Category: Featured news

feature-1-pic-illia-article-1-470x260.jpg

When Doctors Are At-Risk for Suicide

00Burnout, Depression, Embarrassment, Emotion Regulation, Featured news, Health, Suicide May, 19

Source: Feature: skeeze at Pixabay, Creative Commons

They had known each other well enough in the early days of medical school, when they were students studying well into the night. After graduation, they went their separate ways, each assuming the other was doing well.

“I wanted you to hear it from me,” a colleague sadly said on the phone. Dr. Ranjana Srivastava nearly fell to the pavement when she was told that her long-time friend and colleague—a clinician, wife, and devoted mother—had died by suicide.

Unfortunately, this is not the first that time Dr. Srivastava had to face the suicide of a colleague. In a piece she wrote for The Guardian, Srivastava explains:

“Forced smiles and tough hides abound in the workplace, where always being ‘fine’ is a badge of honour. This is why it can be so difficult to distinguish doctors who will indeed be fine from those who need help.”

Research shows a higher rate of mental health problems among physicians. A 2013 report estimates over 25% of doctors in Australia having at least a minor psychiatric disorder, with 10% reporting suicidal thoughts in the past year. A survey of 2000 U.S. physicians showed that roughly half believed they met criteria for a mental illness in the past, but had not sought treatment. And in Canada, recent research estimates over 26% of Canadian doctors suffer professionally due to poor mental health, with 20% of them reporting they had been depressed in the last 12 months. Overall, roughly 30% of physicians worldwide have depression or symptoms of it, according to an extensive review published in the Journal of the American Medical Association (JAMA).

Why is this the case? The answer isn’t all that clear, but according to physician and social worker Katharine Gold and colleagues, stigma is to blame. Their research looked at survey responses of over 2000 female physicians, and it showed that stigma attached to mental illness is greater among medical trainees and physicians than in the general population. According to one respondent:

“I have been discriminated against in a department after disclosing my history of well-treated depression to my department chief.”

And this is not an isolated incident. Studies show that 50% of doctors are less likely to work with a colleague who has a history of depression or anxiety disorder, with four in ten admitting to thinking less of such a colleague. And throughout the years, healthcare organizations have favoured a punitive approach when addressing the issue of physician mental illness, rather than a supportive one. So disclosing mental health issues by a medical doctor can pose a real threat to licensing, career, and reputation, leading to reluctance to seek help.

In an interview with the Trauma & Mental Health Report, medical student Jamie Katuna explains the predicament physicians face:

“Getting care could mean problems for doctors. If they seek help for mental health issues and if someone decides they are ‘unstable’ and shouldn’t be seeing patients, that physician is out of a job and would have a really hard time finding another one. So instead, doctors suffer in silence.”

When deteriorating mental health makes it difficult to work, many physicians ignore their symptoms and continue to work anyway, often self-medicating with drugs or alcohol to avoid the perceived embarrassment of having a psychological disorder.

Steps are being taken to bring awareness. Many universities and medical organizations are starting conversations about physician wellness and stigma reduction. Physicians and medical students who have lived through suicide attempts, depression, and other mental health issues are standing up for themselves and each other. Likewise, organizations such as the American Foundation for Suicide Prevention and the American Medical Association have recommended reforming medical licensing questions to make it clear that physicians may get help without fear of negative consequences. Despite the growing support, Thomas Schwenk of the University of Nevada School of Medicine noted that change isn’t happening fast enough:

“A lot of [conversations about mental health stigma are] very difficult and very slow to happen, and unfortunately tragic incidents like the two suicides in Quebec and other suicides across the country are still occurring because it’s taking time to change that culture.”

There are some resources available. In Canada, organizations like Physician Health Program and the Canadian Medical Association provide a range of direct services for physicians and medical students at risk of, or suffering from, substance use, psychiatric disorders, or occupational stress. The interventions offered can include awareness workshops, referral to treatment, and monitoring, all while maintaining confidentiality. Also, online resources such as ePhysicianHealth and Combating Stigma are available.

Most solutions exist at a personal or program level, but the problems are pervasive and affect the entire structure of healthcare education. According to Katuna:

“The culture of medicine should undergo amazing and radical transformations. We need to redesign how we implement medical education.”

Systematic problems require systematic solutions and until then, medical professionals remain at risk.

— Ilia Azari, Contributing Writer, The Trauma and Mental Health Report.

-Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

Copyright Robert T. Muller

This article was originally published on Psychology Today

feature-image-copy-470x260.jpg

Misdiagnosis All Too Common for Women with Autism

00ADHD, Autism, Cognition, Featured news, Gender, Health, Wisdom May, 19

Source: Ryan McGuire at Gratisography, Creative Commons

After twenty-eight years of being “dragged through the system,” Emily Swiatek was finally diagnosed with Asperger’s, a branch of Autism Spectrum Disorder (ASD). For Emily, receiving the diagnosis felt like “coming home to a version of yourself that you have been denied of.”

Research shows that Autism Spectrum Disorder is more prevalent in males than females by a ratio of three to one. But there is increasing evidence that this gender difference may be slimmer than we think, and that autism symptoms in women and girls are frequently overlooked and misdiagnosed. 

In an interview with the Trauma and Mental Health Report, Emily explains her frustration with being shuffled from one specialist to another for years, without receiving an adequate explanation for her symptoms: 

“I’ve been through quite a long journey, being given about 10 mental health diagnoses along the way. It was getting to that point where it felt like I was caught in the middle of a guessing game. I kept coming up against the same response of ‘we don’t really understand let’s keep throwing the labels and see what sticks’.” 

The National Autistic Society survey conducted in the United Kingdom found that compared to males, women and girls are more likely to be misdiagnosed, with 42% of females diagnosed with a mental disorder other than autism when being assessed, as opposed to 30% of males. 

Emily’s experience is not unique. Hannah Belcher, who was diagnosed with Asperger’s Syndrome at 23, shares her experience:

“Throughout my life, I’ve been diagnosed with Anxiety, Depression, Bipolar, traits of Borderline Personality Disorder, and ADHD. Some correct and comorbid, some incorrect and misdiagnosed.”

There is no clear explanation as to why women with autism are often misdiagnosed. Child psychiatrist Meng-Chuan Lai, a clinician-scientist at the Centre for Addiction and Mental Health says that while there is a range of different reasons why women receive a diagnosis of ASD later in life, one possibility is that autism characteristics aren’t so evident in females: 

“Girls and women may be more able to master ‘camouflaging’, so ‘typical’ autistic characteristics could be masked when they learn social skills.” 

Lai describes this as the ability to learn neurotypical social behaviours such as eye contact, gestures, holding conversations, and the utilization of social scripts.  These neurotypical behaviours represent those who are not on the autism spectrum in contrast to the neurodiverse behaviours which refer to differently wired brains and cognitive styles attributed to those on the autism spectrum. 

In the foreword for Safety Skills for Asperger Women by Liane Holliday Willey, Tony Atwood describes this “camouflaging” phenomenon, reporting that young girls mask the symptoms of autism by socializing and interacting with their peers, causing a delay in diagnosis.  

Both Hannah and Emily attribute mimicking socialization patterns as an important factor. Emily explains: 

“I’m not a part of that traditional profile of autism… It never even occurred to anyone who was assessing me that somebody who looks like me, somebody who presents like me, could be autistic because I’m smiley, I’m eloquent, I can probably make eye contact if I have to, even though I don’t like it. I’m a very strong mimicker and that masking and mimicking profile is true for me.  I think I very much fit that ‘well behaved little girl’ image—very intelligent, liked reading, very quiet, maybe they’d say I was shy.”  

Lai notes that another possible reason for the misdiagnosis is that women and girls tend to have restricted and repetitive behaviours that are less likely to be recognized:

“The issue is that some of these narrow interests of autism in males, if you only look at the content, are more traditionally male-typical such as trains, dinosaurs, trucks, and they are most easily recognized by clinicians because of our own stereotypes of autism. For girls, their restricted and repetitive behaviours might not be captured by standardized instruments as they are deemed as less noticeable.”

Recent research has touched on the idea of bias in the way autism is diagnosed. One study showed that girls are more likely to be diagnosed if they had an additional intellectual disability or behavioural issues. However, without these, many women are receiving incorrect diagnoses, or none at all. Hannah agrees:

“Sometimes you might feel like you don’t fit in anywhere, everything everyone thinks about autism is male biased. However, as slow and painful as the journey is, there is always a light at the end of the tunnel. It takes us a little bit longer to get to it, but it is worth the journey.

In a study looking at sex differences between children with autism, researchers recommend new strategies for improving autism recognition in females. In fact, Australia is the first country to form new national guidelines to help increase early diagnosis of women with autism.  Considerations of social camouflaging, anxiety, sensory overload, and depression are being included in these new guidelines.  

If these guidelines are implemented, it will be possible to decrease the number of misdiagnoses in women and girls who have autism, leading to less frustration for these women and more time to learn how to manage their diagnosis. Emily says that since she received her diagnosis, her life has changed for the better:

“It was instant relief the minute I got my diagnosis. It just made sense. It was right. It was instantaneous the difference it made. My general well-being just went up and up and up, and is still on an upward trajectory.”    

-Lucia Chiara Limanni, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today

feature-image-copy-470x260-2.jpg

Misdiagnosis Is All Too Common for Women with Autism

00ADHD, Autism, Cognition, Featured news, Gender, Wisdom May, 19

Source: Ryan McGuire at Gratisography, Creative Commons

After twenty-eight years of being “dragged through the system,” Emily Swiatek was finally diagnosed with Asperger’s, a branch of Autism Spectrum Disorder (ASD). For Emily, receiving the diagnosis felt like “coming home to a version of yourself that you have been denied.”

Research shows that Autism Spectrum Disorder is more prevalent in males than females by a ratio of three to one. But there is increasing evidence that this gender difference may be slimmer than we think, and that autism symptoms in women and girls are frequently overlooked and misdiagnosed. 

In an interview with the Trauma and Mental Health Report, Emily explains her frustration with being shuffled from one specialist to another for years, without receiving an adequate explanation for her symptoms: 

“I’ve been through quite a long journey, being given about 10 mental health diagnoses along the way. It was getting to that point where it felt like I was caught in the middle of a guessing game. I kept coming up against the same response of ‘we don’t really understand let’s keep throwing the labels and see what sticks.’” 

The National Autistic Society survey conducted in the United Kingdom found that compared to males, women and girls are more likely to be misdiagnosed, with 42 percent of females diagnosed with a mental disorder other than autism when being assessed, as opposed to 30 percent of males. 

Emily’s experience is not unique. Hannah Belcher, who was diagnosed with Asperger’s Syndrome at 23, shares her experience: “Throughout my life, I’ve been diagnosed with Anxiety, Depression, Bipolar, traits of Borderline Personality Disorder, and ADHD. Some correct and comorbid, some incorrect and misdiagnosed.”

There is no clear explanation as to why women with autism are often misdiagnosed. Child psychiatrist Meng-Chuan Lai, a clinician-scientist at the Centre for Addiction and Mental Health says that while there is a range of different reasons why women receive a diagnosis of ASD later in life, one possibility is that autism characteristics aren’t so evident in females: “Girls and women may be more able to master ‘camouflaging,’ so ‘typical’ autistic characteristics could be masked when they learn social skills.” 

Lai describes this as the ability to learn neurotypical social behaviors such as eye contact, gestures, holding conversations, and the utilization of social scripts. These neurotypical behaviors represent those who are not on the autism spectrum in contrast to the neurodiverse behaviors which refer to differently wired brains and cognitive styles attributed to those on the autism spectrum. 

In the foreword for Safety Skills for Asperger Women by Liane Holliday Willey, Tony Atwood describes this “camouflaging” phenomenon, reporting that young girls mask the symptoms of autism by socializing and interacting with their peers, causing a delay in diagnosis.  

Both Hannah and Emily attribute mimicking socialization patterns as an important factor. Emily explains: 

“I’m not a part of that traditional profile of autism… It never even occurred to anyone who was assessing me that somebody who looks like me, somebody who presents like me, could be autistic because I’m smiley, I’m eloquent, I can probably make eye contact if I have to, even though I don’t like it. I’m a very strong mimicker and that masking and mimicking profile is true for me. I think I very much fit that ‘well behaved little girl’ image—very intelligent, liked reading, very quiet, maybe they’d say I was shy.”  

Lai notes that another possible reason for the misdiagnosis is that women and girls tend to have restricted and repetitive behaviors that are less likely to be recognized:

“The issue is that some of these narrow interests of autism in males, if you only look at the content, are more traditionally male-typical such as trains, dinosaurs, trucks, and they are most easily recognized by clinicians because of our own stereotypes of autism. For girls, their restricted and repetitive behaviours might not be captured by standardized instruments as they are deemed as less noticeable.”

Recent research has touched on the idea of bias in the way autism is diagnosed. One study showed that girls are more likely to be diagnosed if they had additional intellectual disabilities or behavioral issues. However, without these, many women are receiving incorrect diagnoses or none at all. Hannah agrees: “Sometimes you might feel like you don’t fit in anywhere, everything everyone thinks about autism is male-biased. However, as slow and painful as the journey is, there is always a light at the end of the tunnel. It takes us a little bit longer to get to it, but it is worth the journey.”

In a study looking at sex differences between children with autism, researchers recommend new strategies for improving autism recognition in females. In fact, Australia is the first country to form new national guidelines to help increase early diagnosis of women with autism. Considerations of social camouflaging, anxiety, sensory overload, and depression are being included in these new guidelines.  

If these guidelines are implemented, it will be possible to decrease the number of misdiagnoses in women and girls who have autism, leading to less frustration for these women and more time to learn how to manage their diagnosis. Emily says that since she received her diagnosis, her life has changed for the better: “It was instant relief the minute I got my diagnosis. It just made sense. It was right. It was instantaneous the difference it made. My general well-being just went up and up and up, and is still on an upward trajectory.”    

-Lucia Chiara Limanni, Contributing Writer, The Trauma and Mental Health Report

-Copyright Robert T. Muller

This article was originally published on Psychology Today

original-work-veerpal-470x260_0.jpg

Jurors Are Left Traumatized by Some Court Cases

00Decision-Making, Dopamine, Empathy, Featured news, Health, Law and Crime, Post-Traumatic Stress Disorder, Stress, Trauma April, 19

Source: Marica Villeneuve, Trauma and Mental Health Report artist, used with permission

On November 7, 2016, the Ministry of the Attorney General of Ontario reached a settlement with a juror diagnosed with vicarious post-traumatic stress disorder. The juror served on the trial of eight-year-old Tori Stafford’s killer.

The woman, who cannot be named due to a publication ban protecting the identity of jurors in this case, received the diagnosis months after performing her civic duty. Four years ago, she was one of 12 jurors in the trial of Michael Rafferty, the man charged and convicted of kidnapping, sexually assaulting, and murdering Stafford.

While sitting on the jury during the two-month trial, the woman visited scenes of rape, saw photographic evidence of the crime, and heard eyewitness testimony from Rafferty’s girlfriend and accomplice, Terri-Lynne McClintic.

In a submission to the Ontario Court of Appeal, the juror said that, almost immediately after the trial, she lashed out at her children, suffered from depression, had flashbacks to disturbing pieces of evidence, and experienced short-term memory loss and difficulties with concentration.

Over the course of a criminal trial, jurors are often exposed to disturbing graphic evidence. And while jury members are instructed to remain unbiased and evenhanded, the process can take a toll on their mental health.

Beyond the traumatizing effects of graphic evidence, the weight of the task itself can be harmful to jurors’ wellbeing. The high-stakes decision that members have been tasked with, which includes determining the fate of someone’s life, can be psychologically taxing. This pattern of stress and anxiety is frequently observed in other high-pressure jobs that involve exposure to traumatic information and heavy responsibilities, such as social work.

Patrick Baillie, a psychologist with Alberta Health Services, and former Chair of the Mental Health Commission of Canada, says that jury members are often not mentally prepared to sit through a criminal trial:

“These are twelve citizens who don’t typically have any involvement with the system, which is why we want them to serve as jurors, being given this extraordinary task with not a whole lot of mental support.”

In addition to the responsibility of remaining impartial, jurors are not allowed to share any details related to their deliberations. To protect the integrity of the trial, members are prohibited from discussing their personal views on the evidence, witnesses, or trial process, to ensure confidential information cannot be related back to discussions that took place in the jury room. Baillie explains:

“It is illegal to disclose the deliberation of a jury to anybody. So, [you] can’t tell a spouse and family and friends… people in [your] usual support system and the mental health professionals that [you] may want to come in contact with down the road. We need to make sure that jurors are not identified and to make sure the process is pure as it can be.”

Under these circumstances, jury members are left to process the psychological and emotional effects of the trial on their own.

Barbara Legate, the lawyer representing the juror from Stafford’s case, argues:

“We ask jurors to sit through days, weeks, and sometimes months of testimony and sometimes that testimony is very, very difficult, and we ask them to keep it to themselves, not discuss it with people outside.”

Until recently, Ontario judges were responsible for deciding whether jurors should be offered counseling at the end of a trial. Jurors would then either be connected with counselors provided by the Ministry of the Attorney General or would pursue counseling on their own.

Starting in January 2017, however, Ontario initiates a new program to provide free and accessible counseling services to anyone serving on a jury. The Ontario Attorney General Yasir Naqvi says the Juror Support Program will be available for anyone serving in a criminal or civil trial, or an inquest.

Jurors will be provided with information on the program at the beginning of a trial, and then again as it finishes. They will call a designated phone number, speak to a specialist who does an assessment, and have counseling made available to them. A third party will provide and cover the costs of the counseling services, but the government still determines who that third party will be. Naqui says:

“Jurors in difficult trials do face evidence that could be quite horrific, and we’ve heard those stories. It’s only appropriate that we provide appropriate services.”

-Veerpal Bambrah, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today

amanda-feature-1-470x260.jpg

Assisted Dying: We Need a Larger Conversation

00Aging, Caregiving, Decision-Making, Empathy, Featured news, Guilt April, 19

Source: Alberto Biscalchin at flickr, Creative Commons

We know that death is inevitable, yet most imagine it in the distant future. But those with a terminal illness face the harsh reality of death’s imminence. Cancer is the most common terminal illness, and in 2016, an estimated 1.5 million new cases will be diagnosed in the US, and almost 600,000 people will die from the disease.

Over the past decade, European countries such as Belgium and the Netherlands have legalized assisted dying. More recently, Canada passed Bill C-14 in June 2016, allowing assisted dying to be an option for those with a terminal illness. According to Health Canada, since the bill passed, there have been a total of 2,149 assisted deaths, and 63 per cent of them were cancer-related.

I lost my grandparents to terminal diseases, and saw what they endured. I wonder what choice they would have made had assisted dying been legal at the time. Both my parents believe that if someone is suffering, they have a right to end their life. As both of them had to care for their own ailing parents, they shared similar sentiments. In my mother’s words:

 “You feel frustrated, because you’re helpless. There is no cure and there is literally nothing you can do. You get very depressed, angry, and sad yourself. It’s also so hard to watch someone who was once so strong not be able to tie their own shoe anymore.” 

My father recalled a moment with my grandmother, when she could no longer bear her suffering. “I remember being in the kitchen with her and she put her head down on the table and said, ‘I just want it over with.’”

Since my paternal grandparents did not suffer long, my father does not think assisted dying would have been an option for them. My mother, however, feels differently and would have suggested it to her mother if the law would have been in place.

The right to assisted death provides some with relief. Barb Gibson Clifford, from Alberta, has stage 4 uterine cancer and in a short film by Dying With Dignity Canada, explains how this legislation impacts her:

“It’s terrifying to think that, if I don’t have choice, it could be very nasty, both for myself and for my family members. I’m so grateful to those nine judges of the supreme court for choosing to be in consensus about what they were doing. I cheered. I cheered in my kitchen.”

There are others who do not agree with their family members’ choice of assisted death. Former journalist, Deborah Binner from the United Kingdom, watched with inner turmoil and despair as her husband, Simon, made the choice to travel to Switzerland to end his life. This came after he received a motor neuron disease (MND) diagnosis. In her story, she explains how her husband’s choice made her feel:

“I didn’t want Simon to suffer but I didn’t want him to die, either. Watching him plan his own death, while I still wanted more time, was overwhelmingly traumatic. He had rights, but how much of his life was mine? I won’t join any campaign or celebrate his ‘choice’; nor would I condemn any other human being for making the same one.”

In a study of terminally ill patients in the United States, approximately 60 per cent supported assisted dying, but roughly 10 per cent considered it for themselves. Those who were more likely to consider it had depressive symptoms, essential caregiving needs (washing, eating, etc.), and pain. There are still some patients who do not make this choice for themselves. 

Michael Wenham from the United Kingdom, who also has MND, writes on his blog, “Investment in universal best palliative care is the true expression of compassion, not the offer of a cocktail of barbiturates, which is a perversion of therapy.”

With assisted dying laws being introduced in a number of countries, there is still a divide. It is a choice that affects many people and their communities. The conversations around Bill C-14 and other assisted dying laws tend to focus on ethics and morality. Yet, it is important that we recognize the human life behind these legislations. 

– Amanda Piccirilli, Contributing Writer, The Trauma and Mental Health Report.

-Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today

diving-455765_1920-470x260.jpg

Asthma Brings Surprising Challenges

00Anxiety, Cognitive Behavioral Therapy, Depression, Environment, Fear, Featured news, Health March, 19

Source: Free-Photos at Pixabay, Creative Commons

During the summer of 2017, Adrian and his partner, Kayla, ventured out to explore the dense forest in a remote area of south-eastern Canada where they were vacationing. Hiking on a trail that took them deep into the woods, Kayla shouted back at Adrian, urging him to catch up. Turning to him, Kayla could instantly tell something was wrong. After a wave of panic, he collapsed to the ground, gasping for air.  

As Adrian began to fade in and out of consciousness Kayla frantically dialed 911, despite knowing there was no cellphone service within miles of their location. They were completely isolated. Trying to provide comfort, all Kayla could say was, “This is not the end.” 

Approximately 300 million people worldwide suffer from asthma. This inflammatory lung disease, which causes swelling of the airways and constricted breathing, can be life-threatening. Globally, 250,000 people die each year from the condition, and researchers have yet to find a cure.  

Asthma is a common health concern, and the traumatic experience of an asthma attack can affect the emotional well-being of the sufferer and loved ones.

A Canadian study by Renee Goodwin and colleagues published in the Journal of Psychosomatic Research found that asthma is related to numerous mental health conditions, with the greatest links between asthma and posttraumatic stress disorder (PTSD), mania, and panic disorder. Using data from the World Health Organization, Kai On Wong and a team of researchers found that, globally, asthma is associated with depression and anxiety. 

Alex Watford is not surprised by these findings. In an interview with the Trauma and Mental Health Report, he discusses the toll his asthma has had on his mental health, and provides insight into what it is like to experience an asthma attack: 

“It feels like you’re drowning. All of a sudden, you’re not getting enough oxygen despite how much you try to breathe. While attempting to breathe, you can hear phlegm rapidly filling your lungs, slowly suffocating you. You then become light-headed and begin to lose vision while your body becomes weak and lifeless.” 

With diagnoses that include PTSD, anxiety, and depression, Watford believes his psychological distress is largely due to his terrifying flashbacks that cause him to live in constant fear of the next attack; fear which in turn provokes a level of anxiety that makes breathing difficult.

Clinical health psychologist Laura Flower, and Senior Research Fellow at the University of Southampton, Ben Ainsworth, describe Watford’s experience as the ‘cycle of breathlessness,’ a factor that contributes to the “complex and bi-directional” association between asthma and mental health challenges: 

“The experience of breathlessness is distressing; and it’s a normal reaction to be anxious about it. This anxiety then leads to an increased chance of breathlessness – which causes more anxiety.”

According to Flower and Ainsworth, the association between asthma and mental illness is further complicated by the complex relationships asthma sufferers have with their symptoms: 

“Some people are deconditioned to them (e.g. “it’s just my lungs, it’s just me”) and therefore aren’t motivated to manage them. Other people find them really uncomfortable, and are unable to work or enjoy a satisfactory quality of life. Both of these can lead to social isolation, poor lifestyle factors, such as fitness, which in turn worsen asthma symptoms.”

Watford describes how his daily life has been impacted by the disease:

“Having asthma affects my everyday life, as it makes having to walk long distances, such as across campus, really tough. This often deters me from going to class because I will feel so exhausted afterwards that attending feels useless. I often find myself avoiding many other activities for this same reason.” 

In a UK-based asthma community forum, members offer further insight into asthma’s invasive nature and speak to the unpredictability and uncertainty of life with asthma. 

“You don’t know what to expect tomorrow. Will you be able to breathe? Will there be someone there wearing strong perfumes or aftershave? Is there dust in the air? Oh, and just the sheer tiredness of it all, the worrying, not being in control of your surroundings…”

Some members say they are unable to perform simple tasks, such as walking up staircases or showering. Asthma sufferers describe the impact of the disorder as “genuinely life destroying and heart breaking”. 

Complicating matters further is the stigma associated with asthma, resulting from a lack of awareness and understanding. The stigma can lead to improper management of the disease, as well as social isolation that creates further mental health challenges in asthma sufferers. 

This is a theme that comes up in the asthma community forum:

“…sometimes we trivialize asthma as a society. It makes us think our illness isn’t that bad and so all the problems associated with it aren’t genuine.”

Clinical health psychologist Stacy Thomas, shares some of the ways psychologists, like herself, help asthma sufferers cope with the mental health aspects of chronic disorders, including asthma: 

“Using therapeutic interventions, health psychologists help to eliminate the psychological barriers that moderate the experience of asthma. For example, cognitive behavioural therapy, considered the ‘gold standard’ in terms of therapeutic approach, examines the thoughts and beliefs that contribute to problems with mood or anxiety, the tools one can use to find more balance in their thinking, and the behaviours that might need to be changed.”

Adrian survived his close call that summer hiking in the woods.  But like many others, he continues to re-live the attack with great intensity and struggles with the anxiety that such an experience leaves. Sometimes Adrian forgets that he suffers from asthma. For now, Adrian tries to remain positive, while patiently hoping for a cure. 

-Julia Martini, Contributing Writer, The Trauma and Mental Health Report.

-Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today

my_own_prison_by_solnovi-d4f0upo-470x260.jpg

Solitary confinement offers no prep for the outside.

10Anxiety, Environment, Featured news, Loneliness, Social Life, Social Networking March, 19

Source: Solnovi at DeviantArt, Creative Commons

Ryan Pettigrew is a Colorado native who spent eight years of a 12-year prison sentence in solitary confinement. Struggling with bipolar disorder as a teen, he was abandoned by his parents and left homeless. On the streets, Pettigrew turned to drug trafficking to survive, and was eventually indicted on assault and drug charges. His resulting incarceration led to time in prison isolation for fighting with another inmate.

Solitary confinement is the practice of keeping a prisoner apart from the general population of a correctional facility. Prisoners spend up to 23 hours per day in their cell alone, deprived of both environmental and social stimulation. The majority of Colorado inmates in isolation have a mental illness.

In an interview with the Trauma and Mental Health Report, Pettigrew said:

“For the most part, solitary in Colorado is 24-hour lockdown. I went eight years without seeing sunlight, without human contact. Without anything.”

Cells vary widely, even within North America. Some cells include a bed, toilet, and television. Others contain no furnishings and a bucket or hole for use as a toilet. Not surprisingly, the United Nations (UN) states that placing a person in solitary confinement for more than 15 days constitutes cruel and inhumane treatment, and is tantamount to torture.

Partly due to pressure from the UN, both American and Canadian governments have expressed intentions to reduce the use of isolation in correctional facilities. Pettigrew believes that this change is long overdue, stating in another interview that solitary confinement exacerbated his bipolar disorder. He claims that this type of prisoner abuse often leads to anti-social behaviour after incarceration, rather than to rehabilitation:

“My message to the public is: regardless of how you feel about criminals, most of them get out [of prison], and public safety requires they be released prepared to become productive citizens rather than angry and ignorant. I’m not asking for sympathy, just a rational win-win solution.”

Stuart Grassian, a psychiatrist from Harvard Medical School, spent much of his career researching the impact of solitary confinement. His findings show that it produces a distinct psychiatric condition. Symptoms include hypersensitivity to external stimulation, hallucinations, panic attacks, problems with thinking or memory, intrusive and obsessive thoughts, paranoia, and impulsivity.

Pettigrew experienced many of these symptoms himself:

“The first six months to about a year [in isolation] was really hard. It felt like the walls were closing in. I would have panic attacks and start hyperventilating.”

In a recent PBS documentary, Last Days of Solitary, Grassian stated:

“One of the important clinical findings in solitary confinement is that people deprived of an adequate level of stimulation become intolerant of stimulation. They overreact; they become hyper-responsive to it, and they can’t stand it.”

Upon being released, Pettigrew found that he was not the same person he used to be. Before his incarceration, he was outgoing and loved to socialize. Afterward, he no longer enjoyed being around people and moved to the countryside to avoid contact:

“I get overly stimulated very quickly. Just too much going on drives me crazy. My first week out, I locked myself in my brother’s basement. That’s why I like the country. There are not all the noises and lights.”

In an interview with PBS, Grassian also explained that the brains of people who are exposed to extended periods of isolation show greater activity in response to external stimuli, compared to those who haven’t.

In light of these findings, some U.S. prisons, including Maine State Prison, are reducing their dependence on this type of punishment. The prison’s warden Rodney Bouffard said in the PBS documentary that every effort should be made to reintegrate prisoners into the jail’s general population. He believes that keeping them in isolation is harmful:

“Putting them in confinement and forgetting about them is going to make them worse. There’s no question in my mind. If I have someone who comes in with a five-year sentence, you can have them do their whole time in segregation. But I wouldn’t want them living next to me when they release them.”

Instead, Maine State Prison’s program teaches inmates to resolve conflicts without violence and to control their actions and emotions. Between 2011 and 2017, Maine State Prison successfully reduced the number of inmates held in solitary confinement from 100 to 8. And now over 30 other state prisons are attempting solitary reforms.

It may not be possible to eliminate solitary confinement immediately, but reducing its use is in the best interest of prisoners and the public.

– Stefano Costa, Contributing Writer, The Trauma and Mental Health Report.

-Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

Copyright Robert T. Muller

This article was originally published on Psychology Today

ty-f1-470x260.jpg

When Male Rape Victims Are Accountable for Child Support

00Adolescence, Caregiving, Featured news, Law and Crime, Sex, Trauma February, 19

Source: Steve Halama at Unsplash, Creative Commons

When Shane Seyer was 12, he was sexually exploited by his 16-year-old babysitter Colleen Hermesmann. She became pregnant with Seyer’s child in 1989 and was charged with statutory rape shortly afterward. Instead of being convicted of rape, Hermesmann was declared a juvenile offender under the non-sexual offense of “contributing to child misconduct.” Seyer was subsequently court-ordered to pay child support.

In 1993, at the age of 15, Seyer appealed this decision to the Kansas Supreme Court, arguing he should not be liable for these payments. He maintained that his babysitter (Hermesmann) took advantage of him sexually when he was too young to give consent.

The Kansas Supreme Court ruled against him. The judgment stated that, because Seyer initially consented to the sexual encounters and never told his parents what was happening, he was responsible for supporting the child.

This court case set a precedent for male rape victims to make child-support payments. The financial needs of the children outweigh the court’s interest in deterring sexual crimes against male minors, even if statutory rape is the cause of conception.

More recently, in 2014, Nick Olivas of Arizona was forced to pay over $15,000 in back-payments to a woman who had sex with him when he was 14. She was 20 years old at the time. Commenting on the Olivas case and others like it, Mel Feit, director of the New York-based advocacy group the National Center for Men, told the Arizona Republic newspaper:

“To hold him unresponsible for the sex act, and to then turn around and say we’re going to hold him responsible for the child that resulted from that act is off-the-charts ridiculous… it makes no sense.”

Peter Pollard, co-founder of 1in6, an organization designed to help male assault survivors, explained in an interview with the Good Men Project why we downplay the severity of male sexual assault:

“We’re all raised in a culture that says boys are always supposed to initiate and enjoy a sexual experience and males are never supposed to see themselves or be seen as victims. The easiest default is to blame the victim, to say ‘he wanted it,’ ‘he must have chosen that.’”

These attitudes toward male sexual assault are apparent even in the way these men are treated during their court cases.

In 1996, the court heard the case of County of San Luis Obispo v. Nathaniel J in which a 34-year-old woman became pregnant after sexually exploiting a 15-year-old boy. He was also forced to pay child support, and then Deputy Attorney General Mary Roth alleged:

“I guess he thought he was a man then. Now, he prefers to be considered a child.”

Some professionals, such as Mary Koss from the University of Arizona who published the first national rape study in 1987, even argued that men and boys cannot be raped by women. In a radio interview, Koss stated:

“How would [a man being raped by a woman] happen… how would that happen by force or threat of force or when the victim is unable to consent? How does that happen? I would call it ‘unwanted contact.’”

Research indicates, however, that men can be stimulated and achieve an erection in times of fear and terror, despite not being aroused. Studies range from cases where men report arousal during assault, to scientific experiments that find men have erections under many non-sexual circumstances, including when they are unconscious.

In her research, Myriam Denov, a professor at McGill University who holds the Canada Research Chair in Youth, Gender and Armed Conflict, asserted:

“The professional assumption that sexual abuse by women is less harmful than similar abuse by men has potentially dangerous implications for [male] victims of sexual abuse. If professionals fail to recognize sexual abuse by women as potentially serious and harmful, child protection plans will not be made.”

She goes on to say that, as a result, the experiences of male victims who come forward to disclose sexual abuse by women may be trivialized. These misconceptions can lead to delayed referral to social services, or failure to provide victims with the care and support they require.

Until the idea that women cannot rape men and other rape myths are dispelled, cases where victims are misunderstood and mistreated, and even made to pay child support to their former abusers, are likely to continue.

– Ty LeBlanc, Contributing Writer

The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today

fernf-470x260.jpg

What Can Minimalism do for Mental Health?

00Consumer Behavior, Featured news, Gratitude, Happiness, Health, Loneliness, Mindfulness, Sensation-Seeking February, 19

Source: Torley at flickr, Creative Commons

Ryan Nicodemus was once a senior executive making a six-figure income in a corporate job. He found himself unsatisfied with his life and depressed. He explains:

“I had everything I ever wanted. I had everything I was supposed to have. Everyone around me said, ‘you’re successful.’ But really, I was miserable.”

He looked to his life-long friend Joshua Fields Millburn for advice. Millburn pointed him toward Minimalism, namely, placing less focus and meaning on material possessions, and simplifying life to concentrate on what makes a person happiest and most fulfilled.

Nicodemus re-evaluated his circumstances and decided to de-clutter and downsize, leaving his career to pursue a life of simplicity. Together, he and Millburn branded themselves “The Minimalists.” The two attribute improved mental health to this change.

These experiences are detailed in their film Minimalism: A Documentary About the Important Things where they also reveal their difficult upbringings. Both Nicodemus and Millburn witnessed addiction and substance abuse in their families. They faced the limitations that come with living in low-income households. Their challenging pasts initially led them to aspire to acquiring wealth and material objects.

Rick Hanson, a psychologist whose work lies in personal well-being, states in the film:

“I think we’re confused about what’s going to make us happy. Many people think the material possessions are really at the center of the bull’s eye and they expect that gratifying each desire as it arises will somehow summate into a satisfying life.”

He goes on to say that this is not the case, and that the media perpetuate this way of thinking.

In the film, philosopher and neuroscientist Sam Harris argues that it is natural to use other’s lives or what’s in the media as yardsticks to measure one’s own success. He adds that this approach can lead to immense dissatisfaction.

Research seems to back up Harris’ claim. Mario Pandelaere of Ghent University cites a relationship between materialism and depression. Further, Pandelaere has found that “materialists” are, on average, not the happiest people.

In fact, Rik Pieters of Tilburg University has established a link between materialism and an increase in loneliness over time, and also reports a correlation between loneliness and depression.

And, there is support that materialistic consumption doesn’t lead to satisfaction.

The Minimalists advocate tackling materialism and consumption to fight depression. They describe excess consumption as a hunger that never gets fulfilled, and as a hopeless search for contentment. They say that, when letting go of the need to consume, people can tune in to their feelings and address unhappiness. Nicodemus and Millburn note:

“No matter how much stuff we buy, it’s never enough.”The two maintain that, if people abandon what is superfluous and only keep the items that add value, they can lead more satisfying lives. By regularly asking “Does this add value to my life?”, people are left with possessions that either serve a purpose or bring joy. Nicodemus and Millburn claim that answering this question leaves more room to build meaningful relationships and facilitate personal growth.

Not everyone agrees. With increased attention on Minimalism and de-cluttering in the news, there is some backlash to the movement. Many people are asking “How accessible is Minimalism? Is it something only for the wealthy elite?”

Most cannot afford to uproot their lives or leave their jobs to engage in a Minimalist lifestyle. Also, the portrayals of Minimalism so often seen on social media—images of chic white walls and trendy delicate jewelry—are far from attainable. Some people even say that they like having lots of knick-knacks and “clutter”, opting to call themselves “Maximalists.”

In his discussion of materialism, Pandelaere says:

“Everybody is to some extent materialistic, and materialistic consumption may not necessarily be bad. It may largely depend on the motives for it. If people consume in an effort to impress others, results may be adverse.”

– Fernanda de la Mora, Contributing Writer

The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today

midnight_oil_by_sevenfloorsdown-1-470x260.jpg

Pressures to Breastfeed Can Harm Maternal Mental Health

00Child Development, Decision-Making, Embarrassment, Featured news, Guilt, Health, Parenting, Postpartum, Stress, Suicide January, 19

Source: sevenfloorsdown at DeviantArt, Creative Commons

Florence Leung of British Columbia, Canada went missing on October 25, 2016 while struggling with post-partum depression. Less than a month later, her family discovered that she had taken her own life, leaving behind a husband and infant son.

In an emotional public letter, Leung’s husband Kim Chen wrote an impassioned plea to new mothers asking them to seek help if they felt anxiety or depression. He also revealed that his wife’s difficulties with breastfeeding, and the resulting feelings of inadequacy, likely contributed to her condition. Urging women not to criticize themselves about an inability to breastfeed or a decision not to breastfeed, Chen wrote:

“Do not ever feel bad or guilty about not being able to exclusively breastfeed, even though you may feel the pressure to do so based on posters in maternity wards, brochures in prenatal classes, and teachings at breastfeeding classes.”

Speaking with the Trauma and Mental Health Report, Melissa (name changed) said that she was struck by Chen’s words, and recalled the scrutiny around breastfeeding she experienced with her first child:

“I was tired, sore, and the baby was cranky and constantly wanting to feed. It surprised me that, despite my vocal frustration and obvious difficulty breastfeeding, the nursing staff and lactation consultants were adamant that I continue to breastfeed exclusively.”

The frustration worsened once the couple returned home. The week that followed was exhausting, spent trying to calm a screaming newborn who constantly wanted to feed. The couple attended several breastfeeding clinics that reiterated the same message: breast is best. Melissa and her husband felt confused and defeated.

Shortly thereafter Melissa became completely overwhelmed:

“I began to get scared, and not trust myself. My inability to easily nurse and soothe my baby without intense discomfort led to feelings of failure. My emotions were overwhelming. I wasn’t sleeping because I was constantly pumping breastmilk or nursing.”

Within a week after giving birth, Melissa’s infant was suddenly much quieter and less agitated. Upon closer examination, she noticed that the baby looked pale, and was lethargic and dehydrated. A frantic trip to the emergency room (ER) revealed the newborn was not getting enough liquids and nourishment—despite the many scheduled feedings. Melissa said:

“When the ER doctor apologized for the miscommunication and advised us that supplementing with formula is not only okay, but sometimes necessary, I felt a mixture of relief and betrayal. Relief because I knew we would be okay, yet betrayed by some health professionals who put their personal agendas above our health and well-being.”

In an interview with the Trauma and Mental Health Report, Diane Philipp, a Child and Adolescent Psychiatrist at SickKids Centre for Community Mental Health in Toronto, shared that she meets many mothers suffering from stress, shame, and guilt associated with breastfeeding. Philipp explained that the judgements of others place unnecessary pressure on mothers:

“It’s important for mothers to have access to frank and open discussions that are safe and non-judgemental where they can seek out information and make the most knowledgeable decision that is best for their child and for themselves in terms of breastfeeding.”

Every woman’s situation is unique. Lifestyle habits, medication use, and medical and psychological history can complicate the post-partum experience. With this context in mind, the healthcare team should provide a comfortable environment—free of judgement—when discussing post-partum issues, including how to provide an infant’s nourishment.

For mothers who are unable to nurse, be it for medical, physical, or personal reasons, their decision can be supported and honoured in a way that promotes emotional well-being and encourages healthy parent-child bonding. Philipp said:

“For parents who can’t breastfeed for whatever reason, wonderful attachment bonds can still be made. Breast milk is not the only ingredient in a valuable, long-lasting relationship.”

Melissa, now a mother of two healthy school-age children, remains sensitive to others’ assumptions of breastfeeding:

“I felt so pressured to get it right, and so judged when I couldn’t provide for my child. Even when you come to terms with your decision not to breastfeed, people question your choice. Looking at my children today, I know I did the right thing.”

– Kimberley Moore, Contributing Writer, The Trauma and Mental Health Report.

-Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today