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Mental Health & Survivorship

Mental Health & Survivorship. Joel Tourigny, Ph.D., C.Psych . Pediatric Psychologist. Presented by:. Outline. What are Mental Health Problems ? Anxiety Depression PTSD. What are we doing here… on planet Earth?. So we are adventuring…. What good are emotions anyway?.

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Mental Health & Survivorship

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  1. Mental Health & Survivorship Joel Tourigny, Ph.D., C.Psych. Pediatric Psychologist Presented by:

  2. Outline • What are Mental Health Problems? • Anxiety • Depression • PTSD

  3. What are we doing here… on planet Earth?

  4. So we are adventuring…

  5. What good are emotions anyway? • Emotions give us information • Emotions communicate to and influence others • Emotions motivate us and prepare us for action

  6. The Stats

  7. Canadians seeking help for MH

  8. Survivors seeking help for MH

  9. Serious MH event - Canada

  10. Serious MH event - Survivors

  11. Mental Health Issues: • Are experienced by half of us, • Touch the lives of most of us, • Are slightly more common in those who have experienced trauma and chronic illness. • Although they are serious, painful, and often require treatment… • … they are also an invitation to improve our lives

  12. Anxiety and Performance Performance Low Anxiety High

  13. Assessment: Normal vs. Pathological • Persistently interferes with Functioning? • OR: • Persistently causes significant Distress or Suffering? • THEN: Its time to seek professional help

  14. Common Signs of High Anxiety • Physical Symptoms • Panic attack • Anticipatory anxiety symptoms • Physical consequences of chronic anxiety • Worry • About past traumas • About people, humiliation, rejection • About every little thing • Avoidance • A place or situation that triggers anxiety • Social events, new situations • Situations one believes may trigger a panic attack

  15. Prevention:Day to Day Anxiety Regulation • For the Body: • Sleep, Eating, Exercise • Develop some soothing skills • For the Mind: • Start with ‘just noticing’ those troublesome thoughts • Develop that into a mindfulness practice • For the Urge to Avoid: • Avoid Avoidance (“Lean in”)

  16. Depression and Sadness • “It’s so difficult to describe depression to someone who’s never been there, because it’s not sadness. I know sadness. Sadness is to cry and to feel. But it’s that cold absence of feeling— that really hollowed-out feeling.” J.K. Rowling

  17. The Gift of Mental Illness • “Depression is Nature’s way of pushing you out of your comfort zone” (Lara Honos-Webb) • Healing from depression can mean: • Realizing and accepting your imperfect self • Experiencing more authentic (and challenging) emotions • Letting go of toxic beliefs or assumptions we have been carrying with us

  18. Depression Symptoms • Weight changes • Sleep problems • Agitated or Sloth-like • Fatigue • Guilt • Poor concentration • Dark thoughts • Depressed mood • Lack of pleasure

  19. Dealing with Depression • For the Body: • Sleep, Eating, Exercise • For the Mind: • Start with ‘just noticing’ those negative thoughts • Gently challenge the thoughts… are they fair? • Add in a practice of gratitude

  20. Dealing with Depression • For the emotions: • First, notice and accept feelings without judgement • Care for yourself with some simple soothing • For the situation you find yourself in: • Stay active and engaged by: • Accumulating positive experiences • Build Mastery • Cope ahead of time with planning

  21. Post-Traumatic Stress Disorder • Exposure to Trauma • Intrusive re-experiencing • Avoidance of Trauma cues • Depressive symptoms • Anxiety symptoms

  22. Complex Trauma • T TT • ttttttttttttttttttttttttttttttttt… • ttttttttttttt T tttttttttttttttt… • tttt T tttt T Ttttttt T tttt T TTtttttttt… • [ T ] - Shhhhhhhhhhhhh!

  23. A problem to solve: • How to soothe, when soothing is disrupted? • Provoke crises • Use Food, Sex, Drugs • Gambling, Screens • Self-Harm • Dissociate

  24. Anxiety and Depression Skills • For the Body: • Sleep, Eating, Exercise • For the Mind: • ‘Just noticing’ • Gently challenge • Gratitude • For the emotions: • No judgement • Soothing • For the situation: • Accumulating positive experiences • Build mastery • Cope ahead of time • For the Body: • Sleep, Eating, Exercise • Soothing • For the Mind: • ‘Just notice’ • Mindfulness • For Avoidance: • “Lean in”

  25. PTSD Treatment • Assess carefully • Stabilize • Process the Trauma • Integrating memories • Integrating parts • Generalize and Expand Life

  26. Mental Health Issues are: • Likely to touch your life at some point… • … but will not rule your life. • Can be aided with skills… • …and professional help. • Are a natural part of our adventures here on earth… • … and offer us a chance to build a better way of living.

  27. Resources for Anxiety • Websites: • https://anxietycanada.com/ • Books: • Coping with Anxiety and Panic Attacks, by Jordan Lee Rosen • Coping skills interventions for children and adolescents, by S. Foreman • Anxiety and Phobia workbook by Edmond Bourne • Apps: • “Headspace” app • “Calm” app

  28. Resources for Depression: • Online: • Dealing with Depression Workbook (Google “Dealing with depression workbook” and look for the PDF • Books: • Mind over Mood by Padesky • DBT workbook by Mckay, Wood, Brantley • Adolescent Depression: A Guide for Parents, by Francis Mark Mondimore • Bipolar Disorder: A Guide for Patients and Families, by Francis Mark Mondimore • The Depression Workbook: A Guide for Living with Depression and Manic Depression, by M. A. Copeland

  29. Adult Mental Health Centers • In hospital services • Varies by hospital and by clinic • Family physician referral to psychiatry in community • Waitlists and availability can be an issue • Social and Support Organizations for Cancer Survivors • Wellspring at www.wellspring.ca • Wellspring is a network of community-based support centres offering programs and services that meet the emotional, social, practical and restorative needs of people living with cancer and those who care for them… free of charge.” • Gilda’s club of Greater Toronto at www.gildasclubtoronto.org

  30. Adult Mental Health Centers • Public mental health: • Child and Youth MH agencies that cover young adults • Some agencies see youth up to 21, 25, or 26 years. • Search for agencies at www.cmho.org • CMHA’s “Quick Guide to Mental Health Resources Serving Toronto” • http://www.uhn.ca/healthcareprofessionals/SCOPE/Referrals/Toronto_Mental_Health_Resources.pdf • CMHA has other resources listed in various ways by region • Family Navigation Project through Sunnybrook Health Sciences Centre • https://sunnybrook.ca/content/?page=family-navigation-project • For youth 13-26 and their families who live in the GTA • “Using a combination of clinical and lived experience, we collaborate with families and their youth with mental health and/or addiction issues to understand their unique needs and match them with supports and services to enhance their health and family functioning.”

  31. Mental Health Centers • Public Mental Health (cont): • CAMH • www.camh.ca, intake: 416-535-8501, press 2 • Addictions services are self-referral • Mental Health Services are physician or NP referral • DBT program opens its waitlist every few months, check the website for the next opening • Private Mental Health • Recommend a professional with a regulatory college (psychologist, social worker). The following sites only link the public with professionals who are members of the association in question: • Ontario Psychological Association http://www.psych.on.ca/Utilities/Find-a-psychologist.aspx • Ontario Association of Social Workers: http://www.findasocialworker.ca/ON/en/default.asp

  32. Mental Health Centers • Distress Lines: • Mental Health Helpline: • www.mentalhealthhelpline.ca • 1-866-531-2600 • Assaulted Women’s Helpline: • http://www.awhl.org/ • Phone: GTA- 416.863.0511 & toll free: 1.866.863.0511 

  33. References • Bandelow, B., & Michaelis, S. (2015). Epidemiology of anxiety disorders in the 21st century. Dialogues in clinical neuroscience, 17(3), 327–335. • Remes, O., Brayne, C., & Lafortune, L. (2014). The prevalence of anxiety disorders across the life course: a systematic review of reviews. The lancet, 384, s66. • Knoll, A. D., & MacLennan, R. N. (2017). Prevalence and correlates of depression in Canada: Findings from the Canadian Community Health Survey. Canadian Psychology/Psychologiecanadienne, 58(2), 116-123. • Amerigen, M., Mancini, C., Patterson, B., & Boyle, M. (2008). Post-traumatic stress disorder in Canada. CNS Neuroscience & Theraeutics, 14(3), 171-181. • Nathan, P., et al. (2018). Adverse mental health outcomes in a population based cohort of survivors of childhood cancer. Cancer, 12(4), 2045-57. • CMHA Fast Facts about Mental Health https://cmha.ca/fast-facts-about-mental-illness • DBT Skills Manual, Marsha Linehan • Wieland, S. (2008). Complex Trauma & dissociation in Children and Adolescents. [Power point slides] retrieved in person. • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington, D.C: American Psychiatric Association. • Briere, J. (2002). Treating adult survivors of severe childhood abuse and neglect:Further development of an integrative model. In Myers, L. Berliner, J. Briere, C.T. Hendrix, T. Reid, & C. Jenny (Eds.) The APSAC handbook on child maltreatment, 2nd Edition. (pp. 175-202). Newbury Park, CA: Sage Publications.

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