression. I call it casual because it doesn’t have a significant impact on my day-to-day functions, but it does make me feel lethargic and heavy some days. And I often feel a weight of sadness that is not caused by anything I can put my finger on. My depression gets worse in the cold, grey winter months or maybe it’s just harder for me to manage in the darkness. But in February, even though the clouds are lifting in Vancouver and the sun is starting to shine, I feel heavy. Sort of like I imagine a knight would feel in plated armour, my motions are slower and where I place my energy has to be more calculated. I tire sooner and I feel like I am not able to do as much and I dislike feeling that way. But it doesn’t feel like sadness. So today I remind myself that sadness does not always show up as tears. That my sadness over losing my mother has changed from a deep sense of grief into a vague sense of emptiness and longing. Both of these feelings are valid and have been a significant part of my process. But dealing with grief is never easy, so let’s talk about grief in a more practical way – and what we can do to manage it best we can. What is grief? And how does it change over time?Grief is a natural response to loss. It’s the emotional suffering a person feels when something or someone they love is taken away. It’s common to experience all kinds of difficult and unexpected emotions, from shock or anger to disbelief, guilt, and profound sadness. The pain of grief can also disrupt our physical health, making it difficult to sleep, eat, or even think straight. These are normal reactions to loss – and the more significant the loss, the more intense the grief will be. The most important thing to know about grief is that there is no one way to grieve. And there certainly isn’t a benchmark for what is normal when it comes to grieving. As time passes, the loss doesn’t disappear completely and it probably never will but it changes. How to manage grief Most of us have probably heard of the stages of grief; denial, anger, bargaining, depression and acceptance. While many people do experience these, calling them stages can be problematic for many. Grief is not something neat and tidy – and it is rare for anyone to experience these ‘stages’ in sequential order and in the way that they’re described to us. So, don’t worry so much about the stages or what you ‘should’ or ‘shouldn’t’ be feeling when it comes to grief. My thoughts on dealing with grief I have learned a lot about the grieving process over the years and here is what I think about how to manage grief.
Final Thoughts Remember that grief looks different for everyone and despite the fact that we are only given a short amount of time off work for grieving, that does not mean the grieving process is or should be over at the end of that allotted time. The first year is going to be the hardest because you have an entire year of first experiences without that person. If you are dealing with grief, no matter what stage you’re at or how much time has passed, and you need support- reach out. Sign up today for a no-commitment referral with a therapist at Dr. Joti Samra & Associates. By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth The question:
When is retail therapy unhealthy? The answer: “Retail therapy” is a tongue-in-cheek term we tend to use (especially us women) to refer to shopping behaviour that has the primary aim of improving our emotional state. Getting something new that we like can naturally make us feel good – particularly when it is something that may contribute to enhancing our self-esteem or confidence, such as clothes, shoes or makeup. The natural little high that comes along with this is very normal and for the majority of people will not become problematic. But some people may find that they have an urge to shop when they are sad, depressed, anxious or even angry. Although this can lead to a temporary lift in mood, often our decision-making is poor when we are experiencing negative emotions and we may make choices we later regret. There are three key questions to ask yourself to determine whether your shopping behaviour is unhealthy: 1. Do you get the urge to shop particularly when you are experiencing negative emotions? 2. Do you find it difficult to resist the urge to shop during these times? 3. Is your behaviour resulting in negative results effects (e.g., are you getting yourself into financial debt; do you feel guilty afterward; is it creating conflict with your partner)? If you answer yes to one or more of these questions, you are likely engaging in shopping behaviour that is unhealthy. There are a few things that you can do to work on this. First, articulate the negative effects of your behaviour. Write them down and be specific. Put this list somewhere visible. Second, identify which particular moods tend to increase the likelihood that you will engage in “retail therapy.” Work to regulate these negative emotions. Seek treatment for underlying mood issues if these have been unaddressed. Try instead different activities that will intrinsically improve your mood, such as visiting with a friend or going for a walk. Third, Third, consider what environmental triggers urge you to shop (e.g., a fight with your partner, a bad day at work). Work on a solution to these situations because targeting the underlying cause will be more effective than focusing strictly on the shopping behaviour. Fourth, put a price to your behaviour. What is this costing you on a monthly basis? And how is that interfering with other short- and long-term financial goals you have? Finally, make a commitment to change your behaviour. Be specific about what you are going to do. And start immediately. 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  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 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  Managing Suicidal Thoughts: How to prevent them in the future
Suicidal ideation, plans and attempts are common: conservatively, 1 out of 10 adults will consider suicide as an option at some point in their life. Despite how common suicide thoughts are, there are effective, evidence-based approaches to managing suicidal thoughts and reducing their frequency in the future. Managing Suicidal Thoughts
Preventing Suicidal Thoughts But, what can we do to decrease the chances of feeling suicidal in the future? 1 - Get treatment for mental health problems: It is important to get treatment for depression, anxiety, and alcohol and drug problems. Just seeing your family doctor may not be enough. It can help to see a mental health specialist, such as a psychologist or a psychiatrist. You can get referrals from your doctor or learn how to find a specialist from one of the referral lines listed on the last page. If you are already receiving treatment, speak up if your treatment plan is not working. 2 - Identify high-risk triggers or situations: Think about the situations or factors that increase your feelings of despair and thoughts of suicide. Work to avoid those situations. For example, going to a bar and drinking with friends may increase feelings of depression. If this is a trigger for you, avoid going to a bar or seeing friends who drink. 3 - Self-care: Taking good care of yourself is important to feel better. It is important to do the following:
4 - Follow through with prescribed medications: If you take prescription medications, it is important to make sure you take them as your doctor directed. Speak to your doctor if medications aren’t working or if side effects are causing you problems. If you have just begun taking antidepressants, it is important to know that the symptoms of depression resolve at different rates. Physical symptoms such as energy or sleep may improve first. Improvement in mood may be delayed. Speak to your doctor if you are feeling worse. 5 - Structure and routine: Keep a regular routine as much as possible, even when your feelings seem out of control. Here are some tips for creating structure in your life:
6 - Do things you enjoy: When you are feeling very low, do an activity you enjoy. You may find that very few things bring you pleasure. Think of things you used to enjoy doing at times you didn’t feel so depressed or suicidal. Do these things, even if they don’t bring you enjoyment right now. Giving yourself a break from suicidal thoughts can help, even if it’s for a short time. 7 - Think of personal goals: Think of personal goals you have for yourself, or that you’ve had in the past. Some examples are: to read a particular book; travel; get a pet; move to another place; learn a new hobby; volunteer; go back to school; or start a family. Final Thoughts If you’ve been feeling suicidal know that you’re not alone. And just because you’ve felt suicidal doesn’t mean those thoughts will last forever. Taking small steps toward improving your mental wellness can help to prevent suicidal thoughts from returning. And remember there is help if you need it. 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 find that when something’s bothering me (such as something my brother-in-law says or slacker behaviour by a co-worker) I get really fixated on it and keep turning it over and over in my head. How do I move my mind off it and stop obsessing? The answer: Spending more time than usual thinking about situations that are upsetting or annoying is a very natural human reaction. Rumination (repetitive, obsessive thoughts) and the associated emotional responses (worry, anxiety, anger) serve a useful function. The function of virtually every emotional state is threefold: (1) to validate to ourselves that something is happening that affects something important to us; (2) to communicate to others that we need support or that their behaviour has been inappropriate; (3) and to motivate action. So let’s take a look at the situation relating to your “slacker” co-worker. Your obsessive thoughts (and the associated emotions) may be functioning in the following way: (1) to validate to yourself that you value a strong work ethic and take pride in your work, and you do not respect people who do not hold this same view; (2) your behaviour at work (intentionally or not) may be communicating to your boss that you need him or her to intervene, or you may be communicating to your co-worker that his or her behaviour is unacceptable because it affects your ability to do your job well; (3) it may motivate you toward the action of approaching your boss or another co-worker to seek advice, or to talk directly to the co-worker in question about his or her behaviour and how it is affecting you. An important question to ask yourself is this: Is your rumination serving any of the above useful functions. If so, your job is to understand the function it is serving, and then ask yourself if there anything you can do about it. If yes, take the appropriate action. If no, then your job is to find a way to move on. There are a few strategies that can help. First, increase your awareness to the thoughts you are having (we can’t change thoughts unless we are aware that we are having them in the first place). Then write down your thoughts. It is amazing how powerful thoughts can become when we are caught in the trap of silent rumination. Putting those thoughts on paper is a technique that can help take their power away. Once you have written your thoughts down, ask yourself if the thoughts are realistic and accurate. For example, if you have the thought “my co-worker is a total good-for-nothing and can never do anything right” this is likely not fully realistic nor accurate. For any unrealistic or inaccurate thoughts, come up with more realistic ones (e.g., “my co-worker has not pulled his or her weight on this big project, but generally does a decent job when assigned tasks”). Then actively remind yourself to challenge and replace your negative, extreme thoughts. This takes practice, but over time your mood will improve and the ruminative thoughts will decrease. Excerpted from Dr. Joti Samra’s “Ask the Psychologist” weekly column in The Globe and Mail. By Dominic Brennan, RCC  Everyday personal and workplace stress. The choice is yours!
I was wondering the other day if my everyday personal and workplace stress could talk to me, what it would say? But I guess, if I’m under stress, I wouldn’t take the time to listen. I’m a closed system, I’m a man and I’m probably the victim here! It’s got nothing to do with me! If only everyone knew what I was going through! I’m smart and I have got it together, they don’t! That’s how we mostly cope with stress, I guess, and it gets us through but at a cost, sometimes a very high cost. It wrecks our work, our personal life and ultimately our own health and well-being. It can even be fatal or lead to incarceration by doing something we regret. The stress emotions take over. It happens every day, globally and it’s not culture-bound. Hello and welcome to my first blog. My name is Dominic Brennan and I am a Registered Clinical Counsellor with Dr. Joti Samra, R.Psych & Associates. I’m hoping I can connect with men through my blogs. With this quick read, I aim to bring awareness to various issues men face. My Experience with Stress Myself, having risen through the corporate ranks to senior positions, where I was in charge of thousands of employees and managing billions of dollars worth of assets, I experienced a lot of workplace-related stress. Then I switched careers into mental health and wellness, and that along with a cross-culture marriage and raising two children motivates me to work with men on issues surrounding mental health and wellness. I feel it’s the time to support men on their journey, as, without mentors, coaches, and the willingness to listen, I would not be where I am today. Not without stress, but managing it so that it works for me in a healthy way. Let’s go back to the first thought about what my stress would say if it could talk to me. Dominic, if only they knew what I was going through! Why can’t they think like me! They have no idea what they’re talking about! Look at them! I need to show how good I am! It’s my bosses that have no idea what they are talking about! Our clients are so unreasonable! My partner has no idea what I am doing for the family and our well-being! The kids and pets need too much from me sometimes! I wish my mates thought like me! I don’t need to talk to anyone about my issues as I’m fine! I can teach them a thing or two! What a bunch of cowards and weaklings they are! The list could probably go on. I’m sure I have missed many (unhelpful) self-talks! The Impacts of Stress When stress talks to us in these ways, it’s dominating and controlling us. Most of the negative things happening in our life can be underlined with the word stress. This type of stress, particularly when it’s ongoing, can lead to; angry outbursts and being argumentative, alcohol/ drug misuse, excessive worry and/or anxiety, overeating or undereating, disturbed sleep or insomnia, broken relationships at home and at work, physical pain, health conditions such as heart disease and cancer, and overall poor quality of life. This can lead to eternal unhappiness, grumpiness and resentment! When overly stressed and not managing it effectively we may get nasty; we get mad at things regardless of how small, we miss golden opportunities of career growth, miss the opportunity of having a loving relationship and family. As a result, we live with the hope that other people will see things the way we do which leads to huge amounts of frustration and banging our heads against the wall. Phew! That even stresses me out to think about. Time for a drink perhaps?!!! (Just kidding: of note, alcohol is not an effective coping response and often creates more issues than it solves.) Managing Personal and Workplace Stress Well, what can we do about it? The first thing is to go back to the first question raised. What would stress say to me and then ask what is stress doing in my life? For most of us, stress is having all the negative impacts on us mentioned above. It not only negatively impacts our mental wellness but our physical health as well. What we need is the skills to more effectively manage our stress as well as the opportunities to discuss our feelings. For us men, we often don’t want to hear from anyone that we need counselling, not from a loved one or from company human resources. We don’t want to hear that we need to talk to someone about our anxiety and/or stress or that we have to seek anger management support, mandated, or not. We have it together, we believe. And again, we are back to the closed system, that many men seem to be. Where do we men go from here? To be stress free! I feel most of the time counselling isn’t the right word for issues men face. Generally, I feel men simply need an open ear to process what’s going on in their lives. While also learning to let the person give food for thought, provide potential solutions and options for consideration, and perhaps some cognitive restructuring (that must be from a professional by the way). Opening up about challenges in our lives helps men manage their stress and reduce it to a level that doesn’t hurt us or those around us but rather lifts us up, and motivates us to see another way of doing things. Positives Associated with Opening Up The few men that aren’t closed systems, either naturally or have had the right support, tend to be leaders at work and in their families. They’re generally mentally healthy and resilient, they lift others up, they’re able to discuss experiences and roadblocks, they’re able to receive feedback, and find solutions from others about how to become what they want to become and be in a position of acceptance. Yes, we can live in the present and not be overly stressed about what’s happened in the past or what may happen in the future. Yes, we can get on with everyone if we want to and know how to. Some seem to have it all together naturally, and yet they still seek mentorship, feedback, coaching and support on their journey to keep them on track. Their success is a direct result of this support (they didn’t do it alone). We can all be more stress-free if we become less of a closed system and allow the spirit of “It’s Good to Talk!” into our lives. Final Thoughts Stress is a natural part of our lives both at home and at work. While a small amount of stress can be motivating, when we don’t effectively manage our stress or talk about our challenges, it can easily become overwhelming and damaging in our lives. For men, counselling may not be the most effective word when it comes to dealing with stress and other challenges they face but opening up can make a significant difference in all of our lives. The right professional is there to help you see there are choices on how we live our lives and if you’re interested in changing, they can help you make that change. The choice is yours! By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth  Psychiatric medications are one of the most commonly prescribed classes of medication. Every year, up to 1 out of 5 adults will be prescribed medications for mood and often end up taking them for the long-term. Medications can be helpful when symptoms of anxiety or depression – the most common mental health issues – are acute and severe. However, long-term use is often not required, needed or even recommended. If we are taking medications for mood, and as symptoms improve, it’s wise to consider whether ongoing use is needed – particularly given the unpleasant side effects. Any changes to medications should always be discussed with your physician, but it can be helpful to go into these conversations armed with information.
What causes anxiety and depression? For most people, the emergence of anxiety or depression symptoms is the result of a complex interplay of multiple factors, which include:
The way we think about the world (our thoughts) and the way we cope with stress (our actions and behaviours) also play an important role in whether – and to what degree – we will manifest the emotional state of depression. Although there is little empirical support that anxiety or depression are exclusively caused by a biochemical imbalance, biochemistry does play a role. The efficacy data on the use of antidepressants and anti-anxiety medications are also very clear: they are most effective and recommended when symptoms are moderate to severe – primarily to assist with improving what is called the vegetative (or physiological) symptoms that accompany anxiety and depression – such as sleep or changes in appetite. When symptoms are less intense, non-pharmacological interventions such as cognitive behavioural therapy (CBT) are recommended. Contrary to popular belief, long-term, permanent use of psychiatric medications is not recommended or even needed – and can lead to other side effects and problems. In fact, an extended duration of time during which mood is consistently stable, combined with significant changes in psychosocial circumstances and external stressors is often an indication that psychiatric medication use can be reduced, if not eliminated altogether. Safely reducing or eliminating medications If you feel that you are ready to reduce or eliminate the psychiatric medications that you are taking, here are three things to keep in mind before making any decisions on your own. Enlist the support of a mental health professional who can offer insights into the psychosocial factors that played a contributing or exacerbating role for you. They can also help build a relapse prevention plan – with a heavy focus on preventative strategies that can help you manage symptoms from a non-pharmacological perspective. Any reduction of medications should be done in close consultation with a physician so that the side effects of both the reduction in medication, as well as close monitoring of symptoms can be conducted. Then, if you decide that reducing the medication is the right next step for you, make sure to involve your partner or get the support of a close friend or family member. Having the support of another can help you to identify and manage any symptoms that emerge as a result of the tapering off process. Remember that not everyone is reliant on medications for their lifetime, but there is no shame if they are required. 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 just had a baby and despite support from my husband and family, I feel completely overwhelmed. My doctor says these “baby blues” are normal. Are they? The answer: Having a baby falls at the top of the list when it comes to major life stressors, and feeling completely overwhelmed after the birth of a baby is so very common. So rest assured that you are not alone in how you are feeling. Many women will feel low, down, sad or tearful after the birth of a baby. Up to three quarters of women will experience these “baby blues” that typically last a few days to a few weeks. This is a very normal response to a significant life change which does resolve over time. This can feel highly confusing and upsetting to moms, though, as feeling low seems to be so at odds with the joy and happiness that one expects should be associated with having a baby. The baby blues are attributable to a number of factors. First, there are significant hormonal changes that occur in the days following delivery (progesterone levels decrease significantly to allow milk production to begin). There is an adrenaline crash following birth. This, combined with sleep deprivation very understandably leads to changes in mood. In addition, the reality of having a baby and having full responsibility for another life can feel overwhelming and anxiety provoking. But these are very normal feelings and they will resolve. Speak to your nurse, midwife or family doctor. Attend a parenting group where you can get the support of other new moms, or speak to a trusted friend or family member that already has had a child. The majority of women will start to find their mood improves within a few days or weeks, as they start to get more sleep and as hormonal changes start to regulate. About 10 per cent of women, however, will go on to develop post-partum depression, which refers to clinical levels of depression following the birth of a baby. If you are experiencing pervasive sadness or loss of interest in your usual activities for more than a month after your baby’s birth, more often than not, and this is also associated with changes in your appetite, recurrent crying episodes, and anxiety or irritability, seek help. Speak to a health professional such as your nurse, midwife, or family doctor. A referral to a psychologist or psychiatrist may help. There are a number of risk factors that can increase the likelihood of post-partum depression: a family history of depression; your own previous history of depression; and lack of social supports. If at any point you consider harming yourself or your baby, seek immediate help by calling 911. 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 Recently, I heard a variant of the “don’t let a few seconds ruin your day” message that really resonated with me – it was about not letting 5 minutes ruin or taint the rest of your day. Now the message isn’t a new one, and it’s one I regularly teach – but something about this really clicked. I think it’s because I realized the day-to-day frustrations that have the potential to impact me do in actuality take up more than just a few seconds: a frustrating interaction with someone, a conversation about something upsetting, even spilling something on yourself as you head out the door already late. I think (most days!) I’m calm enough that it’s not just something that happens for a few seconds that has the potential to ruin my day – it’s something that takes up a decently substantive amount of bandwidth…up to 5 minutes.
This past week, I challenged myself to reflect on the power I gave 5 minutes. I had a frustrating interaction regarding an ongoing issue with a toxic family member – someone who has by all objective indices behaved and spoken in highly offensive and disrespectful ways, on many occasions, over the course of now several years. Unfortunately – as with many of our extended family members, simply removing them from our immediate presence doesn’t eliminate the insidious impact they can continue to have through their words and statements, and this individual’s behaviour continues to be tolerated, reinforced and enabled by others – and the ripple effect on my immediate family unit (my hubby and I) continues. I found myself, after another (new) trigger this past week, ruminating & repeating the multi-year history with this individual in my mind. While working, while cleaning the house, while eating – both inside my own head, and in my conversations with my other half. I then caught myself – I was allowing the 5 minutes of the new trigger to impact my entire day (‘days’ plural, in fact). The trigger was a new one – but it’s not the trigger that kept the momentum going. It was my repetition of all the litany of past things this individual has said and done, and the associated hopeless realization that I have zero ability to change it – and that the people who do have control have little to no interest in working to resolve or repair the situation. And so although the (5 minute) trigger, via a third party, was something I had zero control over – the rest of the hours of bandwidth and energy this person was taking up was only happening as I allowed it. So I made a firm commitment to allow myself to focus on the 5 minute trigger only – and exhausted thinking and venting about it – but vowed to become much more diligent with myself in not allowing the hamster wheel to give any more power than needed. Through the weekend I had to many times catch myself, but it’s amazing the freedom we can have once we can start to gain better, intentional control over where we allow our thoughts to go. This week I invite you to consider the following: Each time an annoying, irritating, frustrating, discouraging thing happens, pause and and ask yourself “how will I choose to let this 5 minutes impact the rest of my day?” |
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