WADING THROUGH YOUR MENTAL HEALTH TREATMENT OPTIONS—CONSIDERING YOUR NEXT STEPS TOWARD BRIGHTER, CALMER DAYS

Each year, millions of Canadians suffer from mild to debilitating bouts of depression and anxiety. “It’s so hard to figure out what next steps to take when your attention, concentration, emotional distress and basic sense of vitality are so affected by declining mental health” says Dr. Lila Z. Hakim, C.Psych, Centre Director at the Centre for Interpersonal Relationships in both downtown Ottawa and Toronto.

Figuring out your next steps isn’t so easy. Clients are often overwhelmed by the numerous choices and decisions that have to be made about treatment possibilities and who might be the appropriate mental health professional to help them.

Decades of research on depression and anxiety point to biological, attachment, developmental, childhood trauma, socio-cultural context, environment, emotional, cognitive, behavioural, personality and interpersonal factors as possible precipitators of symptoms. What’s causing you to be depressed and anxious can be complex to sort through.

“CFIR mental health clinicians employ a biopsychosocial model to understand and capture a broad picture of the factors that may be affecting your well-being. It’s not always so simple that there is only a sole factor underlying your symptoms—sometimes many factors have to be considered to address the different layers underlying a person’s distress” cautions Dr. Hakim, C.Psych., “and it’s important to find a practitioner that can understand your depression and anxiety in complex ways. For example, sometimes it’s not just about changing thoughts and how you are thinking about a situation.”

Choices and decisions also have to be made about treatment —medication and/or psychological treatment and what type of psychotherapy might be best for you. Adding to the burden of decision-making is the recent advent of computerized psychological treatments—where treatment involves minimal contact with a care provider. Dr. Hakim, C.Psych. offers several suggestions to help you wade through these complex waters.

“It’s always important to have a general physical health exam to rule out physical causes for your depression and anxiety. Your physician can help you with decisions about which medication might be best for you, and there’s even testing you can have done that can inform you about which medications might have lesser side effects for you. Physicians have different levels of training in mental health treatment and do provide medication options. You might want to also seek out a professional trained as a mental health practitioner along with your visit to your doctor”, according to Dr. Hakim, C.Psych.

Whether you decide to take medication or engage in psychotherapy as a first line treatment approach will depend on you. Numerous research studies, however, have been conducted to guide clients on this subject. Dr. Hakim, C.Psych provides insights from these studies; “Research shows that psychotherapy is effective for mild to moderate symptoms, and a combination of both medication and psychotherapy might be the way to go for individuals with severe and debilitating symptoms. Medication increases neurotransmitters in your brain and can make you feel better, and adding psychotherapy to the mix improves outcomes because the other possible factors underlying your depression and anxiety symptoms still have to be addressed.”

When it comes to choosing what type of psychotherapy might be right for you, clients have further complex decisions in front of them. Dr. Hakim, C.Psych. provides further guidance to help you sort through these decisions. “Some mental health care professionals provide clients with support to change the way they think about situations, or provide skills and strategies to deal with distress and symptoms (e.g., Cognitive-Behavioural Therapy). These types of approaches try to help the client to feel better by managing symptoms, yet there are often many potential factors underlying anxiety and depression. Other mental health care professionals will work with your past and present-day experiences to help you gain awareness and insight into your emotions, self and relationship patterns, self-protection and defences that interfere with healthy functioning. These approaches help you to find more adaptive responses to everyday life but requires a deeper exploration of and engagement with the individual’s emotions, self and past experiences (e.g., Psychodynamic Therapy).”

Some individuals may prefer to learn strategies to diminish symptoms and feel good without deeply understanding themselves by exploring their pasts and emotional reactions to every day life while others may want to understand themselves more profoundly. “The idea that our past influences our present-day experience is a commonly held notion in the field. The way we think and feel about ourselves, think and emotionally react and respond to others, and how we behave and relate to others in our present-day is highly influenced by our past experiences” according to Dr. Hakim, C.Psych. Her final word on this topic is “that finding a mental health clinician who can flexibly work with you and integrate different psychotherapy models might provide more opportunities to work on different factors underlying depression and anxiety symptoms.” This view of treatment is the basic philosophy that underlies the treatment approach offered by the over 75 mental health clinicians at Dr. Hakim, C.Psych.’s centre. They offer flexible treatment options to work with different factors underlying anxiety and depression, and can move between symptom and distress management to working with deeper underlying factors causing your distress.

Finally, Dr. Hakim, C.Psych. shares her perspective on computerized psychological treatment. ‘In Ontario, free computerized psychological treatment services are offered, which is good and I do refer my clients to these sites as an adjunct to the treatment I am providing. Computerized treatment isn’t for everyone and doesn’t necessarily capture the complex factors underlying a unique individuals struggles with depression and anxiety. Sitting alone in front of a computer with only intermittent meetings with a mental health care professional may not allow for the necessary support and treatment related to the numerous factors underlying symptoms. Depression and anxiety have attachment, developmental, emotional, personality and interpersonal factors that are difficult to address on a computer.”

Four Helpful Tips to Start Feeling Good

As we move through winter and the COVID-19 pandemic, it is vital to make your mental and physical well-being one of your most important priorities. Dr. Lila Z. Hakim, C. Psych. (Registered Psychologist and Centre Director at CFIR Toronto), offers a few helpful tips below to start feeling good: 

Nourish Your Body

Many of us experience cravings for certain foods throughout the winter season, and our bodies develop a yen for carbohydrates. Carbohydrates are directly linked to the neurotransmitter serotonin production, an emotion regulator that helps you feel emotionally stable, less anxious, calmer, more focused, and energetic.

When that 3 p.m. craving for a savoury or sweet snack hits, it’s your body’s way of self-medicating, seeking to improve your mood by boosting your serotonin levels. Listen to your body and give yourself that much-needed serotonin lift.

Instead of calorie-dense, sugary pieces of bread and sweets that offer a quick mood-boost and then a crash, consider healthier alternatives such as fruits, nuts, and yogurt.

Get Active!

Physical activity increases the calming neurotransmitter serotonin and increases dopamine, the emotion and pleasure neurotransmitter, and endorphins, your pain-relief, and pleasure neurotransmitters. Incorporating movement into your day (climbing stairs, going for a walk, etc.) gives your body the activity it needs to keep your mood up throughout the day.

Make Sleep a Priority

Sleeping excessively (or hibernating) is customary in the winter and is often a reaction to the cold. Still, for some, ongoing insomnia or difficulties falling or staying asleep create challenges that can lead to the blues. Provide yourself with a space at home that includes comforting objects (such as a warm blanket, beautiful items, etc.) to calm your stress hormones. Aim to get precisely the amount of sleep you need to feel fully rested and ask a professional if you are unsure about how much rest is the ideal amount.

Do Things that Light You Up

Find activities in your life that give you a sense of pleasure and meaning, involving curiosity, exploration, and interest¬–this could be collecting or building things, researching something you love like travelling, or discovering creative ways to connect other people. Artistic endeavours, like making and listening to great music, are also great options. Pleasure, curiosity, exploration, and interest all stimulate dopamine, making you feel exhilarated and alive!

(**Note: If you are experiencing continual depression symptoms, it is important to seek attention from a physician or mental health professional.)

Lessons from a Bereaved Cancer Parent on How to Emotionally Survive the COVID-19 Pandemic

Almost two years ago, the worst thing in the world happened: my precious, loving, silly, joyful, brilliant, freshly two-year-old son was unexpectedly diagnosed with cancer. Despite putting him through every treatment available, nine months after that, he suddenly began to decline, and one day, he came to die in my arms. 

For the past two years, I have been living every parent’s absolute worst nightmare, every single moment of every single day. 

And yet, for the past two years, I have also maintained a thriving psychotherapy practice; expanded my skills and hobbies and personal culture; developed a deeper practice of self-compassion; cultivated a stronger sense of connection with others both close and far and across different life domains; and immersed in a strong sense of meaning and purpose, more than I could have ever imagined at any point in my life before losing my son… 

This era that the world has been ushered into so suddenly and most unexpectedly, by the novel coronavirus and COVID-19, reminds me in so many important ways of the life of a cancer parent:

  • One day, you and I each woke up to a whole new world. Nothing was as we expected it to be anymore. All of the mainstays of our day-to-day lives, everything we had come to count and rely on, everything that made us feel like our normal selves—our daily routines, our goods and services, our relationships with others, all the sights and sounds we had grown accustomed to—had seemingly ceased to exist. Our sense of normality, sense of safety and security, hopes and dreams for the future—all of these and more were shaken to their very core, one day, oh-so-unexpectedly. And this new world had no roadmap. We felt lost and disoriented and scared.
  • As we took in the intensity and severity of what was happening around us, we lost the luxury of ever forgetting, even for a second, how fragile life really is. Without a moment’s notice, everything can change, even for the worst, despite our best efforts and wishful thinking. Our shared experiences, like confinement to our homes, financial strain, social isolation, perceived scarcity, and a sense of helplessness, all combine to worsen the impacts of the situation further, while also failing to make it better. 
  • We learned, in an undeniable way, once and for all, that we are all vulnerable—that even we are impermanent.

When our basic sense of normal is so shaken up—when we understand that we are vulnerable to this disease, that it can get and take us or our loved ones, or at least, our financial means and other things that mean so much to us, this is such a massive weight that becomes piled onto our shoulders. 

“…even when the worst thing imaginable happens, we can still be okay.”

Reesa Packard, M.A., Ph.D., R.P. 

Notice that in calm times, to feel free and peaceful and relatively unburdened, the fragility of life and our inherent vulnerability is not always at the forefront of our thoughts—it simply cannot be. To feel okay enough in the present moment, we cannot also be so terribly consumed with what might happen in the next moment, or tomorrow, or next month or year.

The burden is so heavy that we cannot sustain carrying it so much all of the time. Sometimes we have to put it away and change our focus to something else—ideally something uplifting, something that deeply soothes and nourishes, whatever that is for you (nature? connection with self or other? a sense of something bigger than yourself? something creative? something fun?). 

COVID-19 and its consequences are still going to be there when you return to thinking about it, and your time away will not change anything significant, so we can surely all afford a good, well-deserved, full break from it every now and then.  

The helplessness of all of this is a common theme that I am hearing people struggle with the most. We want to protect ourselves; we want to fix it, and we want to be safe. To this, I offer some food for thought:   

  1. There is only so much that we can control. If we trouble ourselves with trying to control it all, all we end up with is despair. Learn, through credible sources, what we best understand for now as being some ways to protect yourself and your loved ones, and take these actions, and then speak to yourself directly to remind yourself: “I have done everything I can.” 
  2. Because we cannot control everything, there will be things that upset or stress us, that we cannot directly do anything about. In moments when these feelings strike, try to embrace them, and try to embrace yourself as you experience them. Speak to yourself again, this time to remind yourself: “this is hard—really, really hard—and we have to get through it. This will come to be okay, somehow, someday. It will pass because nothing has ever lasted forever, so nor will this”. 
  3. There is a harsh reality that none of us can truly ignore right now: even though we have done all we could, and coped as well as we could, sometimes, things still go wrong or not as planned. Sometimes all that we can do is not enough, and the worst happens anyway… And even as we work to accept this harsh reality, I am here to tell you—because I now absolutely know this to be true—that even when the worst thing imaginable happens, we can still be okay. We still get to wake up the next morning, coax ourselves out of bed, and choose to find or create the meaning and purpose that keeps us going. We can make it through, and we will make it through. 

Suffering is relative. Many of you have already survived so much. Some other hard thing you lived through before this might have already felt like “the hardest thing ever.” This, right now, may or may not be harder. 

Remember that you are strong and resourceful and have a lot, already inside of you that can help get you through this. You have come this far, and you will keep trekking forth. 

Remember that you are not alone and that we are globally in this together through our common humanity and shared experience. 

Remember that we can choose to approach this current crisis with the goal of simply trying to make the most it that we can while trying to minimize negative impacts as best we can. 

Remember that the brain and the body respond to the demands that we place on them. Whether or not you can imagine this, you can and will grow in incredible ways as you live this extreme experience that is capable of stretching you, far beyond the confines of your previous self that didn’t yet have to deal with all of this. 

Remember that we can and that we will. 

Take good care. 

Reesa Packard, M.A., Ph.D., R.P. is an Associate and registered psychotherapist at CFIR (Ottawa). She has a doctoral degree from the Saint Paul School of Psychotherapy & Spirituality and works in private practice as a registered psychotherapist. She works with clients hoping to develop a more integrated sense of self as a means to well-being and meaningful, lasting transformation. Reesa is also involved in the teaching and supervision of psychotherapists-in-training and advanced knowledge through research in her specialty fields.

Shame

Shame…everyone experiences it, but few talk about it. Brené Brown describes shame as “the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging.” Experiencing shame can be unbearable, as it can often be felt with overwhelming intensity and power.

Shame is like a snowball, forming in childhood from our first experiences of feeling unlovable and unacceptable from unmet emotional needs from important others. The shame snowball builds throughout our lives with every experience similar enough to our earlier experiences. When toxic shame remains inside us, it can lead to depression, anxiety, low self-esteem, and many other psychological or relationship difficulties.

We have many protective psychological responses to shame that have developed along with the emotion itself. We can become critical of ourselves. We can withdraw from others, or detach from ourselves through self-harm and alcohol. We can attack others with our shame. Although these reactions serve a purpose, being that they relieve the intensity of shame at the moment, they do not help us very well in the long run. These protective reactions weaken our relationships and our sense of identity and self-esteem, which ultimately blocks us from living authentic lives and building strong relationships.

The first step in healing shame is to acknowledge shame experiences at the moment they are occurring. Once we’ve acknowledged our shame experience to ourselves, we can then speak about it with trusted others. Most importantly, we must be kind and build compassion toward ourselves in these moments of pain and struggle to heal the shame inside.

Therapists at CFIR can help you to heal the shame experiences that may be at the root of your anxiety and depression or that cause difficulty in your intimate relationships. We are here to help!

Whitney Reinhart, R.P. (Qualifying) is a qualifying registered psychotherapist, at the Centre for Interpersonal Relationships (CFIR) in Toronto. She supports adult and couple clients with a wide range of difficulties related to depression, anxiety, traumatic experiences, and interpersonal conflict.

Weathering the Grief Storm Well: What is grief, and when will it pass?

by: Reesa Packard, M.A., Ph.D., R.P.

What is grief?

Grief is the emotional, bodily, cognitive, spiritual, and/or relational impacts of any important loss. The loss can be obvious, like the death of a loved one, or subtler, like a small or big shift in life circumstances. 

Lots of people find grief to be very difficult – if you feel unable to function normally in the aftermath of losing someone or something that you cherish, or are very used to, know that this is a common feeling. Some people react to the intense emotions of grief by trying to ignore them or push them away. This strategy rarely works in the long-term though, since grief is a process that we just cannot run from – like a storm, it cannot be derailed, but instead, has to run its course. 

Why is grief so hard?

Grief can be like a storm also in the sense that it rushes in – sometimes by great surprise – and ravages some or all of what we had previously known as ‘normal’. The grief storm can bring crashing waves of anger, sadness, and guilt. These emotional waves can be big, and frequent, and unpredictable. During and after the storm, it is easy to feel overwhelmed and disoriented. 

To get through the grief storm, we have to actively care for ourselves in it, which takes work. There is a decent payoff for this work, though: if we can manage to do this, then those big, crashing waves of emotion can gradually become less intense, less frequent, and more predictable. While the loss itself never goes away, the pain it brings can become easier to tolerate. Over time, we can begin to find ways to re-build a new normal. 

So, how can we weather the storm well?

Striking the right balance between connecting to difficult emotions and also taking regular breaks from them, is key. 

To connect with the difficult emotions, you can try any strategy that will help you feel and release the emotions, such as taking in a moment of silence with yourself either in stillness or while moving, journaling or drawing about the feelings, or sharing the feelings by talking to a good friend or a therapist; find ways to let it out. 

To take a break from the emotions, you can try any strategy that can re-resource you, remind you of a different perspective, or shift your experience, such as engaging in hobbies or activities that you typically enjoy. This might include social, creative, active, spiritual, or deep experiences; find ways to be a bit more okay, even just for a minute or two. 

Remember that everyone grieves differently and that your needs are likely to vary from moment to moment, and situation to situation. The process of learning to weather the grief storm well is less about doing any one specific thing, and more about exploring, and learning about yourself and what you might need. While the balancing of feeling emotions and taking breaks from them can be important, how you go about balancing these will be specific to you. Grief storms can be hard, and anything you do to get through them, that also supports your overall wellness (or doesn’t take too much away from it), can be absolutely okay

Take good care.

Reesa Packard is an Associate at CFIR. She has a doctoral degree from the Saint Paul school of Psychotherapy & Spirituality and works in private practice as a registered psychotherapist. She works with clients hoping to develop a more integrated sense of self as a means to well-being and meaningful, lasting transformation. Reesa is also involved in teaching and supervision of psychotherapists-in-training and advanced knowledge through research in her specialty fields.

Self-Harm – It’s More Than You Think

What is Non-Suicidal Self Injury?

Non-suicidal self-injury (NSSI), commonly described as self-harm, involves deliberate acts (such as cutting) that directly damage the body but occur without suicidal intent. Typically, when we think of NSSI we think of individuals who cut, burn, punch, or pinch themselves. In the psychological literature, these behaviours are referred to as direct NSSI. In an ideal setting, individuals who engage in self-harm behaviours either independently seek out psychological support in the form of therapy, or are noticed to be engaging in self-harm by individuals close to them and are encouraged to seek help at that time.

Indirect NSSI

However, individuals can also engage in other self-harm behaviours that are not as clearly noticed by others, since the methods of self-harm do not directly lead to bodily damage. These behaviours are termed indirect NSSI. 

‘Indirect’ methods of NSSI can include:

  • Involvement in abusive relationships
  • Substance abuse
  • Risky or reckless behaviour (e.g., reckless driving, bar fights, unsafe sexual practices)
  • Intentionally putting one’s body into physical danger (e.g., ‘daredevil’ acts)
  • Disordered eating behaviour

Since these activities are not often identified as self-injury, and can even be missed as warning signs by therapists, hospitals, and primary care physicians, it is crucial to notice problematic behaviours before their severity increases.

Men and Self-Harm

For a variety of reasons, individuals who identify as male are more likely to engage in indirect self-harm than those who identify as female (St. Germain & Hooley, 2012; Hooley & St. Germain, 2014). One such reason that has been proposed is that behaviors that have often been labeled as traditionally male expressions of anger and frustration sometimes contain indirect forms of NSSI (e.g., punching walls, picking fights with others, overconsumption of drugs and alcohol; Green & Jakupcak, 2016). Adherence to these traditional male gender norms is also associated with difficulties articulating thoughts and feelings, which can further increase an individual’s risk of engaging in self-harm (Levant et al., 2003). As a result, some men might not readily identify the intentionality behind some of the harmful actions described above.

Finding Help

Psychologists and therapists at CFIR are able to diagnose and guide the treatment related to direct and indirect self-harm for all individuals. We provide support to children, adolescents, adults, couples, and families who themselves struggle with self-harm, or have loved ones who do. We help clients establish solid networks of physical and emotional care and support. We also provide specific psychological treatment for individuals who self-harm, supporting them through the cascading negative emotions that may precede or accompany instances of self-harm.

Dr. Brent Mulrooney, C.Psych. is a psychologist in supervised practice at CFIR (Toronto). He has substantial interest and treatment experience in the realm of family functioning and relationships, anxiety and mood disorders, work and school success, addictions, violence (especially violence in the home), trauma, and gender identity and sexuality. Brent holds a PhD in School and Clinical Child Psychology from the University of Toronto, as well as a Masters degree in Applied Social Psychology from Memorial University of Newfoundland.

Depression: Two Types, Two Treatments

by: Dr. Alexander Vasilovsky, C.Psych. (Supervised Practice)

We’re used to thinking about depression in terms of its symptoms: for example, depressed mood, inability to feel pleasure, sleep disruption, and loss of appetite, weight, and/or sexual desire, among others.

But, have you ever thought about there being two types of depression? 

Some mental health professionals have begun to focus not just on symptoms, but also on the everyday life experiences associated with depression: feelings of loss and of being abandoned and unloved on the one hand, and feelings of worthlessness, failure, and guilt on the other.

Based on these two different experiences related to depression, Sidney J. Blatt, a professor emeritus of psychiatry and psychology at Yale University’s Department of psychiatry, along with his colleagues, distinguished two types of depression.

One type of depression is the “relational” type, sometimes called the “anaclitic” version, from the Greek word for “to lean on.” Typically, this depression is characterized by feelings of loneliness, helplessness, and weakness, as well as intense and chronic fears of being abandoned and left unprotected and uncared for.

The other type of depression is the “self-critical” type, sometimes called the “introjective” type. Typically, it’s characterized by feelings of unworthiness, inferiority, failure, and guilt. Introjectively depressed individuals engage in harsh in scrutinizing and evaluating themselves. They have a persistent fear of criticism and of losing the approval of others.

Not only do these two types of depression reflect two different internal experiences of depression – “I’m empty, I’m hungry, I’m lonely, I need a connection” (relational) versus “I’m not good enough, I’m flawed, I’m self-indulgent, I’m evil” (self-critical) – they also indicate different therapeutic needs.

Research shows that those who are relationally depressed are more responsive to the supportive interpersonal or relationship aspects of therapy. In contrast, those who are introjectively depressed are more responsive to the interpretive or explorative elements of the treatment process. A mental health therapist who understands different types of depressive experiences can help a range of depressed individuals understand themselves better and also overcome the difficulties that come along with depression.

Psychotherapists at CFIR can support you to deal with your negative beliefs of self and other, and the relentless characteristics that might be at the root of your depression. We integrate cognitive-behavioral, mindfulness and acceptance and commitment, and psychodynamic-based approaches to help you deal with the thinking that might be contributing to your depressed moods.

Dr. Alexander Vasilovsky, C.Psych. (Supervised Practice) is a psychologist in supervised practice at the Centre for Interpersonal Relationships (CFIR) in Toronto. Dr. Vasilovksy works with adult and couple clients from an integrative therapeutic perspective, and helps them overcome difficulties related to depression and mood, anxiety and stress, trauma and PTSD, interpersonal conflict, major life transitions, and identify-related struggles.

How CBC Toronto Employees Helped to ‘Beat Blue Monday’

by: Roselin Leonard, Internal & External Relationships Manager

Monday, January 15, 2018 (the third Monday in January) marked what’s come to be known as Blue Monday, also known as “the most depressing day of the year”. A time when the impact of holiday spending, frigid temperatures, and long carb-loaded days laden with low motivation hits hard.

While the theory behind Blue Monday has yet to be scientifically proven, symptoms of the winter blues feel undeniable for many of us. According to CAMH British Columbia, 2-3% of Canadians will experience Seasonal Affective Disorder (S.A.D) in their lifetime. This makes up about 10% of all depression cases.

When Kai Black, Executive Producer at CBC Music in Toronto, heard about the Blue Monday phenomena, he knew it was a great starting point for a discussion about mental wellness at CBC. He envisioned an event that would raise mental health awareness and offer valuable resources to help counteract the effects of Blue Monday. Once his vision was realized, the wheels of action were set in motion.

Kai engaged CBC Toronto’s abilicrew –an amazing ‘Employee Resource Group’ for CBC employees with disabilities and their allies– to create something great. Let’s just say, they did not disappoint. The team transformed Kai’s idea into ‘Beat Blue Monday’, now an annual event.

The event today rose out of a need to communicate to staff that this is not just the saddest day of the year, but it’s a good day to find out how you can deal with your own sadness at this time.” – Kai Black


Centre For Interpersonal Relationships (CFIR) was thrilled to be invited back to ‘Beat Blue Monday’ alongside other local exhibitors for yesterday’s festivities at the Toronto Broadcasting Centre. More exciting than the invitation itself was the opportunity to connect with employees eager to learn more about mental and physical wellness and strategies to beat the blues.

The entertainment was fun, informative and elevated the festivities to another memorable level!

CFIR Clinical Director and psychologist, Dr. Lila Z. Hakim, C. Psych. joined CBC personalities including the host of CBC Radio’s Day 6, Brent Bambury, CBC Sports host Scott Russell, and CBC Music’s Raina Douris and Angeline Tetteh-Wayoe in a game show testing their ’emotional intelligence’.

Lisa Clarkson (Executive Director, Business & Rights and Content Optimization at CBC and Executive Sponsor for the Beat Blues Monday Event) introduced the ‘Mayfield Magnetics’, the top Grade 12 vocal jazz class in Ontario and the winners of 2016’s CBC Music Class Challenge.

‘Beat Blue Monday’ 2018 was a wonderful experience. Sincere congratulations to Kai Black, Helen Kugler, Sylvie MacLean, CBC’s Engagement & Inclusion team, the CBC Toronto’s EAP, the abilicrew, DiversifyCBC and outCBC for a successful event and for their ongoing commitment to–and investment in–the mental wellness of CBC employees.

Think you might have a case of the winter blues? 

Dr. Lila Z. Hakim, C. Psych. offers a few helpful tips below to start feeling good again **:

Nourish Your Body

Many of us experience cravings for certain foods when the winter season blows in and our bodies develop a yen for carbohydrates. Carbohydrates are directly linked to the production of the neurotransmitter serotonin, an emotion regulator that helps you feel emotionally stable, less anxious, calmer, more focused and energetic.

When that 3 p.m. craving for a savoury or sweet snack hits, it’s your body’s way of self-medicating, seeking to improve your mood by boosting your serotonin levels. Listen to your body and give yourself that much-needed serotonin lift.

Instead of calorie-dense, sugary breads and sweets that offer a quick mood-boost and then a crash, consider healthier alternatives such as fruits, nuts, and yogurt.

Get Active!

Physical activity increases not only the calming neurotransmitter serotonin, but also increases dopamine, the emotion and pleasure neurotransmitter, and endorphins, your pain-relief and pleasure neurotransmitters. Incorporating movement into your day (climbing stairs, going for a walk, etc.) gives your body the activity it needs to keep your mood up throughout the day.

Make Sleep a Priority

Sleeping excessively (or hibernating) is normal in the winter and is often a reaction to the cold, but for some, ongoing insomnia or difficulties falling or staying asleep create difficulties that can lead to the blues. Provide yourself with a space at home that includes comforting objects (such as a warm blanket, beautiful objects, etc.) to calm your stress hormones. Aim to get exactly the amount of sleep you need to feel fully rested and ask a professional if you are unsure about how much rest is the ideal amount.

Do Things that Light You Up

Find activities in your life that give you a sense of pleasure and meaning, that involve curiosity, exploration, and interest­–this could be collecting or building things, researching something you love like travelling, or caring for other people. Artistic endeavours like creating and listening to remarkable music are also great options. Pleasure, curiosity, exploration, and interest all stimulate dopamine, which makes you feel exhilarated and alive!

Which strategies do you find most effective for curing winter blues? Feel free to share your comments or feedback below.

(**Note: If you or a person you know is experiencing regular symptoms of depression, it is important to seek medical attention from a physician. If you don’t have a family doctor, click here for additional information and options via Ontario.ca.)

Accompanying You Through Your Losses and Grief

by: Dr. Dino Zuccarini, C.Psych.

Life can be a symphony of losses. Many of us struggle to cope with unresolved losses from either the past or present day. We can experience loss as we transition through various life stages (i.e., childhood onward toward the end of life). Some individuals will experience loss as a result of unmet needs, separation, divorce, or death of loved ones, or unfulfilled goals and potentials. Some of us will experience a deep sense of loss as we inevitably experience changes in our physical and mental abilities, health status, and roles and identity. The emotional residue and grief associated with these losses, when left unaddressed and unprocessed, can evolve into anxiety and depression.

In terms of overcoming your grief, we help you to understand the meanings of your losses, and to process the unresolved or complicated emotional residue from these losses. Unprocessed grief and loss can affect our emotional well-being, our functioning in everyday life, and our interpersonal relationships. We support you throughout your grieving process so that you may move forward with your life with a renewed sense of meaning, purpose, and hope. Psychologists and clinicians at CFIR employ psychodynamic and experiential approaches to support you through the process of dealing with past and present-day losses.

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

Let’s Talk About Depression, Mood and How Can We Help You

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.

CFIR OTTAWA is moving to its new home JULY 4TH, 2022. Click here for more details.