It’s not so much about sympathizing with people and making them feel better with things or with stories to please their ego. It’s about getting to the core of things with people. Connecting with them, feeling what they are feeling, relating to them and bringing no judgement into the situation at all. Next time you are the ear that listens, provide words that don’t fulfill an ego/mind story and see how much of a difference it makes for the other person.
Since I was 15, I’ve been dealing with depression. I’m not talking about the blues, sadness, or simply the Mondays, but suffocating, full-blown depression—the kind that leaves you empty and hurting all at the same time.
Throughout early adulthood, I had to constantly force myself to go to high school, college, and eventually, a full-time job. But then at 19, I was diagnosed with bipolar and things got even more complicated, adding mania, anxiety, and rapid cycling to the mix of symptoms. It seemed impossible to be productive, and there have been countless days, weeks, and even months when I worried I would lose my job to the all-consuming force of my depression.
In 2013, MacMillan published Perfect Chaos, a memoir co-written by me and my mother, detailing my struggles with depression and her efforts to be there for me. Over the years, I’ve become an expert in my own symptoms and the hows and whys of leading a productive life under these conditions. And while the conversation is being brought further and further out of the dark with each person that decides to speak up, I’d like to offer up some practical advice that’s served me well, because here’s the thing, dear reader: In my many moments of debilitating depression, I have not once lost my job, nor even been reprimanded. Here’s how I make sure to take care of myself within the context of getting out of bed to go to work every day, even when it seems impossible:
1. I create the quickest morning routine possible, one painful, brilliant step at a time. The night before, I take a shower and choose an outfit. One that makes me feel comfortable, smart, and capable—that just says, “Yes, that’s me, a total badass. I got this.” The next morning, I dress, apply mascara and a bright punch of lipstick, and then I leave. No time to climb back into my closet trying to find body acceptance in a state of morning confusion. Out the door in fifteen minutes flat. No excuses.
2. Once I arrive at work, it’s time to make a daily task list. Tasks in general feel utterly impossible when you are depressed. The word “task” makes you want to cry on your desk. But this is important: I ask myself what needs to get done and what I can get done. I break each overwhelming, essential task down to the smallest possible steps and write an in-depth to-do list. Then I only focus on that task. I don’t allow myself to look further down the list. Once I manage that first task, I force myself to do two things: proudly revel in my success and—this is crucial—take a five-minute break.
3. Next—and this is the hard one—I decide if I need to inform my supervisor. Because depression is constantly recurring in my life, it’s important to let my supervisor know I have a chronic illness. On those days when I do call in, he knows it’s valid. This is also something that you can discuss with your HR manager. Your supervisor doesn’t need to know the gritty details of your struggles; they simply need to know that you are experiencing a health struggle and that you are doing your best to work to your highest ability. You may need to present a doctor’s note to HR, but management may surprise you and support you beyond your expectations.
4. Lastly, at the end of that exhausting day, I do my best to prepare for the next day and attempt some exercise (those endorphins do help!). Most importantly, I celebrate my victory. When you are depressed, the most powerful thing you can do for yourself is celebrate each accomplishment. You got out of bed; I’m so proud of you! You ate food; you are killing it! You stayed at work for a whole eight hours; you are a superstar! Never stop praising these steps, and slowly but surely you will find your way back out of that hole into the productive light of day.
Does your mind sometimes create thoughts – ones that make you anxious or worried – that you’d rather not have?
When our unconscious brain provides a random thought like this – if we’re not aware – we can become overly focused on these thoughts that can negatively impact our mental health.
This micro skill introduces a concept called cognitive defusion – a strategy we can use when we need to become untangled from our thoughts.
By learning how to defuse unwanted thoughts we can remove their power over us. Those thoughts can be as simple as our mind telling us there’s a difference between what we have and what we want. The thought is nothing more than a warning light. What we do with this thought defines our thinking and emotions.
When an automatic, unwanted, negative thought comes to the top of your mind, doesn’t feel good, and is distracting, the first step is not to fight it or hide from it. Acknowledge it as being present and a source of information. By “thanking our mind” for this thought without fighting it or judging we position ourselves to defuse its intensity, allowing us to use the information for some healthy action.
Dr. William Glasser, author of choice theory, suggested that we may not have 100 per cent control over our thinking, but we have 100 per cent control over our actions. Where our body goes, our mind follows. By changing our focus from troublesome thoughts to an action we enjoy, or by giving our mind an opportunity to engage in something we find interesting, we can leave the negative thought at the curb and take control of our thinking. This is not hiding from the negative thought; it’s moving past it. There may be nothing to do now, and there’s no value in focusing on negativity that’s distracting.
Persistent, negative thoughts that refocused attention doesn’t curb may require more action. Negative thoughts can be like weeds; they can multiply and take over our mind.
Cognitive defusing is about helping gain perspective so that we don’t give negative thoughts power to grow. “See thoughts as what they are, not what they say they are,” advises Steven Hayes, a professor at the Department of Psychology at the University of Nevada. Meaning a thought is just a thought – nothing more less.
Accept thoughts by name without any judgment – If negative thoughts are hanging around after you’ve engaged in an activity to re-direct them, this is fine. Stop for a moment and acknowledge the thought by name, like you would when meeting a new person. For example, “So it seems there’s anxiety, because I’m having thoughts that are due to my concerns about money and work.”
Re–direct your mind – Take charge of your mind. Unhelpful thoughts are projections of some past or future concern that aren’t happening right now, so re-direct your mind in a non-judgmental way to something more positive. For example, “I get that this thought is providing me information and isn’t as helpful as it could be. Thanks for the anxiety, but I think I’d rather be calm.”
Focus on the now – We live in the now, not the future. Take a deep breath, focus on the now, and recognize that the unhealthy thought has no connection with what’s happening in the present; it’s just a thought. Practice focusing on the now, accept the thought and redirect your focus “since this isn’t happening now and there’s no danger, I’ll focus on getting my planned work done, then get to the gym for a good workout.”
By practicing cognitive defusion you can learn to look at negative thoughts as not being bad, just words and images in your mind that you can shape, process and release. The benefit is that this micro skill can teach you how to accept negative thoughts as information only; they don’t need to dictate your actions or feelings.
Bill Howatt is the chief research and development officer of work force productivity with Morneau Shepell in Toronto and creator of an online Pathway to Coping course offered through the University of New Brunswick.
This series supports The Globe and Mail and Morneau Shepell’s Employee Recommended Workplace Award.
This award recognizes employers who have the healthiest, most engaged and most productive employees. It promotes a two-way accountability model where an employer can support employees to have a positive workplace experience.
You can find all the stories in this series at this link:tgam.ca/workplaceaward
The numbers aren’t pretty, but the future may be brighter for families with children experiencing learning or mental-health issues, thanks to a new initiative led by Western Education.
According to Children’s Mental Health Ontario, as many as 1-in-5 children and youth in the province will experience some form of mental-health problem, with 5-in-6 of those not receiving the treatment they need.
The Child and Youth Development Clinic hopes to fill that gap by welcoming children who are currently without access to the types of services the clinic offers. This week, Western opened the clinic’s doors in the former Bank of Montreal Building, 1163 Richmond St., just outside the Western Gates.
“Every family has a child who, at one time or another, is at risk of learning or mental-health issues,” said Vicki Schwean, Education Dean and the clinic’s founder. “Ensuring the mental health and wellbeing of our next generation is immensely important and we’re thrilled to open the doors to the community at our new clinic.”
The clinic offers services for kids 3-18 years of age with educational, psychological, behavioural and speech and language difficulties – without a doctor’s referral.
Parents, guardians and service providers, such as school officials, mental-health providers and doctors, may refer children and youths to the clinic.
Families may call 519-661-4257 to make an appointment. They will be emailed a package asking them to fill out the child’s or youth’s developmental, medical, social or academic history. This information, along with any reports from previous evaluations and/or school information, will help the clinic plan the most appropriate assessment(s).
Cost is based on a sliding scale based on a parent’s income. No health card is required.
Western graduate students – under the supervision of experts in their field – will provide assessment and treatment options for children with educational, psychological, behavioural and speech and language difficulties either individually or in groups.
The clinic has eight Psychology graduate students and eight Speech and Language students.
As a school and clinical child psychologist, Education professor Colin King has learned a lot working in a variety of hospital, community and private settings with children having various learning, social-emotional and behavioural challenges.
“An interdisciplinary assessment provides families with the most complete profile for their child,” said King, who serves as the clinic’s director.
“It takes a village to raise a child. Once we fully understand a child’s developmental, medical and academic history, we can provide the most informed evidence-based psychological assessment, intervention and treatment.”
“The way someone treats you isn’t meant to be taken lightly. How they treat you, is how they view you.”
It’s been a chaotic few weeks to say the least. I’m grateful for having had the chance to get away for my reading week and take some time to focus on something other than school.
I guess I would say the past couple weeks have been filled with a lot of anxiety and recurrences of my depression. Coming back into school to find out half my courses are cancelled because of a provincial wide strike was a bit much. I pay to learn and I pay to gain experience but yet half my courses including my clinical have been shut down until an agreement has been reached between the two parties. It’s a pretty crappy feeling to not be able to do something you love. It’s even worse when you come across articles pointing out the strike will be ‘protracted’ and previous strike have been 3 weeks +.
I guess I shouldn’t complain too much because I have at least my science courses to focus on and i’m grateful for what the Faculty has done in moving our classes to off campus locations across the city. I also can still attend my community placement which is also always a treat. I think the more I work with kids, the more I enjoy what I do.
Aside from that I can finally say I have recovered from strep throat. I’m usually not one to go see a doctor but even that was rough, who would think a sore throat could cause THAT much misery over three days. It got to the point I realized ibuprofen, lozenges, and my throat spray were not doing anything that I decided I needed to make a visit to the doctor. After sitting in a lecture and half way through googling the nearest walk-in clinic because I had chills and was literally in the most pain i’d ever experienced. I have a lot of respect for people that get it often, it was terrible.
But obviously bad news comes in threes….lucky me. Last week also saw my first car accident happen. Physically I was okay but emotionally I was shaken (or ‘shook’ as the youngin’s say). It was an experience and it still gives me anxiety if I think to hard about it but it’d definitely a learning experience and luckily the car can be fixed and my health is okay. I would say i’ll be more on edge driving now and I choose to walk more to do things rather than drive, but in time my confidence will grow again for driving but for now it’ll be one step at a time.
Aside from that, life is moving forward and i’m just trying to focus on making it through this term. The past couple weeks i’ve found myself in a rut where i’m not feeling motivated but then stress myself out because I don’t feel motivated. A vicious cycle. I guess it’s exciting to think I may actually have a long Christmas break this year (permitted everything goes smoothly) finishing around mid-December. Hopefully will also hear some positive news in regards to the results of my Master’s dissertation in the coming weeks. Hopefully the new year will see me heading to London to collect my degree and see some good friends :).
Right now, there is a baby nurse who is searching online and deep inside for an answer. There is a brand new member of the profession who is questioning her calling. There is a newly-minted graduate who wonders how school seemed to teach her everything and nothing all at the same time. There is a greener-than-grass new hire who is praying that she doesn’t kill somebody at work tomorrow, and wonders if she already did yesterday.
Dearest baby nurse, don’t let this scary new world drag you down. You’re going to have moments when you are sitting on a toilet seat for far too long, probably for the first time in your entire shift, and question why you even decided to become a nurse in the first place. That’s okay.
You’re going to have days — many of them — when you plop down in your car after leaving work two hours later than anticipated; and you’re going to turn off the radio; and you’re going to roll down the windows; and you’re going to cry the most painful and ugly cry. That’s okay.
You’re going to have shifts where your head is spinning and your hands are shaking and your brain is thinking faster than your fingers can type. That’s okay.
You’re going to have moments when you clean more bodily fluids in one 12-hour day than an average person might in a lifetime. You’re going to feel that — sometimes — you’re the only person on the entire unit, because everyone around you is just as busy as you are. That’s okay.
You’re going to have times when patients yell at you for something you didn’t know (that perhaps you should have). They will complain about you to anyone that might listen. They may even become so frustrated with their care that they threaten to leave. And this is going to bother the hell out of you. That’s okay.
You’re gonna listen for 20 minutes and still not hear a damn murmur. That’s okay.
You’re going to have moments when you feel like something “just isn’t right” with the patient in your care. You won’t have enough experience as a frame of reference for what may be happening, or why. You’re probably going to feel helpless in these moments — it’s a “tip of the tongue” phenomenon to the highest degree. That’s okay.
You’re going to feel devastated the first time a veteran nurse yells at you — even more so when their reaction is for something nit-picky and non-essential. You’re going to mumble something unsavory about them under your breath. That’s okay.
You’re going to call a doctor to clarify an order, and she’s going to complain. She’s going to want answers, details, vital signs, and a picture of what is happening with your patient, and you’re going to word-vomit something that probably makes very little sense to an angry cardiologist at 3 a.m. That’s okay.
You’re going to walk into a room expecting to pass your morning medications and come to find your patient unresponsive. Maybe she’s stopped breathing. Perhaps she’s lost a pulse. Either way, you’re going to bring forward everything you learned in every class, clinical, and scenario — and forget how to do any of it. You’re going to scream for help. You’re going to look like a deer in headlights. And you’re going to wonder, “When the hell am I ever going to be able to be as good as they are?” That’s okay.
You’re going to lose that patient, on an unexpected shift, and in an unexpected way. You’re going to think it was your fault. You’re going to be riddled with guilt and feel ashamed of how you reacted. You’re going to replay that scenario in your head over and over again, and every time wonder why you didn’t see it coming. You can’t always see it coming. You can’t always be the hero. And that’s okay.
Because someday you will be.
Someday you’ll understand the subtleties and nuances that no one can teach you except for time Herself.
Someday you’ll be able to balance the full-fledged mountain emergencies with the miniature mole-hill ones.
Someday you’re going to address a patient or family member who is frustrated with a sense of firm yet compassionate care, and will know how to redirect their emotions.
Someday you will call a doctor, and she will thank you for keeping such a close eye on whatever concern you’ve already handled.
Someday you’re going to finally take a lunch break, and it will actually be during lunchtime.
Someday you’re going to do chest compressions or inject medications or ventilate a patient, and your paralyzing fear will be replaced by sheer adrenaline.
Someday, somebody is going to die on your watch — but whether it’s through blood, sweat, and heroics or a quiet and accepted end — you will have made a difference in the journey of that patient and his or her loved ones.
And while some days you may still feel like a hamster on a wheel, going through the motions just to stay afloat — someday you will realize that you are not the one sinking and needing to be saved. Rather, you’ve grown into a life raft for another baby nurse, insecure and unaware of all of her untapped potential.
Someday you will understand that the nursing profession is perhaps the hardest of them all, but in so many different ways, the most rewarding.
And someday you will stand up for yourself; stand up for your patients; and stand up to the barriers that impact your highest capacity to care — this day will remind you why you trudged through every tear, scream, and exasperated sigh.
So do not give up, baby nurse: new to the world in which nurses beget nurses; still questioning why nothing ever ends up like the texts books might have said. No matter how bad it feels — no matter how hard it seems — always turn to the nurses who can teach you that one can have a brilliant mind and a beautiful soul; one can be funny when things feel too serious; one can be tough as nails and still be softened by the circumstances; one can make mistakes and still maintain integrity. Stand your ground, baby nurse; ask questions; study hard; prioritize what matters; own up when you don’t know; and don’t let anyone beat you down — especially that little voice in your own head. If you allow yourself to do it, you’ll be amazed by how quickly a baby nurse can grow.
Lovingly cheering you on,
A Former Baby Nurse
I’ve honestly never felt so overwhelmed in my life entering the clinical portion of my program. Friday was my first day as a level 2 clinical student! I finally reached a big milestone in working with actual patients :O
It’s crazzzzzy how much nurse’s know and the things that are expected of us. I mean I always knew it wasn’t an easy jbo, but when you actually see what goes on behind the scenes, it’s eye opening.
Don’t get me wrong, I was completely excited by the opportunity to finally be in hospital, but i’m also so nervous to be seen as incompetent by the veteran nurses on the floor.
I realize it’s pretty normal to have the experience be nerve wrecking, i’m grateful my clinical group and mentor are all very open about our feelings and are all eager to learn and grow from our experiences. I’ve been slowing trying to change my mind set from one of wanting to impress and be the “star” of the group, to one of which I want to try to use these rotations to learn as much as possible.
While I’m happy to have been given my first choice of placement, I knew my instinct it would likely not be an area in which I would want to specialize and focus on in the future. I picked the Chest unit, largely because of the exposure it would given to to common diseases like COPD, asthma, and lung cancers, but also because of the fact I would get to better understand and differentiate between lungs sounds. I wasn’t particularly fond of the respiratory assessments in first year, partially because I don’t really know what i’m supposed to be listening for. While simulated mannequins are great for understanding placements of the stethoscope and palpating, they don’t really give you a realistic understanding of what the lungs actually sounds like in practice. I mean sometimes when you listen the heart sounds can be distracting or sometimes if the patient is wheezing, you might not get a clear picture of the heart beating.
Regardless of whether I love the chest unit by the time December rolls around, I will be grateful for everything i’ve learned. I’m excited to make a difference in patient care. I get being the ‘baby nurse’ i’ll get delegated tasks that aren’t so glamorous (ex. bed washes, cleaning poop/vomit/pus/saliva, inserting catheters), but I do believe every aspect of nursing care has an important place in making a patient feel cared for. Sometimes the smallest things have the biggest impact, how great does it feel to sit in a clean night gown, have your hair brushed, or even have a cleanly shaven face? While I want to help provide the medical aspects of nursing care, the other aspects are just as or even more important.
They say life is what you make of it, well, it is my opinion that the same is true for clinical and preceptorship experiences. I know mistakes will happen The important thing to do is to learn from them, and move forward. While I feel overwhelmed now, having never had the chance to perform many of the skills I learned in person (ex. catheter insertions) I know skills will come with time and practice.
While i’ve already had days where I’ve questioned if nursing is for me. I know in time these days will become few and far between, and I will feel the rewards of nursing. I look forward to the day when a patient’s thanks me and this appreciation will make all the hard work of pushing through nursing school worth it.
While sometimes I want to believe that i’m a super hero and can do everything on the first short, I know everything won’t always be perfect, but with a positive attitude, I can hopefully make my experience this term a great and rewarding one.
The depression mask. What I would define as a defence mechanism because if you looked like you felt, no one would ever want to be around you.
Depression has levels that is hard for people who don’t have it to understand. It makes me angry when I come across comments calling people like Chester selfish. To me, it’s a suicide is a failure of society to protect individuals for for letting them down to feel like this was the only viable option. Depression IS a disease. Sometimes medication can help and sometimes they don’t similar to any other sickness. The difference with depression compared to other illnesses is people think it’s okay to say things like: ‘get over it’, ‘stop being stupid’, ‘this needs to stop’, or even ‘you’re just being lazy’.
Depression isn’t simply being “sad”. It’s more than that. It’s a feeling of worthlessness and that you’re a burden to everyone around you. The most toxic feeling with depression is the utter hopelessness that goes with it. Not only do you feel worthless, but you have no reason to believe that it will change. Everyone’s experience will also be different, some people can still be high functioning while others struggle to get about their daily tasks. I can say i’ve been in both situations. I wouldn’t be where I am without the hardwork I put in to be here but I’ve also had days where i’ve struggled to even get out of my bed and have the motivation to do anything because I feel empty, unmotivated, and worthless. Its a spectrum condition where the word does not define the symptoms, the individual does.
I think in my experience one of the worst things about having depression or going through a cycle is knowing you have so much to be thankful for and that there are so many people worse off. But that feeling of feeling nothing and just finding no joy in life is horrible and isolating. Instead you start to feel guilty for feeling pathetic and rather than burden people with your feelings, you lie and pretend you’re fine to get people to back off.
I think one of the most important things for people to remember is that suicide is a behaviour. Depression often drives a person to the point they want to die, but not all depressed people have self harming or suicidal tendencies. Some people who are not recognizably or clinically depressed will commit suicide or hurt themselves in a sudden moment of sadness. It’s a tragically complicated issue.
To the unknowing eye, he doesn’t look like someone suffering from depression and severe PTSD from the traumas he experiences growing up and navigating the industry. To the experienced eye though, his eyes say it all. Sometimes moments like these make it worse; you’ve had fun with the family, a few hours pass and you still feel it. Then guilt, shame, and hopelessness creep in. You think, “If I’m still depressed after having fun with the people I love, will I ever feel better?”. To be honest, it’s not easy to seem “happy” around people. It actually hurts more when you’re lying to yourself trying not to seem upset. The human mind can only take so much torment, either from others, or itself. Those like Chester weren’t weak and should NEVER be labelled as such. It still makes me sick to think about how I let someone treat me as such in a moment of cowardice. If you’ve never been through depression you have NO idea how much mental strength it takes to hold on, especially after prolonged or traumatic events.
It still makes me sad to realize he’s gone. There’s apart of me that still can’t believe it and I honestly can’t imagine what his family, friends, and bandmates must be going through. His legacy will not be forgotten, and while his loss is horribly tragic, I do believe it serves as a warning and example for all that mental health is not imagined. I think this video shared by his family serves to remind people that depression doesn’t look the same on every person or at every point in time. This was Chester’s depression.
At the end of the day we must support those who suffer, and awareness is the first step.