Last week there were crowds of people amassed at grocery stores; carts full of bottled water and toilet paper, and shelves left barren. Now, businesses are closing their doors, while many are near empty as people begin to self-isolate and avoid crowds. Some people are now out of work, and they’re worried about how to make ends meet. It’s hard to ignore the impact that COVID-19 has had on Canada, and around the world. Amid so much panic and uncertainty, what can we do, and how can we cope? 

Some of the most important things we need to remember are to stay calm, be prepared, and stay informed. It’s entirely understandable for everyone to have concerns or anxiety surrounding a growing global pandemic. In particular, individuals with pre-existing mental health conditions may be more prone to experiencing these symptoms. While stress and anxiety are seemingly at an all-time high, there are some strategies and techniques that can help as we navigate through this period. 

Grounding

Grounding is a technique that can help to focus on the present and pull away from challenging emotions. One method to practice grounding is to follow the 5-4-3-2-1 rule – identify five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste. Helping your mind to focus on the present is an excellent way to calm down quickly. 

Positive Self-Talk

Positive self-dialogue helps identify negative thoughts and attitudes and works to turn them into positive ones. A positive mindset or outlook is better able to take on and tackle life’s challenges and help to mitigate stress and anxiety. 

Journaling

Writing in a journal is a great technique to help you collect and organize your thoughts. When things are so chaotic and uncertain, journaling can be a means of self-reflection, and a means to provide more clarity. Additionally, keeping a gratitude journal can be a great way of focusing on the positives and silver linings of this situation.

Exercise

The benefits of exercise extend beyond that of just physical. Physiologically, exercise helps to address your body’s stress responses by releasing “feel-good” endorphins, while, psychologically, it can boost self-confidence and take your mind off your worries. Some numerous programs and organizations are offering free video sessions for yoga and physical exercises so that you can stay healthy at home. 

Reach Out for Support

Don’t be afraid to reach out to friends or family to help provide comfort or support, however possible. Also, be sure to take advantage of community or government resources as available and as necessary. 

Meditation

Through meditation, we learn about our internal thoughts and emotions, safely explore them, and work to better cope and manage them. Meditation is a great technique to help regulate stress and anxiety. The Calm app is currently offering several free resources, from guided meditation to relaxation techniques, to music and sleep stories. 

Deep Breathing

Breathing exercises can offer simple techniques that can help overcome emotional strain. It can be used on its own or in tandem with other methods like grounding or meditation.

Stay Busy

By focusing on our behaviors and things we can accomplish during this time, we can stay productive and mindful. Making effective use of this time by learning a new skill or hobby, spending quality time with loved ones, getting our spaces organized, and focusing on self-improvement (all the things that we don’t normally have time for). When we get productive, we can increase our moods and decrease our stress and anxiety. Staying healthy by controlling what you can when things feel out of control. 

Make Our Spaces Cozy and Peaceful

During this time when we are all cooped up in our homes, it can begin to feel as though we are trapped in our environments. When we don’t want to spend times in our physical environments (e.g. messy, cramped, chaotic), we can increase negative thought patterns and turn to potentially unhealthy coping mechanisms (e.g. isolation, lashing out at others). Make your space inviting by keeping it clean and organized. Having a cozy place to curl up and watch a movie or read a book is essential. By making a relaxing environment, you will want to enjoy your time at home. You can use essential oils and diffusers, as well as calm lighting and soft blankets (or weighted blankets) to slow down your arousal response and reduce your stress levels. 

In addition to the anxiety-reducing techniques mentioned above, the Government of Canada website offer ways to help reduce and contain viruses like COVID-19 such as:

• Practice proper hand hygiene and coughing/sneezing etiquette

• Stay home if you are sick

• Reduce exposure to crowded places, whenever possible

• Avoid direct contact with individuals

• Stock up on essentials, but avoid panic buying

• Disinfect frequently touched objects like doorknobs or toys

• Get reliable information

• Communicate and make a plan

It’s completely normal to be concerned or experience stress and anxiety from the growing challenges we are facing from COVID-19, but it’s essential to stay calm, be prepared, and stay informed. Mental health professionals can work with you and develop ways to manage the stress and anxiety surrounding this global pandemic – it’s never too late to start. 

Clinicians at CFIR are offering secure video and teletherapy sessions during this time, to ensure continuity of care. Please reach out if you would like to have a safe, confidential therapy session from the comfort of your own home. 

For additional information and important updates related to COVID-19, please refer to the following links:

• https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19.html

• https://www.who.int/news-room/q-a-detail/q-a-coronaviruses

• https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

Dr. Brianna Jaris, C.Psych. is a clinical psychologist at CFIR.  She has extensive experience in psychological assessment and diagnosis and the treatment of a wide range of psychological issues, including trauma, depression, anxiety.  She is currently the head of CFIR’s Trauma and PTSD service. You can visit www.cfir.ca to find out more about Dr. Jaris.

It’s the week after the “spring forward” time change for daylight saving time (DST). How are you feeling? Many people feel slight groggy the first Monday after DST starts, due to losing an hour of sleep, but the adverse effects can linger for days or even weeks! Circadian rhythms can affect sleep. Are you looking for proof? One sobering statistic shares that fatal car accidents increase by 6% the week after DST begins.

Circadian Rhythms 

The term circadian means ‘about a day.’ The circadian clock, located deep in the brain in the suprachiasmatic nucleus (SCN), coordinates systems throughout the body, including sleep and hormones. Exposure to light keeps our circadian rhythm tightly linked to the local 24-hour environment. 

Circadian Influence on Sleep 

In normal sleep, two processes interact to keep people awake for approximately 16 hours and asleep for around eight hours. One process keeps track of the need to sleep, while the other method (controlled by the circadian clock), provides strong signals favoring sleep or waking at specific times. 

Sleep disorders can be caused by a mismatch between sleep needs and the timing of the signals from the circadian clock. The result can be fatigue, poor work performance, and sleep disturbances, particularly difficulty falling asleep or waking up at desired times. 

Night shift work 

People who work at night often experience reduced alertness and job performance during their shift, as well as inadequate daytime sleep ( one to three hours less) when they return home. They may also have trouble staying awake while driving home. 

Advanced Sleep Phase Syndrome (ASPS) 

ASPS folks are “early birds” with bedtimes around 6:00- 9:00 pm, and early morning awakening around 1:00- 3:00 am. Sleep quality is generally normal if they can go to bed early, but poor if trying to stay up late. 

Delayed Sleep Phase Syndrome (DSPS) 

DSPS people are extreme “night owls,” with bedtimes around 3:00-6:00 am and wake times around 12:00-3:00 pm. Sleep quality and duration are normal when they are allowed to sleep at their preferred biological times, but DSPS symptoms appear when trying to sleep earlier because of work or school demands. 

Conclusion 

Conflicts between the circadian clock and work/social demands can lead to poor sleep. Careful control of exposure to light and sleep timing can help people adjust their clocks to the requirements of their jobs and social lives. 

Suggested readings 

Boivin, D.B. & Boudreau, P. (2013). Circadian rhythms and insomnia: Approaching the time barrier.  Insomnia Rounds, 2(4), 1-8. https://css-scs.ca/files/resources/insomnia-rounds/150-010_Eng.pdf

Fritz, J., Vopham, T., Wright, K., Vetter, C., & Fritz, J. (2020). A chronobiological evaluation of the acute effects of Daylight Saving Time on traffic accident risk. Current Biology, 30(4), 729–735.e2. https://doi.org/10.1016/j.cub.2019.12.045

Walker, M. (2018).  Why We Sleep: Unlocking the Power of Sleep and Dreams. Scribner. 

Elaine Waddington Lamont, Ph.D., M.S.W., R.S.W. is a clinician at CFIR (Ottawa) with experience in helping people to rediscover and harness their inner resources. Elaine has spent the past 15 years doing neuroscience research aimed at better understanding how the environment influences biological rhythms like sleep, hormones, and metabolism, which, in turn, affects our mental health. 

by: Natalie Guenette, M.A.

Stigma is a negative judgment and stereotype that brings people to feel ashamed, dismissed and dehumanized. People can be stigmatized by family, friends, colleagues, in social media, and sometimes even by health professionals. It changes how people see and feel about themselves, but also how other people see them. People living with mental health and substance use issues can be profoundly affected by stigma. They can isolate themselves for fear of being judged, which can bring them to have low peer support. It can prevent people from disclosing a mental health diagnosis and increase suicide risk.

Stigma is one of the greatest barriers to help-seeking and treatment, which can delay diagnoses and treatment options for people affected by stigma, however, there are ways to change this.

1. Educate yourself and others around you by asking questions and doing research: you can visit http://www.camh.ca/or https://www.canada.ca/en/public-health/topics/improving-your-mental-health.html for informative resources;
2. Be mindful of the language you use to talk about mental health and substance use (i.e. non-judgmental, inclusive and respectful language);
3. Be aware of your attitudes and opinions: upbringing and society can influence your views on mental health and substance use; and
4. Speak up when you hear or see something that is stigmatizing: people do not always realize the impact they have on others and it is sometimes a question of not knowing all the facts about certain topics.

Clinicians at CFIR provide evidence-based treatments to individuals from an array of backgrounds based on their needs and personal differences. We continue to stay informed about leading-edge research related to the presenting issues of the clients who come to our offices.

Natalie Guenette, M.A., is a counsellor at the Centre for Interpersonal Relationships (CFIR) in Ottawa. She employs treatments that include aspects from Cognitive-Behaviour Therapy, Mindfulness-based Therapy, Motivational Interviewing, and Psychodynamic Theory, and she has an interest in working with adults experiencing a diversity of psychological and relationship issues. Natalie is currently completing a Master of Arts in Counselling Psychology at Yorkville University. At CFIR, she is under the supervision of Dr. Karine Côté, C.Psych.

References

Canadian Mental Health Association. (n.d.). Stigma and Discrimination. [online] Available at: https://ontario.cmha.ca/documents/stigma-and-discrimination/ [Accessed 29 Nov. 2019].

Centre for Addiction and Mental Health. (n.d.). Addressing Stigma. [online] Available at: https://www.camh.ca/en/driving-change/addressing-stigma [Accessed 29 Nov. 2019].

Knaak, S., Mantler, E., & Szeto, A. (2017). Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthcare management forum, 30(2), 111–116. doi:10.1177/0840470416679413

Mental Health Commission of Canada. (2019). Stigma and Discrimination. [online] Available at: https://www.mentalhealthcommission.ca/English/what-we-do/stigma-and-discrimination [Accessed 29 Nov. 2019].

Life can seem like a circus at times. We can feel like we are goofy clowns needing to always act silly or angry lions having to growl at everything. We could feel like brave acrobats, smiling in the face of danger, but needing to engage in death-defying stunts. We could feel like cyclists trying to balance on one wheel, contortionists trying to fit into impossible spaces, jugglers keeping all the balls in the air at once, or majestic elephants dancing to others’ tunes. Most of the time, we feel like ringmasters trying to keep all our different acts running smoothly, as part of a big show.  

Life presents its challenges in a similar vein. Sometimes our needs are about doing better in some areas, like managing our time and achieving the goals we have set for ourselves. At other times, we want to reduce our distress by managing our difficult emotions or problematic behaviours, like addictions. Deeper still, we need help with understanding our unhelpful patterns or in dealing with relationship issues. We could need help with managing our social situations or our physical pain. We might wish to work on our issues as individuals, or as parents, couples or families. We might need assistance in coming to terms with traumatic issues that happened decades ago, or yesterday. Perhaps we need to find ourselves, our identities, or our own answers to life’s challenging existential and spiritual questions. Often, we can feel that we are trying to manage more than one of these challenges, again as part of some big show. 

Psychotherapy is a framework that attempts to be an answer to these varied questions and challenges that present themselves to us. Psychotherapy can be the big tent, the space where all these different roles, problems, needs, wants and desires reach awareness, exploration, discussion, insight, and resolution. People often view psychotherapy as applicable only to others and not to their own problems. We often experience ambivalence about psychotherapy, with one part our self moving towards getting help, while another part wanting to avoid it at the same time. There are too many preconceived notions and stigmatizing ideas about psychotherapy in the media and culture around us to list here. Needless to say, such notions and ideas hurt rather than help. As discussed above, psychotherapy remains an important framework for a wide range of life’s problems. The various styles and techniques of psychotherapy, such as psychodynamic therapy, CBT, Rogerian client-centered therapy, ACT, DBT, EFT, IFS, mindfulness-based therapies, and so on, address one or more of these complex problems. Experienced practitioners can integrate many different styles of psychotherapy to tailor the treatment to each individual for addressing their scope of problems. If someone has even a dim awareness that their problems would be helped by talking to someone, they should seek professional help for their own unique issues. Psychotherapy is a big tent, and in a skillful and meaningful way, it addresses the challenges of life at many levels. It helps us to live and work freely, it helps the show to go on.

Dr. Ashwin Mehra, C.Psych. is a psychologist at the Centre for Interpersonal Relationships (CFIR). He provides psychological assessment and treatment services to children, adolescents, adults, couples and families, and supports them to understand and overcome a wide range of difficulties related to anxiety and mood disorders, traumatic experiences, substance use and addictions, and interpersonal difficulties.

by Jonathan Samosh, B.A.

What is mental health care? Many people think that mental health care focuses on understanding our internal psychological world and relieving the distress that might exist within it. This perspective is indeed important for effective mental health care. However, a whole wide world also exists outside of our internal psychological experience. In fact, understanding how we all exist within many ecologies can have significant implications for our mental health.

‘Ecology’ refers to all of the complex social systems within which we live. For instance, our families, neighbourhoods, schools, cities, economies, laws, governments, and cultural expectations. In mental health care, ecology means that we want to understand our internal psychological world and all of the many important elements of our external worlds too.

Psychologists with an understanding of ecology can provide mental health care in many ways to promote the wellbeing of individuals, couples, groups, organizations, and communities. With awareness of the diverse ecologies that exist all around us, psychologists can see the bigger picture that enhances treatment to relieve individual psychological distress, alleviate couple relationship difficulties, empower marginalized groups, and address inequalities in social systems. This is the power of ecology in mental health care.

At CFIR, ecology informs psychological services relevant to a diversity of human experiences, such as culture, gender, relationships, and financial means. Read more about CFIR’s multicultural treatment service, gender and relationship diversity service, and accessible low fee psychological service options here.

Jonathan Samosh, B.A. is a counsellor at the Centre for Interpersonal Relationships (CFIR) under the supervision of Dr. Dino Zuccarini, C.Psych. and is currently in his third year of training in the clinical psychology doctorate program at the University of Ottawa. He provides psychological therapy and assessment services for adults and couples experiencing psychological, emotional, and relationship distress in a variety of areas, such as anxiety and stress, depression and mood, anger and emotion regulation, grief and loss, traumatic experiences, self-esteem issues, life transitions, personal growth, existential issues related to meaning and purpose, relationship difficulties, and issues related to sexual functioning.