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Managing Suicidal Thoughts: How to prevent them in the future

20/2/2025

 
By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth
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Managing Suicidal Thoughts: How to prevent them in the future
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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
  1. Problem-solve: It is always helpful to think of ways other than suicide that you can solve your problems. First, make a list of all the problems you are dealing within your life. Second, make a list of all the solutions you can think of for those problems. You can ask someone you trust to help you with this. Dealing with 1 or 2 small problems can help to put an end to immediate feelings of suicide. Once you are thinking more clearly, you can tackle other bigger problems. You can find worksheets on Problem-Solving and Healthy Thinking in the Antidepressant Skills Workbook. 
  2. Think of reasons for living: Most people who think about suicide want to escape their pain, but they do not always want to die. When you feel low, it’s easy to stay focused on things that are negative and upsetting in your life. This makes it easy to think of suicide as the only option. Start thinking about some reasons you have for living. For example, many people have relationships with loved ones, pets they love, religion, goals, and dreams, or responsibilities to others in their life that give them reasons to live and prevent them from acting on their suicidal thoughts. Think of all of the reasons you have for living. Write them down. Remind yourself of them when you are feeling low.
  3. Remember things that have helped in the past: Many people have had thoughts of suicide before. Think of some of the things that helped you feel better when you faced the same types of problems in the past. Some examples are: having faith and trust that time always helps; reaching out to friends and family; seeing a professional; going to a support group; following a safety plan; doing something you enjoy; not being alone; keeping a journal; or not drinking or using drugs. 
  4. Talk to a trusted friend, family member, or professional: It is important to speak to someone you trust about how you feel. Sometimes just talking about how you feel can help. It is important to be open about all of your thoughts. If you have a suicide plan, it is important to tell someone what your plan is. People often say they are relieved that they shared how they felt with someone. Talking can help you feel less alone. 
  5. Do the opposite of how you feel: When you have thoughts of suicide, it can be helpful to do the opposite of how you feel. For example, when people feel depressed they usually want to be alone. Doing the opposite, for example getting in touch with others, can help with feelings of depression.

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: 
  • Eat a healthy diet
  • Get some exercise every day
  • Get a good night’s sleep
  • Decrease or stop using alcohol or drugs, as these can make feelings of depression and suicide worse 

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: 
  • Wake up at a regular time
  • Have a regular bedtime
  • Have planned activities in your day, such as going for a walk or going to the gym
  • Continue to go to work or school


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.

How do I rein in my obsessive thoughts?

16/1/2025

 
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.

Men's Experiences with Everyday Personal and Workplace Stress

14/11/2024

 
By Dominic Brennan, RCC
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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! 
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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!

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Reducing or Eliminating Psychiatric Medications

31/10/2024

 
By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth
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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:
  • Genetic predisposition
  • Early childhood experiences
  • Life events
  • Personality
  • Current stressors
  • Existing social supports

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.
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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.

Are these 'baby blues' normal? I feel so overwhelmed

5/9/2024

 
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.

The Power of 5 Minutes

15/8/2024

 
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.
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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?”​

Box Breathing for Stress: Techniques, Benefits and Tips

25/7/2024

 
By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth
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Box Breathing for Stress

Stress is something we all experience to varying degrees, at various points in our day-to-day lives. When stress becomes unmanageable or our ‘fight or flight’ stress response is triggered, breathing techniques can help calm us, and help us make more rational and conscious decisions. Box breathing can work in high-stress situations by returning breathing to its normal rhythm. So, let’s learn how to use Box breathing for stress.

Why practice breathing exercises?

Practicing simple breathing exercises daily can help to not only manage your overall mood, stress levels and improve your focus – but this practice can help to prepare your body for higher stress situations so that you can preventatively cope in a more effective way. An added bonus is that breathing exercises are easy, can be done almost anywhere and don’t have to take more than five minutes. 

What is box breathing?

Box breathing gets its name because there are four parts – like the 4 sides of a box. One full cycle through the 4 parts takes less than thirty seconds, but it’s recommended to practice for a minimum of three to five minutes. 

Why does box breathing work? And why is it important?

Stress triggers our fight-or-flight response, and when this response is triggered, we tend to shallow breathe.

But 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.

Box Breathing Technique – Here are the steps:
  1. Slowly exhale: sit or stand upright, and slowly, to a count of four, exhale through your mouth, pushing all of the oxygen out of your lungs. 
  2. Hold for a count of 4.
  3. Slowly inhale: with a controlled and slow place, slowly and deeply inhale through your nose to a count of four.
  4. Hold for a count of 4: for another slow count of four, hold your breath. Paying attention to not clamping your nose or mouth shut or increasing tension in your body can help. 

Then, repeat!

You may at first find the practice challenging: don’t give up! Instead, reduce the count to three seconds and continue to practice. Once you’ve become more experienced with this practice you may be able to increase the count to six seconds or more, but start small.

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How can I stave off panic attacks

13/6/2024

 
By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth
The question:

I recently had a panic attack for the first time, after a period of severe stress. It’s only happened once but now I’m worried that it could happen again. Do you have any tips on coping with panic attacks? How do I fight off stress so that it doesn’t get to that point?
 
The answer:
 
A panic (or anxiety) attack can be one of the most terrifying events a person can experience. These attacks are associated with a number of emotional and behavioural symptoms that may include:
 
  • Overwhelming fear
  • Rapid heartbeat and increased breathing rate
  • Chest pain/discomfort
  • Sweating and shaking
  • Dizziness/lightheadness
  • A feeling that you can’t get enough air
  • Feelings that you are losing control or “going crazy”
 
There are effective steps you can take to help shorten the length and intensity of a panic attack, and in some cases prevent it from happening at all.
 
First, make sure that what you are having is in fact a panic attack and not some other physical health issue, such as a thyroid or heart problem. Speak to your family doctor about your symptoms.
 
Once you know that what you’re experiencing is a true panic attack, the most effective approach is to first reduce your general stress and then identify and challenge anxiety-provoking thoughts.
 
Start by listing all the things you feel some stress about right now. Organize these by common areas of your life:
  • Work stressors
  • Conflict in important relationships
  • Child-related stressors
  • Financial concerns
  • Health problems
 
Once you have this list, ask yourself what you can do about each of these problems. Think about all of the possible solutions (remember, you are just brainstorming, so list every possible solution). Write down the pros and cons of each solution, then choose (and take!) some action. Taking action will help reduce your stress.
 
When you are feeling anxious, it can be helpful to pay attention to your thoughts and ask yourself, “What specifically am I predicting will happen?” In the midst of a panic attack, people tend to have exaggerated, unrealistic thoughts. Challenging this faulty way of thinking can help tremendously.
 
You may, for example, have the fear that you will pass out. Ask yourself how likely this is to happen, how often it has actually happened in the past year and if it were to actually happen, how would you deal with it. Asking yourself these questions when you start to feel a panic attack coming on can help reduce the intensity of that attack.
 
One of the most effective treatments for panic attacks is cognitive-behavioural therapy (CBT), typically delivered by a clinical psychologist. Most people experience significant improvement from eight to 12 sessions of CBT. Contact your provincial psychological association and ask for a list of registered psychologists with expertise in CBT.

Causes of Suicidal Thoughts: Helping You Better Understand Your Suicidal Thoughts

14/3/2024

 
By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth
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Helping You Better Understand Your Suicidal Thoughts

Some problems and experiences, especially those that have been around for a long time, can leave you feeling hopeless and overwhelmed. At these times, you may think that you have no options left. You may think about suicide as a way to escape intense emotional pain. There are many potential causes of suicidal thoughts and it can be helpful to better understand your suicidal thoughts in order to work toward managing and preventing them. 

People who consider suicide as an option often think that their problems are unbearable and can’t be fixed. They feel like nothing they have tried has or will change their situation. Their emotional pain can distort thinking so it becomes harder to trust, or to see possible solutions to problems, or to connect with available love and support.
Even if it seems that you can’t stand another minute, it is important to remember that feelings (e.g., grief, anger, sadness, loneliness, shame), especially at this intense level, don’t last forever. Sometimes thoughts of suicide can become very strong, especially if you have taken drugs or alcohol. It is important to not use nonprescription drugs or alcohol, particularly when you feel hopeless or are thinking about suicide. 

Some of the thoughts you may be having are: 
  • Believing there are no other options.
  • Sensing your family or friends would be better off without you.
  • Thinking you’ve done something so horrible that suicide is the only option.
  • Wanting to escape your suffering.
  • Experiencing unbearable pain that feels like it will go on forever.
  • Wanting to let your loved ones know how much you hurt. 
  • Wanting to hurt or get revenge on others. 

Your feelings of pain are very real. However, it is important to know that there is hope. 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. 
Hurting or killing yourself are not your only options. Professionals can help you learn new skills for dealing with your pain. These might include: developing new skills to cope; seeing your problems in a new light; improving your ability to handle intense and painful emotions; improving your relationships; increasing your social supports; or medications. 

Causes of Suicidal Thoughts 

There are a number of potential causes of suicidal thoughts and you are not wrong or weak for feeling them. But the better you understand where your suicidal thoughts are coming from the better you are able to manage those feelings, Some of the potential causes of suicidal thoughts are:
  1. Mental health problems: Some mental health problems, such as depression or anxiety, can increase feelings of suicide. Mental health problems are treatable. It is important to talk to your doctor if you feel low, depressed, or anxious. Counselling or medication may help, consider signing up for a free consultation with the Psychological Health & Safety Clinic.
  2. Conflict with loved ones: You may feel family or friends would be better off without you. It’s important to remember that conflict with others doesn’t last forever. Ending your life is not a way to solve that conflict. We know that people who lose a loved one to suicide say that their lives are not better off. 
  3. Loss: Many different types of loss can increase the chances of feeling suicidal. Some examples include: a break-up; losing a job; losing social status; or losing a loved one or friend. Also, knowing someone who has died by suicide can increase the chance of thinking of suicide as an option. As difficult as your loss may seem, there are people and services that can help you get through difficult times, such as the BC Bereavement Helpline (1-877-779-2223).
  4. Medical problems: Medical problems such as diabetes, thyroid problems, chronic pain, or multiple sclerosis can increase chances that you may think about suicide. Make sure you have proper medical care for health problems. Some medications can increase feelings of suicide. It is important to speak to your doctor about this. You can also get information by calling the BC Nurse Line (8-1-1) or the Living a Healthy Life with Chronic Conditions program (1-877-240-3941). 
  5. Sexual and gender identity issues: People who are lesbian, gay, bisexual, or transgender may have a higher risk of suicide. Uncertainty about sexual identity and fears of possible or real rejection from family or friends can make things worse. There is support available. Prideline (1-800-566-1170) is peer support and information phone line. Prideline is open 7 days a week, from 7:00 p.m. to 10:00 p.m.
  6. Financial/legal problems: Financial or legal problems, such as overwhelming debt, gambling problems, or problems with the law, can be very stressful. It is important to know there may be free services that can help you deal with financial or legal problems. These include the Credit Counselling Society (1-888-527-8999), the Problem Gambling Help Line (1-888-795-6111), or the Legal Services Society (1-866-577-2525). 
  7. Lack of connection to friends and others: Thoughts of suicide can increase if you spend a lot of time alone, or don’t feel you can tell anyone your problems. Talk to someone, like a professional, about ways you can increase social support in your life. You may feel the people that are in your life don’t understand the pain you are feeling. Talk to a professional about ways that you can let others know of the pain and unhappiness you are feeling. The Social Supports wellness module at www.heretohelp.bc.ca gives ideas for how to improve your social supports. 
  8. Drug and alcohol problems: Using alcohol or drugs can make feelings of depression, anxiety, and thoughts about suicide worse. Drugs and alcohol can change the way you think about problems in your life. If drugs or alcohol are causing your problems, you can get information on treatment from the BC Alcohol and Drug Information and Referral Service (1-800-663-1441).

Final Thoughts

As you can see, there are many potential causes of suicidal thoughts. These thoughts are normal and even though they seem unbearable at the moment they aren’t going to last forever and there is support available. Understanding your suicidal thoughts not only makes it easier to manage these feelings but also makes it easier to ask for help.  

If you or someone you love is at immediate risk, call 9-1-1.

What is Burnout

7/3/2024

 
By Darby Eakins, CBT Therapist and certified Psychological Health & Safety (PH&S) Advisor
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What is burnout?

While burnout is not officially recognized as a diagnosable mental illness, recent research (Koutsimani, 2019) suggests that even though it’s often associated with anxiety and depression, it appears to be a robust and stand-alone construct. The World Health Organization defines burnout as “a feeling of intense fatigue, loss of control, and an inability to produce concrete results at work.” 
Another definition indicates burnout is “a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress.” It’s always associated with work, and while it was initially reserved for those in caring roles (nurses, doctors, social workers and teachers), we now know that all workers can be exposed to burnout.
Folks with burnout will often meet the criteria for depression and/or anxiety, and some will even meet the criteria for PTSD. In my case, I met the criteria for all three. But with the context of work removed or the organizational issues remedied, most folks will recover.

Burnout Risk Factors & Facts
  • No one is immune to burnout, and it equally affects men and women.
  • No age group appears to be at higher risk than another.
  • 1 in 4 Canadian workers report being stressed, 60% of these say that work is the source of their stress.
  • There is no clear understanding of exactly what conditions lead to burnout, except that all workers who experience burnout have been experiencing chronic stress, and it arises out of workplace factors as well as personal factors.
  • Burnout is more than an individual issue, and research shows that a combination of individual and systemic factors lead to burnout.  
  • Organizational risk factors include: work overload, lack of autonomy, inability for individuals to participate in decisions that impact their work, an imbalance between perceived efforts made and the recognition received (salary, esteem, respect, etc.), poorly defined responsibilities, insufficient communication, ambiguous roles, unhealthy atmosphere, difficult schedules.
  • Individual factors that put someone at higher risk of burnout include: having high expectations of oneself, making work the sole focus of one’s life, perfectionistic perspectives, having a heightened professional conscience, not knowing how to delegate, personal factors such as family responsibilities or loneliness.


Burnout and the National Psychological Safety Standard

The National Psychological Safety Standard (The Standard) defines a psychologically healthy and safe workplace as “a workplace that promotes workers’ psychological well-being and actively works to prevent harm to worker psychological health, including in negligent, reckless or intentional ways.” (National Standard of Canada for Psychological Health and Safety in the Workplace (CAN/CSA-Z1003-13/BNQ9700- 803/2013) 

The Standard outlines 13 risk factors for psychological safety at work: 
  1. Organizational Culture: Employees hold common norms, values, beliefs, meanings, and expectations. They are then used as behavioural and problem-solving cues.
  2. Psychological and Social Support: Approaches, services and benefits addressing worker mental health.
  3. Clear Leadership and Expectations: Workers know what they are expected to do through effective leadership; changes are shared in a timely manner; helpful feedback is provided on expected and actual performance; and the organizations provide clear, effective communication.
  4. Civility and Respect: People treat each other fairly and with respect.
  5. Psychological Demands: There is a good fit between employees’ interpersonal and emotional competencies and the requirements of the position they hold.
  6. Growth and Development: Workers receive encouragement and support in the development of their interpersonal, emotional, and job skills.
  7. Recognition and Reward: Immediate supervisor appreciates work; staff are paid fairly for work done; accomplishments are celebrated; and, worker’s commitment and passion for their work is valued.
  8. Involvement and Influence: Workers are included in discussions about how their work is done and involved in important decisions that impact their role.
  9. Workload Management: Assigned responsibilities can be accomplished successfully within the time available.
  10. Engagement: Workers enjoy their job and are proud to be a part of the success of the organization.
  11. Balance: A work environment where there is acceptance of the need for a sense of harmony between the demands of personal life, family, and work.
  12. Psychological Protection: The organization deals effectively with situations that can threaten or harm workers (including bullying and harassment).
  13. Protection of Physical Safety: Worker’s psychological and physical safety is protected from hazards and risks related to the work’s physical work environment.

A lack of effective risk mitigation strategies and psychological safety-enhancing strategies across most of the above factors can contribute to burnout risks. In particular: clear leadership and expectations, psychological demands, growth and development, recognition and reward, involvement and influence, workload management and balance are some of the most likely areas of organizational risk associated with burnout.

Preventing and Recovering from Burnout

Burnout does not happen overnight. It is insidious and creeps in over time. Symptoms that may arise include: fatigue, pain, digestive problems, stomach ulcers, skin problems, disrupted sleep, weight loss or gain, frequent illnesses, constant loss of motivation with regard to work, detachment from work, pronounced irritability, spontaneous anger, feelings of incompetence, inefficiency and exhaustion, a desire to isolate oneself, a feeling of failure, a drop in self-confidence, anxiety, worry, insecurity, difficulty concentrating, loss of memory, difficulty in using good judgement, indecision, confusion, and in the most serious cases, suicidal thoughts.

Preventing Burnout

From a prevention perspective, it’s important to notice the flags and risks of burnout to mitigate them in yourself:
  • Pay attention to changes, such as sleep disturbances or increased irritability
  • When you notice flags, pause and reflect on what has become out of balance for you and implement strategies to get back on track: 
    • good sleep hygiene
    • exercise
    • healthy nutrition
    • activities outside of work that bring you joy
  • If you are noticing systemic issues contributing to your burnout (i.e., unreasonable workload), talk with your leader early on to seek support in prioritizing and managing workload.  Ask about mentorship or coaching opportunities.
  • Take breaks – leave your workspace and change your environment during a break.
  • Set boundaries – do this with emails and phone calls outside of work hours.

Recovering from Burnout 

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From a recovery perspective, it’s important to navigate to resources for support: 
  • Seek support from a qualified psychotherapist (counsellor or psychologist) to help you recover and realign.
  • Find out about your work’s supports such as Employee Family Assistance Programs and Disability Management supports.
  • Understand your extended health benefits and utilize them.
  • Talk with your doctor about your burnout, and participate in medical interventions as needed.
  • Take time away or reduce your work schedule, if possible and/or needed.
  • Gradually return to work if you take a leave, and implement your new strategies to manage your health and wellness at work in a balanced way.
  • Understand that burnout is something that happened to you, not something you did, and recovery is within your power to achieve.
  • If you need to, and are able, consider changing jobs or companies if you are not supported to being healthy and well while at work.
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Dr. Joti Samra is a Founding Member of the CSA Technical Committee that developed the CSA National Standard for Psychological Health & Safety in the Workplace and informed the ISO standard
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