by: Dr. Dino Zuccarini, C.Psych.

Depression

Depression can bring about debilitating symptoms, both of a physical and emotional nature. Depressed individuals typically find themselves experiencing hopeless feelings, disruptions to sleep and eating patterns, a loss of pleasure in everyday life, and possibly thoughts about suicide or death. Often individuals who are depressed have physical symptoms, including aches and pains.

Finding a path toward recovery can be challenging, but the good news is depression is treatable; recent research indicates that psychotherapy is extremely important in your recovery from depression.

When depressed, we can become bombarded by an internal chorus of negative thoughts and feelings about our selves other people, and the world around us. We can be overly self-critical of our selves and others, or may find ourselves struggling to come to terms with deep feelings of loss. At these times, it can be difficult to imagine a way to restore our vitality, hope, and optimism for life. When the severity of your symptoms seriously disrupts your capacity to function at home, work, or school, consider consulting with a psychologist immediately.

Negative thoughts and feelings about ourselves and others: Healing requires us to try to make sense of and deal with the distressing negative thoughts, feelings, and emotional responses that lie at the root of our depression. Depression is often linked to negative thoughts and feelings we hold about ourselves, of other people, and of the world around us. The origins of these thoughts and feelings can extend back into our childhoods and onward to the present day. These negative thoughts can create a sense of hopelessness about our selves and the world around us. A negative, critical voice and overly rigid standards and ideals can also be at the root of your depression.

We all have standards and ideals that we internalize from childhood onward about how we should be. These standards and ideals create expectations about our own and other people’s behaviour and guide us in terms of how we ‘should,’ ‘ought to,’ or ‘must’ think, feel, and behave. Some of us will rigidly hold onto and strive to live according to unrealistic standards and ideals, and be unrelenting in our efforts to have ourselves and others live up to them. Rigidly held standards and ideals can fuel harsh self-criticism and perfectionism. Indeed, research affirms that self-criticism and perfectionism often contribute to symptoms of depression.

Unexpressed emotions and needs: For some individuals, unprocessed emotions and unattended needs can result in depression. Depression is, therefore, a signal calling for us to listen to what our feelings are telling us about our selves, other people, and the world around us. Emotions provide us with important information. Being able to identify, label, and express these feelings in words is important for us to understand what our concerns are and to identify the unmet goals or needs that are at the root of the depressed feelings we are experiencing.

Other causes:  Depression may also result from multiple other physical and psychological causes, or as a result of substance abuse. A thorough assessment by your physician and a psychologist provides the best opportunity to determine your best treatment options.

Mood

Some individuals struggle with varying moods. People diagnosed with bipolar disorder struggle with mood variation, including periods of experiencing unusually or somewhat elated moments or ‘highs’, followed by periods of ‘lows’ or depressed periods. During manic periods, individuals with bipolar disorder may engage in risky behaviours leading to financial or legal difficulties. Being aware of triggers or signs of an impending mood episode, developing strategies involving partners, addressing difficult thoughts, creating a more balanced world, and accessing support to adhere to treatment regimens, are all significant components of managing bipolar disorder.

The Depression, Mood & Grief Service at CFIR offers clients counselling and psychotherapy to support them to address depression, mood, and past and present grief and loss. We offer children, adolescents, adults, and couples psychological assessment and treatment of depression and other mood disorders. We provide a comprehensive psychological assessment of your depression and/or mood difficulties, including the use of psychological tests for the purposes of diagnosis and treatment planning. There are different causes of mood disorders, and different types of depression and bipolar conditions. Psychologists are skilled in assessing, diagnosing, and subsequently developing a tailored treatment plan to address the specific issues associated with your current depression and/or mood difficulties. We employ scientific, evidence-based treatments, including Acceptance and Commitment Therapy, Cognitive Behavioural Therapy, Emotion-Focused, Mindfulness, Psychodynamic-Mentalization-Attachment based therapies to help you overcome your symptoms and make deeper changes to your self.

Read more about our Depression, Mood & Grief Treatment Service.

by: Andrea Kapeleris Ph.D.

More common than you think! About 20-50% of children and teens who have experienced trauma meet the criteria for Post-Traumatic Stress Disorder (PTSD) and nearly 75% also experience depression and substance use (Elwood, Hahn, Olatunji, & Williams, 2009). Statistics also show that about 14% of people exposed to a major stressor go on to develop PTSD (Terhakopian, Sinaii, Engel, Schnurr, & Hoge, 2008), and women are about twice as likely as men to develop PTSD after a trauma (Kessler, Berglund, & Demler, 2005). Stressors can be one-time events that cause actual or threatened death or harm to yourself or a loved one (such as, a car accident, sexual assault, mugging, natural disaster), or they can include on-going negative and damaging experiences – such as, chronic stress resulting from military service, or childhood experiences in which there was repeated damage to the attachment relationship between you and your caregiver. These chronic experiences can shatter a child’s sense that the world is benign, the world is meaningful, and the self is worthy, and often results in avoidance coping and an increase in overall level of arousal and anxiety (Roth et al., 1997).

Symptoms of PTSD are Normal Reactions to a Non-Normal Experience

• Re-experiencing the event in a number of ways including, flashbacks, nightmares, or vivid memories that come to you unexpectedly 
• Avoiding any reminders of the event (people, places, or things associated with the event), and a feeling of numbness
• Increased feelings of anxiety or emotional arousal

Treating Trauma

Overstuffed Cupboard Metaphor

The mind is like a pantry cupboard. When a traumatic event occurs, it is as if very large and oddly shaped boxes were hurriedly stuffed into the pantry. Since there was no time to properly place the boxes in the pantry in an organized fashion, each time you open the pantry to get something you need, a box suddenly and unexpectedly falls on you – startling you and possibly hurting you! The same thing happens when our mind experiences trauma. Due to the sudden and overwhelming nature of the traumatic event, the mind doesn’t have the opportunity to process all of the emotions associated with it, and as a result, unpleasant memories or emotions may come to us when we least expect them too. For example, you may become startled by an unsettling memory or emotion when you are relaxing at home, watching TV, or spending time with friends. As a result, you may begin to avoid things you previously enjoyed. 

The purpose of therapy is to help you organize this pantry. We need to take each box out of the pantry slowly and carefully, examine its contents, and then place it in its proper place. Once all of the boxes are organized accordingly, you will be able to enter the pantry without fear, and will no longer need to avoid that part of your home. Similarly, the goal is to slowly process the trauma and place events and their accompanying emotions into sequential order. In this way, your mind will be able to integrate the trauma and make sense of it. You will be able to think more freely and move forward with your life. 

Fight or Flight mode

When we encounter a traumatic event (something that threatens our physical or psychological integrity) our bodies enter a process called the “Fight or Flight” mode. This mode is evolutionarily necessary and served an important purpose – in the times of cavemen and women when our ancestors were being chased by predators (e.g., a tiger) all of the resources in their bodies left the frontal cortex (the part of our brain used to reflect on our thoughts and feelings, and make decisions) and automatically went to their muscles (to prepare them to flee or fight the predator), and also went to pump up their heart rate, breathing, and overall adrenaline (again, to make it easier for them to flee or fight predators). In modern times, when we are faced with a trauma, our bodies go into ‘Fight or Flight’ mode in order to protect us. Later, any experiences, people, places, or things that remind us of the trauma stimulate our body to again go into this fight/flight mode in case we need to be protected again. Part of our work in therapy is to help your body and mind recognize that this threat occurred in the past and that you are no longer in danger. We foster this safety on many different levels:
1) Physiologically: We must help the physical body itself feel safe and come down from overarousal. This may partly be achieved through learning relaxation strategies or overcoming avoidance-coping strategies that maintain and intensify anxiety. 

2) Emotionally: We must help the mind itself feel safe and come down from overarousal. This is achieved through:
a) processing the trauma as described above in ‘the cupboard metaphor’; 
b) learning Emotion Regulation strategies

Emotion Regulation

Emotion regulation is a process of 1) identifying and increasing awareness of your feelings (e.g., what are the names/labels for the vague and sometimes uncomfortable sensations that happen inside?), and 2) ‘sitting with’ the sensations that go on inside and experiencing the waxing and waning of your feelings – all feelings do wax/wane, come and go – the only thing we can be certain of is change from moment to moment. Physiologically, our bodies experience of any emotion follows a bell-shaped curve (i.e., it must come down from its peak) – our bodies cannot maintain the high emotional arousal indefinitely – but sometimes, our feelings about our feelings (feeling angry that we are sad, for example) may intensify our original emotion. In therapy, we help to disentangle this, and in effect, help you to regulate your emotions. Importantly, we also begin to look at your feelings as an important signal that there is something inside that needs our attention

Read more about our Trauma Psychology & PTSD Treatment Service.

By: Dr. Sela Kleiman, C.Psych

Within a few minutes of their first conversation, a White individual inquisitively asks a racialized minority a seemingly innocuous question they have likely been asked numerous times previously, “So, where are you from?” Now, imagine the above scenario but with the actors’ roles reversed (i.e., the racialized minority asks the White individual the same question). Which event is more common? Many people who live in Canada and the U.S would intuitively respond that the first scenario is more likely. The reason for this difference requires a contextual understanding of race relations; that is, knowing which social groups are dominant and as a consequence of this, who defines those that are normal from those that deviate from the norm. In our society, both historically and presently, White folks hold a disproportionate amount of power in society to institute and promulgate these definitions. Perhaps it is not surprising then, that as a result, White people receive messages daily which serve to confirm their sense of being normal. Contrarily, racial minorities often receive messages that convey the opposite sentiment. Given these realities, the question, “So, where are you from?” becomes rife with meaning. Indeed, what comes across as innocent curiosity may be read by those receiving it as reinforcement of a sense of un-belonging, especially given the frequency with which this event may occur. Inter-racial interactions between dominant and non-dominant group members are never just an isolated event; instead, they are historically and contextually grounded within the broader social systems that one lives.

The above incident highlights one of many examples of racial microaggressions which are subtle slights, jabs, and insults which convey demeaning messages to racialized minorities by dominant group members. Perpetrators of racial microaggressions are often well-meaning White folks, mostly unaware of the effect of their actions. This manifestation of racism, of course, stands in contradistinction to the overt, consciously directed racism more typical of a bygone era. And though most can agree that a dramatic decrease in “old-fashioned racism” is a good thing, one consequence has been that contemporary racism falls below the radar of most. Indeed, its subtle and insidious nature makes modern-day racism appear virtually non-existent to those who perpetuate it. Unfortunately, a consequence of this is that racism is referenced as a problem “over there” or “back then” and as such not given the warranted attention. 

Research on racial microaggressions has exploded in recent years (read Derald Wing Sue as a starting point), and various empirical studies have documented their varied manifestations. Moreover, researchers have documented its adverse psychological and physiological effects. As a starting point, it is critical for clinicians working with clients to be aware of current racial dynamics so that discussions of race and racism are not minimized or ignored in therapy. By ignoring these critical issues, therapists unwittingly disempower their clients by locating the root of mental health issues associated with racism within the individual rather than due to prevailing social forces. Clinicians who convey this message risk perpetuating the very thing that may in part be responsible for their client’s mental health issues.

by: Dr. Sela Kleiman, C.Psych.

Throughout life, especially during early life, we internalize messages sent to us by caregivers, siblings, extended family, peers, and larger social and cultural institutions. Growing up, if caregivers are attuned to our emotional needs and respond in a warm and empathic way, we are more likely to internalize, or have an unconscious felt sense, that we are a person worthy of being loved. If, on the other hand, caregivers respond to our emotional bids for affection with rebuke, derision, anger, and so forth, we instead may internalize a felt sense that we are unlovable in some way.

The messages we receive about ourselves from others profoundly impact how we feel about ourselves and how we relate to others. 

Messages sent from the cultural and social milieu in which one lives can greatly influence how we feel about our own worth. Growing up in North America where racism is prevalent, for instance, folks of colour are subject to many recurrent and demeaning messages about their racial identities. These messages often are subtle. For example, they may be revealed in television shows and movies where people of colour represented stereotypically and cast in a narrow range of roles. Additionally, these messages are found in schools. For instance, some children who have to pass through security guards checkpoints every morning before class undoubtedly receive the message that they are dangerous and not to be trusted. Unkempt school grounds and poorly supplied classrooms are a consistent reminder to some students that their education is not as important as those who live in more affluent neighborhoods. Consistently receiving these messages takes its toll on an individual; one result may be internalized racism. 

Internalized racism is a phenomenon whereby people of colour constantly exposed to demeaning messages that imply their inherent badness or lower worth may unconsciously start to feel this way about themselves. One of the most disturbing yet illuminating examples of this was the doll experiments conducted by Clark and Clark in the late 1930s/ early 1940s in which they asked children to rank Black and White dolls (everything the same except for their skin colour) on various characteristics. They showed that both Black and White children typically preferred White dolls over Black dolls in terms of appearance, niceness, and so forth. To Clark and Clark, Black children preferring White dolls for these reasons was an example of internalized racism. 

Aside from cultural and social shifts needed to combat internalized racism, a more intimate domain to work through this issue is in therapy. For this to happen, psychologists, psychotherapists, and other helping professionals must be multiculturally-competent practitioners. Indeed, they must be well-versed in psychological and emotional manifestations of discrimination and be able to engage in meaningful dialogue with clients as these issues arise. Ignoring internalized discrimination and placing the locus of responsibility solely within the client risks reinforcing oppressive patterns responsible for internalized racism. Using therapy as a space to explore themes of badness, worthiness, and so on through a culturally sensitive lens can empower clients to gain a better understanding of their pathogenic beliefs and, through deep and meaningful processing of these themes, detoxify these negative feelings about the self.

by: Ali Goldfield, M.A.

We all have stress in our daily lives. So much so that we often think nothing of running from place to place, eating on the go, and juggling work and family life. You have probably already heard that stress can wreak havoc with our immune systems, our sleep patterns and our ability to enjoy the things we used to, but did you know that stress can actually affect the size of your brain? 

Researchers know that trauma can significantly affect brain structure but one study done by researchers at Yale University now shows that everyday stressors, like a divorce, job loss, the death of a loved one or a serious illness can also affect our brain in the same way that one traumatic event can. These cumulative stressors, it seems, can lead to shrinkage in our brains, reducing the volume of grey matter and lowering our ability to further cope with adversity and may even lead to self-destructive behaviours such as addiction, overeating and depression. 

Past studies have shown that the stress response involves a brain region known as the amygdala, which sends out signals alerting us to any kind of threat. This results in the release of hormones, including cortisol, which prepare us for the flight or fight response to fend off the threat. Prolonged exposure to cortisol can cause brain neurons to shrink and it also interferes with their ability to send and receive information efficiently. This is just another piece of the puzzle in how prolonged stress can impair our ability to think and act in creative, flexible and healthy ways.

And it’s not only about stress shrinking our brains. In another study from Yale University, researchers compared the genetic makeup of donated brain tissue from deceased humans with and without major depression. Scientists found that only the depressed patients’ brain tissues showed activation of a particular genetic transcription factor, or “switch” that basically stops the genes from communicating. This lack of communication leads to a loss of brain mass in the prefrontal cortex. The scientists hypothesized that in the depressed patients’ brain, prolonged stress exposure led to disruption of brain systems. The depressed brains appeared to have more limited and fragmented information processing abilities. This finding may explain the pattern of repetitive negative thinking that depressed people exhibit. It’s as if their brains get stuck in a negative groove of self-criticism and pessimism. They are unable to envision more positive outcomes or more compassionate interpretations of their actions.

While the evidence is not conclusive, it makes a pretty good argument that stress and mental health issues that lead to stress do kill off our brain cells through the damaging effects of cortisol and through the disruption of the genes that facilitate neuronal connections. This shrinkage affects our cognitive abilities, our focus and our ability to concentrate. Since much in our lives is beyond our control, how can we prevent this type of cumulative stress from affecting our ability to deal with what life throws at us? 

The most important thing to remember is that the brain is plastic, meaning that there are ways to reverse the negative impact of stress on the brain. With the right tools and techniques, like meditation, exercise, proper diet (think Omega-3s), yoga and by maintaining strong social and emotional relationships, we can, in fact, counterbalance the damaging effects of stress and stop our brains from shrinking.

Read more about our Anxiety, Stress & Obsessive-Compulsive Treatment Service.

by: Ali Goldfield, M.A., via Therapy Stew (www.therapystew.com), on Sept. 21st, 2013   

It’s always difficult as a parent to know how much to share with your child and how much to shield them from the tragedies that happen in the world around them. While it may seem like a good idea, at times, to try and protect them from all the bad things, depending on their age, it’s not always possible. Children pick up information from other kids at school, from the television and from social media. Talking to your child about a tragedy can help her understand what’s happened and actually help them begin to process the events and feel a bit safer.

It’s a personal decision whether or not to talk to your kids or not. It also depends on their age, their level of maturity and how closely they are affected by the tragedy. Every parent knows best for their own child. If you’re struggling with how to start, here are some ways to help:

Let Your Child Be The Guide

Find out what questions or concerns your child might have. Let your child’s answers guide your discussion. Let your child know that you will always be there to listen and to answer them. Try to make your child feel comfortable asking questions and discussing what happened but don’t force your child to talk if they aren’t ready.

Tell The Truth – In Moderation

When talking to your child about a tragedy, tell the truth. You can focus on the basics but it’s not necessary to share all the unnecessary and gory details. Try no to exaggerate or speculate about what happened and avoid dwelling on the magnitude of the tragedy. Listen closely to your child for any misinformation, misconceptions or underlying fears. Take time to provide accurate information. Share your own thoughts and remind your child that you’re there for him. Your child’s age will play a major role in how he or she processes information about a tragedy.

Talk to Them at Their Level

Talk in a way that’s appropriate to their age and level of understanding. But don’t overload the child with too much information. Elementary school children need brief, simple information that should be balanced with reassurances that the daily structures of their lives will not change. Middle school children will be more vocal in asking questions about whether they truly are safe and what is being done at their school.  They may need assistance separating reality from fantasy. High school students will have strong and varying opinions about the causes of violence and threats to safety in schools, community and society.  They may share concrete suggestions about how to prevent tragedies in society. They will also be more committed to doing something to help the victims and affected communities.

Be Ready to Have More Than One Conversation

Some information can be very confusing and hard to accept so asking the same question over and over may be a way for your child to find reassurance. Try to be consistent and reassuring, but don’t make unrealistic promises that nothing bad could ever happen.

Acknowledge and support your child’s concerns

Explain that all feelings are okay when a tragedy occurs.  Let children talk about their feelings and help put them into perspective.  Even anger is okay, but children may need help and patience from adults to assist them in expressing these feelings appropriately. Let your child know that all his feelings, reactions and questions relating to the tragedy are important.

Limit Media Exposure

Don’t allow young children to repeatedly see or hear coverage of a tragedy. Even if your young child appears to be engrossed in play, he or she is likely aware of what you’re watching or listening to — and might become confused or upset. Older children might want to learn more about a particular tragedy by reading or watching TV. However, constant exposure to coverage of a tragedy can heighten anxiety.

Monitor your own stress level

Don’t ignore your own feelings of anxiety, grief, and anger. Talking to friends, family members or mental health counselors can help. It is okay to let your children know that you are sad, but that you believe things will get better. You will be better able to support your children if you can express your own emotions in a productive manner. Get appropriate sleep, nutrition, and exercise. Kids learn from watching the grown-ups in their lives and want to know how you respond to events.

We have all awoken to disasters before, whether natural, manmade, accidental and terrorist-induced and it’s inevitable that we will wake to them again in the future. What you say to your kids and how you say it will change as they get older but the one thing that shouldn’t change is your validation of your child’s feelings and the fact that you will always love them and do your best to keep them safe. 

Read more about CFIR’s Child, Adolescent & Family Psychology Service & the Trauma Psychology & PTSD Treatment Service.

Originally posted by Ali Goldfield, M.A. on TherapyStew (www.therapystew.com) – August 2013

Lots of kids (and parents) have mixed feelings about the start of the school year. It can be really exciting getting ready for school: getting school supplies, new clothes and looking forward to seeing their friends. However, it can also cause a lot of anxiety for many kids, whether they’re starting a new school or not. Taking the time to talk through their anxieties and fears is the few weeks before school starts could make all the difference. Finding out what they’re nervous about – whether it’s meeting the new teacher, making new friends or finding the bathroom when needed, it’s all important to them.

Try the following tips to further ease back to school anxiety:

Make a Plan

If your child is starting a new school, a tour around the campus can be a simple way to ease the first-day jitters. Make sure they know where their classroom is, their locker and especially the bathroom. If you get a class list before school starts, arrange a get together with one of the kids in the class before school starts — first-day jitters are less jittery if there’s a familiar face in class. Teaching anxious middle-schoolers how to use their lock, talk about whether they will be buying lunches or brown bagging it, even sending your child’s teacher an email introducing yourself and your child can help.

Remind Your Child of the Fun They Had Last Year

Point out the positive aspects of starting school: It will be fun. They will see old friends and meet new ones. Try to refresh their memory about previous years, when they may have returned home after the first day with high spirits because they had a good time,

Address the Anxiety at Home

Talking about the different things that are causing them some worries and even role play out some of the potentially stressful scenarios your child may encounter at a new school — making friends, encountering older kids and encounters with strangers — may help ease their fears.

Get Back Into Routine

Anxious kids can feel soothed by a familiar routine. Prepare kids for a new routine by organizing your house in a back-to-school way. Get their school supplies ready, talk about what they want for lunch on the first day, help them decide what to wear on the first day. If possible, start the back-to-school routine a week or two before school starts. Make sure your back-to-school routine includes plenty of sleep and help your child get back on track with an earlier bedtime and wake-up time.

Read more about our Child, Adolescent & Family Psychology Service.

by: Tatijana Busic, PhD. Candidate

Welcome to our blog on mindfulness. This is the first in a series of upcoming blogs in which we’ll introduce you to the concept of mindfulness and talk about the incredible benefits of this simple, yet, powerful way of living! 

In this first blog, we’ll define mindfulness and talk about some important distinctions between mindfulness and meditation. In our second blog, we’ll explore the psychological and physical benefits of a simple mindfulness practice in everyday life. In our third blog, we’ll talk about how mindfulness can be used to enrich and deepen your relationships at home, school and work. Finally, we’ll tie things up by introducing you to some very basic tools and strategies that you can start practicing, as well as, share some helpful resources. So let’s begin!

To start, lets talk about what mindfulness actually is. Some folks may think of mindfulness as meditation, and this can be scary! Rightly so! We might imagine spiritual gurus spending years of their life practicing and honing the powerful skill of meditation. Although these two concepts are closely related, there are some important differences.

Similarities: The beginning stages of learning mindfulness and meditation are virtually identical. We are learning how to do two very important tasks – How to consciously relax and how to consciously direct our attentional processes. Essentially, we’re learning how to relax our bodies and control where and how our mind wanders.  

Differences: Basically, meditation stems from Buddhist philosophy and spiritualties that derive from ancient monastic traditions. Learning how to meditate involves learning the values, beliefs and traditions that are embedded within various traditions. Mindfulness, on the other hand, emerged from the discipline of psychology, scientific research and modern day language and culture. Learning to be mindful, doesn’t necessarily involve learning the practice or values of monastic traditions. In many ways, mindfulness is far more applicable to our complex, modern society and therefore, a lot easier and faster to learn. 

Some other differences include:

• In meditation we sit still – In mindfulness we can be engaged in any task.

• Meditation takes time. Mindfulness can be switched on at any time.

• In meditation we focus inward on the body. Mindfulness involves thoughts, feelings, actions and any state of mind!

So, what is mindfulness, exactly?

Mindfulness has become a key focus in psychological and educational research and practice since the 1980’s. Our busy, modern-day lifestyles have steered our minds and bodies toward a constant state of frenzy. We’re always doing – multi-tasking, multi-thinking and multi-moving!

It’s like the autopilot switch in our brain has been turned on permanently. At times this kind of intensity is great! We need it to get a job done while under high pressure. However, when chronically activated, over time, our brains and our bodies become hungry for, addicted to constant stimulation. We may find it hard to switch off or we may become uncomfortable when things are quiet. At other times, we may miss the beauty that surrounds us. Have you ever been on vacation or even just walking through an autumn kissed park and found yourself worrying about other things? Things you have no control over in that moment? Have you found yourself unable to take-in the serenity?  Notice it, feel it and reap the rewards from it? 

Put simply, mindfulness is about slowing down our stimulus-bound attentional processes and taking the time to consciously, with self awareness, choose what we pay attention to vs. automatically responding to whatever is going on around us. 

Like any skill, learning how to live a more mindful life, takes time and practice – about 100-200 repetitions or three months to consolidate this new and wonderful practice in your brain, your mind and your body. 

In the next blog, we’ll talk about the physical and psychological benefits of mindfulness. And explain how and why this practice can help alleviate psychological issues such as anxiety and depression.  How it helps us sleep better, feel better and see our selves and the world around us in a different and healthier way.

Stay tuned!

Read more about our Anxiety, Stress & Obsessive-Compulsive Treatment Service.

by: Dr. Julie Beaulac, C. Psych.

According to the National Center for Chronic Disease Prevention and Health Promotion, ‘physical activity’ is “any bodily movement produced by skeletal muscles that results in energy expenditure” (National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1997).

Regular physical activity is linked to a wide range of important health benefits – from weight management, reduced risk of stroke, cardiovascular disease and cancer, to the prevention and management of anxiety, depression, and stress.

For most people, it’s safe to start slowly and gently increase your activity. If you have a health condition and are not currently active, it’s highly recommended that you talk to a physician before starting a new exercise regimen.

How Much is Enough?

The Canadian Society for Exercise Physiology released guidelines on physical activity that suggest the following standards as a minimum for health benefit:

• Youth (5-17 years): 60 minutes of daily moderate- to vigorous-intensity activity
• Adults (18- 64 years and older adults 65+): 150 minutes of moderate- to vigorous-intensity activity per week

You can also build up activities in periods of at least 10 minutes each. Here are a few examples:

• Low-intensity effort: Light walking, stretching, or easy gardening
• Moderate intensity effort: Brisk walking, raking leaves, or biking
• Vigorous-intensity effort: Aerobics, jogging, or fast swimming or biking

How Do You Know an Effort is Moderate?

If your breathing and heart rate are a bit higher, and you feel a bit sweaty by the end, you are using moderate effort or are being moderately active.

For managing anxiety or depression, research suggests that physical activity should be in bouts of at least 25 minutes 3-5 days a week (Smits & Otto, 2009) and add up to the following amounts weekly:

• Moderate-intensity for minimum of 150 minutes (i.e., 2 hours and 30 minutes) weekly or; 
• Vigorous-intensity for minimum of 75 minutes (i.e., 1 hour and 15 minutes) weekly

In terms of types of physical activity, it is recommended that we aim to include a mix of endurance, flexibility, and strength and balance activities.

• Endurance (4-7 days per week): Continuous activities that make you breath deeper and increase your heart rate

• Flexibility (4-7 days per week): Reaching, bending and stretching

• Strength and Balance (2-4 days per week): Lifting weights or own body, resistance activities.

So, if we know it is so good for us, why is it so hard?

Lots of things keep us from being active – work and family responsibilities, feeling tired, low motivation, pain or health conditions, the weather and low confidence, to name just a few. There are some strategies that we can use to overcome barriers. Some ideas include:

• Fit activity into smaller chunks throughout the day, such as walking 10 to 15 minutes three or four times a day or taking the stairs instead of the elevator.
• Choose activities that you enjoy and are familiar with so that they can be more easily integrated into your life, such as walking to run errands instead of driving, walking the dog, active play with children.
• Invite friends or colleagues for a walk during lunch hour at work.
• Do activities like biking, swimming, or bowling, instead of going out for dinner with your family or friends.

If you want to increase your physical activity, the top five tips for success are to:

1. Plan ahead
2. Start slow & gradually increase
3. Do something you enjoy
4. Build it into your life
5. Get family and friends involved

When working to make changes to your activity level, it is important to set goals that are:

• Behaviourally-anchored (“I will walk for 15 minutes 3x/week is a behavioural goal”; “I will lose weight” is not a behavioural goal)
• Realistic – Ask yourself, “Is this goal doable?”
• Important – Set goals that are important to you right now.
• Specific – The most useful goals are specific and concrete (e.g., “I will walk for 15 minutes 3 times per week” as opposed to, “I will walk more”)
• Scheduled – Schedule your goals. Write them goals down. Post them somewhere you can see them and tell others about them.
• Reviewed – Goals change. Review your goals often.

For more information, see the following resources:

• Canadian Society for Exercise Physiology Guidelines on Physical Activity
• Exercise for Mood and Anxiety Disorders by Michael W. Otto & Jasper A.J. Smits (2009). New York: Oxford University Press

The psychologists of CFIR’s Health Psychology Treatment Service can help you create a strategy for increasing physical activity and improving your overall wellbeing.

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Do you have an anxious child?

Childhood fears are a part of normal growing up. Fears of the dark, monsters under the bed, starting at a new daycare or school – all of these may be part of typical child development. Anxiety is also a signal to help all of us protect ourselves from situations that are dangerous- a warning signal about a lack of safety in your child’s world. Under normal circumstances, anxiety diminishes when a child’s sense of security and safety is restored—anxious thoughts and feelings subside.

When is your child’s anxiety something you should be concerned about?

Anxiety is considered a disorder not based on what a child is worrying about, but rather how that worry is impacting a child’s functioning. The content may be ‘normal’ but reach out for help for your child under the following circumstances:

1. when your child is experiencing too much worry or suffering immensely over what may appear to be insignificant situations;
2. when worry and avoidance become your child’s automatic response to many situations;
3. when your child feels continuously keyed up, or,
4. when coaxing or reassurance is ineffective in helping your child through his or her anxious thoughts and feelings.

Under these circumstances, anxiety is not a signal that tells them to protect themselves but instead prevents them from fully participating in typical activities of daily life-school, friendships, and academic performance.

What to look for:

If your child is showing any of the following it may be time to seek help from a qualified professional:

• Anticipatory anxiety, worrying hours, days, weeks ahead
• Asking repetitive reassurance questions, “what if” concerns, inconsolable, won’t respond to logical arguments
• Headaches, stomachaches, regularly too sick to go to school
• Disruptions of sleep with difficulty falling asleep, frequent nightmares, trouble sleeping alone
• Perfectionism, self-critical, very high standards that make nothing good enough
• Overly-responsible, people pleasing, an excessive concern that others are upset with him or her, unnecessary apologizing
• Easily distressed, or agitated when in a stressful situation

A child, adolescent and family psychologist at CFIR can help you and your child to diminish unhealthy anxiety. A thorough assessment of your child will provide you and your child with valuable information about the sources of your child’s anxiety, and evidence-based psychological treatment will be employed to help your child deal with his or her anxiety symptoms.

(This post was originally written by Dr. Rebecca Moore C.Psych.)