‘I want to talk!’ Waterloo students demonstrate for better mental health support

Months of waiting for counselling and the culture of high productivity has University of Waterloo students demonstrating at arts quad Thursday morning.

“I want to talk!” One student chanted. “We want to listen!” The crowd answered.

WaterlooWalkout for Mental Health was organized after a 22-year-old student in his fourth year of study died by suicide on campus on Monday.

About 200 students showed up. Some held signs. Others shared their struggles with mental health and what they believe is a lack of support on campus from counselling services.

“It seemed like they didn’t care about what I had to say,” said Iman Abbarao, who has been studying at the university for almost four years.

“The other day I told my friends that if I didn’t have family and friends in downtown Toronto, I probably would have taken my own life at some point along this journey,” she said in front of the crowd of students.

Iman Abbarao Waterloo mental health

Iman Abbarao, a student in her fourth year, said the only way she can get support is to leave campus and take a two-hour GO bus ride to downtown Toronto where her family is. (Flora Pan/CBC)

One after another, students recalled times when they went to counselling services but were told the next available appointment is months away. Other students spoke about abuse, sexual assault, depression and post-traumatic stress disorder.

Chelsea MacDonald, a first year student studying theatre performance, said she is angry about the state of support available for students.

“And then something like this happens, the university tells me go to counselling services. I can’t even f–ing get an appointment,” she said.

Mental health report

Matthew Grant, the university’s director of media relations, said at the rally that it was “very brave” for the students to share their experiences with mental health.

He said the mental health report being released on March 14 will have recommendations for improving student mental health on campus. There is also a town hall where the president will talk about the report and address student questions.

Currently, there are 22 full-time equivalent counselling services staff and 2 full-time equivalent psychiatrists serving 31,380 undergraduate students and 5,290 graduate students.

For comparison, at the University of Guelph, there are 16 full-time counsellors, one full-time psychiatrist and one part-time psychiatrist serving about 23,000 students.

A Wilfrid Laurier University spokesperson said for approximately 14,500 full-time equivalent students at the Waterloo campus, there are more than 30 staff, a mix of full-time and part-time physicians, nurses and counsellors, at the Student Wellness Centre who address mental health concerns.

Sundus Salame waterloo mental health walkout

Sundus Salame said the pressure to succeed academically is intense and she frequently feels like despite studying very hard, she isn’t good enough. (Flora Pan/CBC)

‘Very competitive’ culture on campus

Aside from the long wait times for counselling, students mentioned the pressure to succeed academically and getting good co-op job placements makes it very difficult.

“Somehow I have to be superhuman, or I have to have some kind of time-turner to catch up with all of these deadlines and readings,” said Sundus Salame.

“A lot of people here are pushed to just work 24/7 just to get 80 average, just because the courses are designed to just weed out anyone who does less than an excessive amount of work,” she said.

Chelsea MacDonald waterloo mental health

Chelsea MacDonald is in her first year studying theatre and performance. She lives in a one-person suite in residence and says she feels isolated. (Flora Pan/CBC)

In her speech to the crowd, MacDonald said students on campus are so wound up in the “grind for grades, grind for co-op,” that there is very little feeling of community.

Despite having friends, she said she frequently feels lonely.

“I don’t feel safe in my dorm anymore,” she said, “Because I know if I was ever, ever, at that point, how long would it take for someone to find me?”

Sarah Welton Waterloo walkout

Sarah Welton organized the walkout in a matter of days after the 22-year-old student died on campus. (Flora Pan/CBC)

Sarah Welton, who organized Thursday’s walkout, said coming to the university as a second-year student was “very alienating, very isolating.”

“I’ve heard so many people express the same sentiment over and over again,” she said.

“I don’t feel that all these reports they keep sending out are going to do enough, if they aren’t actually trying to take action and make some real concrete changes around the university.”

Reposted from: http://www.cbc.ca/news/canada/kitchener-waterloo/university-of-waterloo-campus-mental-health-1.4567382

A New Shift.

It’s been an incredibly busy term, so I haven’t had much time to keep up with my blog or really not think about anything outside of school. Since i’ve come back from my trip in the UK i’ve felt like I had to hit the ground running trying to keep up with all my work.

I’ve honestly really dreaded this term, moreso for the school aspect. To be honest, I think I say this every term, but really you think you’ve conquered one mountain (the last mountain) in nursing school only to be hit with another 2. That’s literally how nursing school feels like at times.

Pathophysiology has really kicked up a notch and now the midterms are over (I did okay), I still don’t feel like i’m sitting in a great spot walking into a full year cumulative exam. Considering I witnessed a number of people sitting in a similar spot fail pharmacology last term and have to stay back a year. Then on the other hand, I thought microbiology would be an okay course, but after that midterm yesterday i’m honestly starting to feel really discouraged with the whole course. It made me even more angry to hear her blame the students for “reading the questions” in the wrong lens, rather than accepting that maybe she made the exam too hard. I find it highly doubtful that 150 people (half the class on the left of the curve) are really that incompetent considering they made it this far in the program.

I think the only part i’ve really enjoyed about this term has been my clinical. As much as I hated how much the strike disrupted my term last semester, I’m really glad i’ve gotten to experience some 12 hour shifts. As exhausting as they are, they actually go by relatively quickly and it’s a great learning experience to actually spend a whole day on a single patient. I was fortunate enough to get to sit in on an endoscopy and colonoscopy and see what the procedure actually looks like and what the physicians look for and then the role of the surgical nurses and what part they play in the procedure and administering and maintain the anaesthesia. I was super fortunate that my patient was willing to let me use that as a learning experience considering how invasive the procedure is. My group as a whole have got to do some pretty cool things, like watching a toe get amputated (not super jealous considering I hate bones), injections almost every week, VRE swabs, or getting to go down to watch hemodialysis with their patients.

To be honest, I know i’ve mentioned it multiple times but I didn’t think i’d enjoy general medicine as much as I have so far. I know it’s definitely not an area I would want to work long-term post graduation, but it’s honestly been a tremendous learning experience and confidence booster. It’s still hard to get used to how to chart everything because there’s a lot but i’m so grateful for the nurses who have been there to answer my questions or make me think deeper.

I think my favourite shift had to have been last week. My patient was an elderly person who was in for something that had been relatively minor but because of her age impacted her ability to move. As a new nurse it always makes me a bit weary when delirium is mixed in because that increases their falls risk. When I asked how the patient ambulates (aka how do they move or get out of bed), the nurse simple stated that they didn’t. When I inquired further the nurse stated that the “patient was old and didn’t like to be moved and that was their right” and to “not worry about it”. Keep in mind this person had been in bed since they were admitted (ie multiple weeks). I felt very unsettled hearing that considering the importance of trying to at least encourage them to ambulate.

When I went to do my head to toe assessment, they were so pleasant and engaging. I was worried they’d be a bit confused having been woken up but they were quite chatty and I got to learn about their life and children and what it was like growing up in the area considering they have lived a relatively long life. I began to ask how they moved around. They began showing me some small exercises their family members had taught them and how she had a rotating lunch/dinner guest list their sister had made for them. I asked them if they wanted to try to get out of bed and why they had turned down physiotherapy’s assistance. This is when I found out that the physiotherapist that had tried to move them a month ago had tried to do a solo maneuver which hurt the patient and made them scared and that’s why they requested to stop.

It wasn’t until the patient’s grown child came later in the afternoon that we really began talking about the importance of moving and trying to understand why physiotherapy never came back to reassess them. I also brought up how nice it would be for the patient to at least be able to sit in a chair for a few hours a day to get some mobility and a different spot to enjoy her paper. Luckily in the moment, the nurse who reported to me stepped in to check on us since her patient was next door and I asked if it was possible to explain to the family why this issue was never re-addressed with the patient. I also brought up that maybe we could at least get them a geriatric chair to sit in as a start and that maybe we could order a new re-assessment to be done for the patient. While the nurse seemed a little flustered to not be able to explain the whole situation or the details (because they obviously just took the blind advice of others) it was at least a start. No patient should ever be left in bed because it increases the risks of pressure ulcers, DVT, infection (especially in lying supine), loss of muscle, depression, etc. While a patient has every right to decide what to do, as a nurse we have a duty to at least ask every day or explain the importance of moving.

It was evident from my patient showing me their mini expercises and bicycle kicks that they wanted to retain mobility and strength and wanted to get out of bed, but no one ever had asked them what they wanted to do or why they had turned down physiotherapy. Moving a patient alone can be scary for both partners, and it made me angry that no one had really investigated this further but rather played it up to the patient age. The patient shouldn’t have to be in bed for that long, considering they had already developed pressure ulcers on the coccyx and heel.

It wasn’t until I came back from my dinner break and went to check on my patient and perform vitals that I had found that the nurse had brought up her a geriatric chair to use the next day. Seeing the look on their face honestly made my entire day. They were so happy and grateful to be able to attempt to use it tomorrow. While it made me a bit sad to inform her I wouldn’t be her nurse tomorrow when they asked, I knew they’d be in good hands with another student nurse the next day. But to hear a patient actually thank me and say because of my actions I made it happen for them and that they’d think of me when they sat in the chair tomorrow made me incredibly grateful to be in this profession. As silly or small as it sounds, to the patient this was momentous.

But really, the patient shouldn’t have to thank me. I did my job. As a nurse I have a duty to advocate for my patients, and this was just simply that. They deserved more than what they were getting and if it were my loved ones I would expect the same from the nurse caring for them had I not gone into this field. I know nursing can be stressful, tiring, and demanding, but at the same time patient safety should triumph everything. I

t makes me angry when nurses sit around (especially when they have students taking patients off their load) and they sit their on the internet or phone ignoring the call bells because “it’s not their patient”. Yes it can be daunting to go into a room and know nothing about the patient (ie. falls risk, medication allergies), but the LEAST we can do is check what is wrong the patient perhaps they are lonely or scared, confused, and offer a bit of comfort or direction, or perhaps it is something more urgent and serious but can wait a bit. But even in those cases we can at least inform them that we will let their beside nurse know and acknowledge their call for help.

Having lost their independence, knowing they’d never be able to live on their own again and basically losing the ability to walk over night, it was something that meant a lot to them. Just to be able to sit in an actual chair again, even if for a few hours a day.

While I know I won’t get the same patient again tomorrow, I am excited to know I have one more 12 hour shift this term where I can go back and hopefully pull up a chair beside them in their new chair and chat. Being in a hospital room can be pretty boring and dreary but I think it’s kind of cool that while i’m still new I have the time to do these kinds of things and really get to know the patients as a person rather than as a number.

I don’t know what tomorrow will bring but i’m excited to find out when I get back on to the floor tomorrow morning and meet a new face.



Antidepressant drugs do work, review on almost 120,000 patients concludes.

A vast research study that sought to settle a long-standing debate about whether anti-depressant drugs really work has found they are indeed effective in relieving acute depression in adults.

The international study — a meta-analysis pooling results of 522 trials covering 21 commonly-used antidepressants and almost 120,000 patients — uncovered a range of outcomes, with some drugs proving more effective than others and some having fewer side effects.

But all 21 drugs — including both off-patent generic and newer, patented drugs — were more effective than placebos, or dummy pills, the results showed.

“Antidepressants are routinely used worldwide, yet there remains considerable debate about their effectiveness and tolerability,” said John Ioannidis of Stanford University in California, who worked on a team of researchers led by Andrea Cipriani of Britain’s Oxford University.

 Cipriani said these findings now offered “the best available evidence to inform and guide doctors and patients” and should reassure people with depression that drugs can help.

“Antidepressants can be an effective tool to treat major depression, but this does not necessarily mean antidepressants should always be the first line of treatment,” he told a briefing in London.

‘Depression causes misery to countless thousands every year and this study adds to the existing evidence that effective treatments are available.’– Dr. James Warner

According to the World Health Organization, some 300 million people worldwide have depression. While both pharmacological and psychological treatments are available, only one in six people with depression in rich countries gets effective treatment. That drops to one in 27 patients in poor and middle-income countries.

The study, published in The Lancet medical journal, found some differences in the effectiveness of the 21 drugs.

In general, newer antidepressants tended to be better tolerated due to fewer side effects, while the most effective drug in terms of reducing depressive symptoms was amitriptyline, discovered in the 1960s.

Some well-known medicines — such as the selective serotonin reuptake inhibitor (SSRI) fluoxetine, sold under the Prozac brand — were slightly less effective but better tolerated.

The scientists noted that their study could only look at average effects, so should not be interpreted as showing that antidepressants work in every patient. Only around 60 per cent of people prescribed depression medication improve, Cipriani said.

“Unfortunately, we know that about one-third of patients with depression will not respond to them,” he said. “It’s clear there is still a need to improve treatments further.”

Several experts not directly involved in the study said its results gave a clear message.

“This meta-analysis finally puts to bed the controversy on antidepressants,” said Carmine Pariante, a professor at Britain’s Institute of Psychiatry, Psychology and Neuroscience.

James Warner, a psychiatrist at Imperial College London, added: “Depression causes misery to countless thousands every year and this study adds to the existing evidence that effective treatments are available.”

Resposted from: http://www.cbc.ca/news/health/antidepressants-meta-analysis-1.4546709

Talking about mental health in Asian communities.

Happy to have been able to work with such a strong organization in blogging about my experience with being diagnosed with depression. I became acquainted with Mind while living in the UK to pursue my Master’s and finally had a chance to figure out a way I could help contribute to their cause in ensuring  everyone experiencing a problem gets both support & respect that they need.

This has been a project that had been in the works for a few months and i’m finally happy to share the result of having such a supportive organization help to share my story. I’m also incredibly humbled from the support I have received over the years in sharing my journey and to be fortunate to have helped others begin theirs.

While I have been fortunate to have the support of my family through my journey, I recognize that this is a prevalent issue amongst the Asian community in terms of stigma and the lack of support in terms of talking about  mental health. Hopefully by contributing to the conversation I can help other young people, especially minorities, find the courage and support they need to navigate and access an often complex mental health care system.



Read more “Talking about mental health in Asian communities.”

The Real Causes Of Depression Have Been Discovered, And They’re Not What You Think.

By: Johann Hari

Across the Western world today, if you are depressed or anxious and you go to your doctor because you just can’t take it any more, you will likely be told a story. It happened to me when I was a teenager in the 1990s. You feel this way, my doctor said, because your brain isn’t working right. It isn’t producing the necessary chemicals. You need to take drugs, and they will fix your broken brain.

I tried this strategy with all my heart for more than a decade. I longed for relief. The drugs would give me a brief boost whenever I jacked up my dose, but then, soon after, the pain would always start to bleed back through. In the end, I was taking the maximum dose for more than a decade. I thought there was something wrong with me because I was taking these drugs but still feeling deep pain.

In the end, my need for answers was so great that I spent three years using my training in the social sciences at Cambridge University to research what really causes depression and anxiety, and how to really solve them. I was startled by many things I learned. The first was that my reaction to the drugs wasn’t freakish ― it was quite normal.

Many leading scientists believe the whole idea that depression is caused by a “chemically imbalanced” brain is wrong.

Depression is often measured by scientists using something called the Hamilton Scale. It runs from 0 (where you are dancing in ecstasy) to 59 (where you are suicidal). Improving your sleep patterns gives you a movement on the Hamilton Scale of around 6 points. Chemical antidepressants give you an improvement, on average, of 1.8 points, according to research by professor Irving Kirsch of Harvard University. It’s a real effect – but it’s modest. Of course, the fact it’s an average means some people get a bigger boost. But for huge numbers of people, like me, it’s not enough to lift us out of depression – so I began to see we need to expand the menu of options for depressed and anxious people. I needed to know how.

But more than that – I was startled to discover that many leading scientists believe the whole idea that depression is caused by a “chemically imbalanced” brain is wrong. I learned that there are in fact nine major causes of depression and anxiety that are unfolding all around us. Two are biological, and seven are out in here in the world, rather than sealed away inside our skulls in the way my doctor told me. The causes are all quite different, and they play out to different degrees in the lives of depressed and anxious people. I was even more startled to discover this isn’t some fringe position – the World Health Organization has been warning for years that we need to start dealing with the deeper causes of depression in this way.

I want to write here about the hardest of those causes for me, personally, to investigate. The nine causes are all different – but this is one that I left, lingering, trying not to look at, for most of my three years of research. I was finally taught about it in San Diego, California, when I met a remarkable scientist named Dr. Vincent Felitti. I have to tell you right at the start though – I found it really painful to investigate this cause. It forced me to reckon with something I had been running from for most of my life. One of the reasons I clung to the theory that my depression was just the result of something going wrong with my brain was, I see now, so I would not have to think about this.


The story of Dr. Felitti’s breakthrough stretches back to the mid-1980s, when it happened almost by accident. At first, it’ll sound like this isn’t a story about depression. But it’s worth following his journey – because it can teach us a lot.

When the patients first came into Felitti’s office, some of them found it hard to fit through the door. They were in the most severe stages of obesity, and they were assigned here, to his clinic, as their last chance. Felitti had been commissioned by the medical provider Kaiser Permanente to figure out how to genuinely solve the company’s exploding obesity costs. Start from scratch, they said. Try anything.

One day, Felitti had a maddening simple idea. He asked: What if these severely overweight people simply stopped eating, and lived off the fat stores they’d built up in their bodies – with monitored nutrition supplements – until they were down to a normal weight? What would happen? Cautiously, they tried it, with a lot of medical supervision – and, startlingly, it worked. The patients were shedding weight, and returning to healthy bodies.

Once the numbers were added up, they seemed unbelievable.

But then something strange happened. In the program, there were some stars ― people who shed incredible amounts of weight, and the medical team ― and all their friends ― expected these people to react with joy, but the people who did best were often thrown into a brutal depression, or panic, or rage. Some of them became suicidal. Without their bulk, they felt unbelievably vulnerable. They often fled the program, gorged on fast food, and put their weight back on very fast.

Felitti was baffled ― until he talked with one 28-year-old woman. In 51 weeks, Felitti had taken her down from 408 pounds to 132 pounds. Then ― quite suddenly, for no reason anyone could see ― she put on 37 pounds in the space of a few weeks. Before long, she was back above 400 pounds. So Felitti asked her gently what had changed when she started to lose weight. It seemed mysterious to both of them. They talked for a long time. There was, she said eventually, one thing. When she was obese, men never hit on her ― but when she got down to a healthy weight, for the first time in a long time, she was propositioned by a man. She fled, and right away began to eat compulsively, and she couldn’t stop.

This was when Felitti thought to ask a question he hadn’t asked before. When did you start to put on weight? She thought about the question. When she was 11 years old, she said. So he asked: Was there anything else that happened in your life when you were 11? Well, she replied ― that was when my grandfather began to rape me.

As Felitti spoke to the 183 people in the program, he found 55 percent had been sexually abused. One woman said she put on weight after she was raped because “overweight is overlooked, and that’s the way I need to be.” It turned out many of these women had been making themselves obese for an unconscious reason: to protect themselves from the attention of men, who they believed would hurt them. Felitti suddenly realized: “What we had perceived as the problem ― major obesity ― was in fact, very frequently, the solution to problems that the rest of us knew nothing about.”

This insight led Felitti to launch a massive program of research, funded by the Centers For Disease Control and Prevention. He wanted to discover how all kinds of childhood trauma affect us as adults. He administered a simple questionnaire to 17,000 ordinary patients in San Diego, who were were coming just for general health care – anything from a headache to a broken leg. It asked if any of 10 bad things had happened to you as a kid, like being neglected, or emotionally abused. Then it asked if you had any of 10 psychological problems, like obesity or depression or addiction. He wanted to see what the matchup was.

Once the numbers were added up, they seemed unbelievable. Childhood trauma caused the risk of adult depression to explode. If you had seven categories of traumatic event as a child, you were 3,100 percent more likely to attempt to commit suicide as an adult, and more than 4,000 percent more likely to be an injecting drug user.


After I had one of my long, probing conversations with Dr. Felitti about this, I walked to the beach in San Diego shaking, and spat into the ocean. He was forcing me to think about a dimension of my depression I did not want to confront. When I was a kid, my mother was ill and my dad was in another country, and in this chaos, I experienced some extreme acts of violence from an adult: I was strangled with an electrical cord, among other acts. I had tried to seal these memories away, to shutter them in my mind. I had refused to contemplate that they were playing out in my adult life.

Why do so many people who experience violence in childhood feel the same way? Why does it lead many of them to self-destructive behavior, like obesity, or hard-core addiction, or suicide? I have spent a lot of time thinking about this. I have a theory – though I want to stress that this next part is going beyond the scientific evidence discovered by Felitti and the CDC, and I can’t say for sure that it’s true.

If it’s your fault, it’s — at some strange level — under your control.

When you’re a child, you have very little power to change your environment. You can’t move away, or force somebody to stop hurting you. So, you have two choices. You can admit to yourself that you are powerless ― that at any moment, you could be badly hurt, and there’s simply nothing you can do about it. Or you can tell yourself it’s your fault. If you do that, you actually gain some power ― at least in your own mind. If it’s your fault, then there’s something you can do that might make it different. You aren’t a pinball being smacked around a pinball machine. You’re the person controlling the machine. You have your hands on the dangerous levers. In this way, just like obesity protected those women from the men they feared would rape them, blaming yourself for your childhood traumas protects you from seeing how vulnerable you were and are. You can become the powerful one. If it’s your fault, it’s ― at some strange level ― under your control.

But that comes at a cost. If you were responsible for being hurt, then at some level, you have to think you deserved it. A person who thinks they deserved to be injured as a child isn’t going to think they deserve much as an adult, either. This is no way to live. But it’s a misfiring of the thing that made it possible for you to survive at an earlier point in your life.


But it was what Dr. Felitti discovered next that most helped me. When ordinary patients, responding to his questionnaire, noted that they had experienced childhood trauma, he got their doctors to do something when the patients next came in for care. He got them to say something like, “I see you went through this bad experience as a child. I am sorry this happened to you. Would you like to talk about it?”

Felitti wanted to see if being able to discuss this trauma with a trusted authority figure, and being told it was not your fault, would help to release people’s shame. What happened next was startling. Just being able to discuss the trauma led to a huge fall in future illnesses ― there was a 35-percent reduction in their need for medical care over the following year. For the people who were referred to more extensive help, there was a fall of more than 50 percent. One elderly woman ― who had described being raped as a child ― wrote a letter later, saying: “Thank you for asking … I feared I would die, and no one would ever know what had happened.”

The act of releasing your shame is – in itself – healing. So I went back to people I trusted, and I began to talk about what had happened to me when I was younger. Far from shaming me, far from thinking it showed I was broken, they showed love, and helped me to grieve for what I had gone through.

If you find your work meaningless and you feel you have no control over it, you are far more likely to become depressed.

As I listened back over the tapes of my long conversations with Felitti, it struck me that if he had just told people what my doctor told me – that their brains were broken, this was why they were so distressed, and the only solution was to be drugged – they may never have been able to understand the deeper causes of their problem, and they would never have been released from them.

The more I investigated depression and anxiety, the more I found that, far from being caused by a spontaneously malfunctioning brain, depression and anxiety are mostly being caused by events in our lives. If you find your work meaningless and you feel you have no control over it, you are far more likely to become depressed. If you are lonely and feel that you can’t rely on the people around you to support you, you are far more likely to become depressed. If you think life is all about buying things and climbing up the ladder, you are far more likely to become depressed. If you think your future will be insecure, you are far more likely to become depressed. I started to find a whole blast of scientific evidence that depression and anxiety are not caused in our skulls, but by the way many of us are being made to live. There are real biological factors, like your genes, that can make you significantly more sensitive to these causes, but they are not the primary drivers.

And that led me to the scientific evidence that we have to try to solve our depression and anxiety crises in a very different way (alongside chemical anti-depressants, which should of course remain on the table).

To do that, we need to stop seeing depression and anxiety as an irrational pathology, or a weird misfiring of brain chemicals. They are terribly painful – but they make sense. Your pain is not an irrational spasm. It is a response to what is happening to you. To deal with depression, you need to deal with its underlying causes. On my long journey, I learned about seven different kinds of anti-depressants – ones that are about stripping out the causes, rather than blunting the symptoms. Releasing your shame is only the start.


One day, one of Dr. Felitti’s colleagues, Dr. Robert Anda, told me something I have been thinking about ever since.

When people are behaving in apparently self-destructive ways, “it’s time to stop asking what’s wrong with them,” he said, “and time to start asking what happened to them.”

Goodbye 2017, Hello 2018.

With the disruption from the college strike, my life was in a bit of a disarray.  I was also feeling a bit depressed during the holidays and I caught myself in those moods and found ways to adjust my coping strategies.

I’ve been pretty fortunate in people being able to turn to me in times of distress and i’m happy to have helped a few people work on their mental health over the past couple months. I know for many people opening up about their struggles with depression and anxiety can be tough, but I have always and will always be there to support anyone in need and I have a number of resources to direct people to. I think I will therefore make a goal for 2018 to to take part in Mental Health First Aid and be able to offer support to those around me.

I must say, the final exams I wrote so far for last term were highly discouraging. I know I am not alone when I say that, but regardless it does take a pretty big hit to your self-worth as a student when you write exams that are seemingly much harder than what you were prepared for. I must say, despite writing some pretty awful exams (and I mean 60s) I still managed to pass last term with and am surprised I even managed to pull off a B in pharmacology.

I’m moreso proud of myself for successfully passing my first clinical rotation. There aren’t any words to really describe your first clinical experience except you feel lost, confused, and like you don’t know anything especially when given your very first solo patient assignment. Let alone when patients are looking at you and watching what you’re doing and nurses are talking to you about your treatment plan. I was given some pretty challenging cases by my preceptor (generally not given to second years) but managed to pull it together and learn quite a bit. Losing out on 5 weeks of a strike in the big picture isn’t a lot, but in the moment it felt worse than it was. Having so many disruptions really takes a toll on my groups (and other classmates) ability to practice our skills and discover and address our learning gaps. However, i’m incredibly proud of the people I had in my group for creating a supportive environment for all of us to grow and success and pass our rotation.

Over the term I grew not only as a student nurse but as an advocate for my patients. I’m grateful for my experience pursuing my Master’s and believe that it’s really helped me to gain a better understanding of my patients as a whole and seemingly it was evident in post-conference talks and the work I turned in. It was even more rewarding to sit down with my tutor for my final evaluation and be recognized for the issues I brought up and the work I put into helping the rest of my group. I feel empowered and encouraged to continue on the path i’m on and to know others have recognized my passion for making a difference in not only healthcare but within my community. I’m grateful to have had such a supportive tutor to guide me through the term and firmly believe that in time I will help change the face of nursing in the role of policy advising to the top levels of government even when it was hard for me to gauge where I was at.

While my next rotation in general medicine will help me build my foundational skills, it still sucks that I lost out on such a great opportunity being in a chest unit. I know in time these rotations help us figure out where we want to do our final consolidations, but i’ll be even more excited (if things go well this term) to get into peds and maternal units.

I must say with this terrible bone-chilling cold weather I am excited to head back to England in a couple weeks to see some good friends and walk across the stage to collect my degree. Hard work has slowly paid off and i’m even moreso excited to see where 2018 will take me in my nursing journey. Therefore, I think a second goal I have for 2018 is to get more involved in community and nursing advocacy through the RNAO, ONA, and CNA as a student member.

Hopefully i’ll get over this cold and actually start the new year on a fresh foot soon. I know it’s cold and flu season, so I remind everyone to practice that HAND HYGIENE.



How to be merry even though it’s Christmas.

IT’S THE MERRY CHRISTMAS season, a holy time, joy-to-the-world days, happy Chanukah, the heartiest and most beautiful holiday of the year — except that it often doesn’t work out that way. And the only way to deal with this paradox is to understand how and why it works.

The truth is, few people get through these gala days without feeling decidedly annoyed by the season. With some, it’s only a flinching reaction to the insistent jollity. Others, particularly those suspended in the middle years between taskless childhood and self-indulgent old age, are harassed by shopping, wrapping, mailing, cooking and debts — and the notion that what started out to be a gentle religious festival has been hoked out of shape by the vendors.

Quite a number of people have an old grudge against Christmas: it is a regular reminder of disappointment, suffering or isolation in some less-than-perfect Christmas past. A proportion of these have what amounts to an annual breakdown at Christmas, one that is now being investigated by psychiatrists who call it either the Holiday Syndrome or Christmas Neurosis. Their main symptoms are depression and deep anger, though they may conceal them gallantly under the requisite degree of ho-ho heartiness.

These individuals are gloomy because of the idealized warmth and sweetness of the season, not in spite of it. Since they cannot, for various reasons, experience all the elation that seems to abound, their private desolation is the mark of failure, and a bitter one.

Most people can bask in Christmas as children do, frankly relishing the food and drink treats, the conspiracy of gift hiding, the expectancy of wish-fulfillment, the tumult of parties and gaudy decorations, the simplicity and sentiment of a baby Saviour. It’s a mass regression to untroubled pre-adolescence, and the pleasure seeking can be atoned for neatly by New Year’s resolutions.

But there are flickers of doubt. Carol singing can grow tedious, week after week, outdoor decorations are competitive and oath provoking, gift-shopping is exhaustion and frustration in a pure form. The relatives gather, not always a happy sight. A lot of people accordingly plan trips to remove themselves from Christmas, only to find themselves sourly marking the oddity of Christmas lights in a palm tree or the cheeriness of strangers in a ski lodge.

“Not being joyous during the Christmas season is much more common than most of us realize,” observed a report by four psychiatrists at the University of Utah, who recently completed a study of psychological complaints at yuletime.

Dismay, in a mild degree, is universal. Sociologists have been noting that ordinary conversations during the pre-Christmas rush are rarely luminous with goodwill. Women complain of weariness, anxiety while shopping, the greediness of their get; men are uneasy over expenses and drinking too much. “There are few spontaneous exclamations about how wonderful it all is,” comments a noted Canadian psychiatrist, Montreal’s Dr. Alastair MacLeod. “There seems to be a great deal of hostility and anger over being impelled into something.”

The tender concepts of the season, in the Christian religion of the Nativity and in Judaism the candlelight memorial to freedom, are hard to confront under the smothering of carnival commercialism. There is a resultant loss of tranquillity felt by everyone.

One of the world’s most distinguished psychoanalysts, Ernest Jones, once wrote that Christmas represents psychologically “the ideal of resolving all family discord in happy reunion.” It’s an excruciatingly vulnerable ideal, since distance, divorce and death can shatter it, while old grievances within the family can make success chancy.

There is a sharp rap of despair when the family can’t be together, or when it can and the gathering tends to stir up old irritations rather than erase them. The disappointment can be so acute that rage breaks out readily — murders are not uncommon at Christmas, or accidents involving a violent mood and family dissension on a monumental scale. In some countries,o notably Germany, the suicide rate climbs at this season.

Scientists became intrigued some twenty years ago with the special depression that Christmas creates, with glancing attention to the lesser blues that sometimes attend vacations in the summer or even Sunday afternoons. Comparing notes, doctors discovered that many of their psychiatric patients suffered severe setbacks during the Christmas season. Succeeding studies of normal people revealed a vast, subsurface ocean of unrest, a distress that seems so ill-timed that its victims usually hide it under a pseudo-enthusiastic and tiring kind of gaiety.

The United States psychoanalyst J. P. Cattell describes the Holiday Syndrome as extending for more than a month before Christmas to a few days after New Year’s Day. It is characterized, he reported in 1954 to the American Psychoanalytic Association, by the “presence of diffuse anxiety, numerous regressive phenomena including marked feelings of helplessness, possessiveness and increased irritability, nostalgic or bitter rumination about holiday experiences of youth, depressive effect and a wish for magical resolution of problems.”

That’s a wordy nutshell. Many people bear with year-long humiliations and misery but cannot avoid the futile hope that Christmas morning will cure it all. The season brings forth an inner child, a loitering Peter Pan who wants coddling and gets instead a hatful of bills. The knowledge that Christmas is an expensive cheat, with only a flash or two of lovely lustre, creates a general jangling of nerves that silver bells cannot quite cover.

Some people have a clear idea why they are unhappy at Christmas. One famous Canadian writer, for instance, was deserted by his wife on Christmas Eve and another buried his only daughter shortly after she had helped decorate the Christmas tree. A young mother of three whose critical in-laws visited her for six weeks before every Christmas, bulging the facilities of a small apartment, eventually detested the entire season. A Montreal engineer felt a chill every Christmas until he was nearly forty, a residue of his mother’s insistence that he open all his gifts alone in his room. A man who was raised in an orphanage doesn’t feel comfortable watching his children receive their presents — they’re never grateful enough.

Some experts feel that the North American accent on gift exchanging is causing a good deal of Christmas blues. To a child’s mind — and many an adult’s as well — the quantity and quality of gifts received is tangible evidence of his valuableness in the world. Friends who receive more and better gifts are assumed to be better loved, a brother or sister getting more lavish presents is a catastrophe. For this reason even mature people feel a droop in spirits as the last gift is unwrapped, while children are inclined to protest violently.

The emotional involvement in gift-giving is such that people who are unable to love their families, or who feel inadequate in some way, tend to give luxurious presents, beyond their means, as a conscience calmer.

Christmas, accordingly, can be an economic disaster and many heads are filled at this season with a dance of debts. The financial demands of gifts, decorations, tips and entertainment is a strain that creates panic, making tempers snappish.

Dr. MacLeod, the Montreal psychiatrist, is reminded at this time of the year of the potlatch customs of some British Columbia Indian tribes, who destroy their enemies by loading them with gifts and food. The guests of honor are expected to give an even more sumptuous feast and gifts in return, wrecking their resources if they comply and disgracing themselves if they don’t. Christmas gift-giving can also be persecution: there is a mutually ruinous trend on this continent to give back a slightly better gift than was received.

But worry over debt is only one of the many factors which disturb people at Christmas. Some scientists, notably Ernest Jones, suspect that a primitive identification with the sun affects mankind, so that the waning of the winter sun rekindles a primitive fear in everyone that human powers are weakening as well.

Some of the responsibility for Christmas depression would then lie with the early Christians who somewhat arbitrarily chose December 25 as Christ’s birthday, usurping the date of the most widely celebrated of pagan festivals. Ardent sunworshippers believed that the winter solstice, the shortest day of the year, was the date on which the old sun died and a new one was born. They celebrated giddily: plentiful food and drink, their best attire, fires lit to support the burgeoning young sun. The Romans ornamented their homes with wreaths and exchanged gifts and visits. The Druids gathered mistletoe and the Saxons holly and ivy.

More than three hundred years after the death of Christ, many of the new church’s followers were distressed that the teachings of the forgiving, love-honoring Son were being overshadowed by the harsher tenets of the Father. To elevate the importance of the Son, they decided to establish His birthday as a festival. Since the actual date was debatable (many modern scholars place it in the spring), the symbolism of the pagan feast to the newborn sun made it the most apt choice of several that were tried.

Bawdy beginnings of holy days

It was a technique of the time to smooth the way for conversion by supplanting pagan ceremonies with Christian likenesses. The Feast of the Epiphany, for instance, takes place on the day that Egyptians marked the virgin birth of their god Aeon. The festival of the goddess Diana was replaced with the Assumption of the Virgin and the Celtic Feast of the Dead became All Souls Day.

(Occasionally Christians grow fretful at the bawdy beginnings of some of their holiest days: An act of English parliament in 1644 abolished Christmas as a “heathen festival”; it was reinstated promptly when the Merry Monarch, Charles II, took the throne. )

Similarly, the Jewish ceremonial lighting of candles during Chanukah bears the imprint of pagan sunworshipping. The eight days of Chanukah have some points of resemblance to the Roman Saturnalia, also a festival of goodwill and rejoicing which was observed originally on December 19 and later extended for seven days. Chanukah, the happiest of all Jewish ceremonial days, celebrates the victory of a Jewish tribe, the Maccabees, in history’s first war of conscience.

The selection of deep. dark, cold winter for determined merrymaking sets up an inevitable conflict that many experts blame for some of the despondency of the season. Days of brief sunshine produce their own melancholy. And so does the imminence of the year’s end — the dying of time, years running out, life running out.

In addition to this, for many North American Jews Chanukah has become a period of painful yielding. Their holiday pales beside the more widely and conspicuously celebrated Christmas, a comparison which causes Jewish children to feel bereft. To offset this, some Jewish parents decorate a Christmas tree — calling it a Chanukah bush — and put presents beneath it. These concessions shame the devout. both those who practise them and those who observe their fellow Jews practising them, and thus contribute to holiday depression.

But the deepest and most serious depressions at this time, bordering on a temporary mental illness, are believed to be a legacy of jealousy in childhood. Some doctors have reported in scientific journals that some adults under psychoanalysis even demonstrate an unconscious and corrosive envy of the Infant who receives so much love and attention at Christmas and cannot be competed against.

Other experts are examining a theory that problems arise at Christmas because reality is suspended by the childish pursuit of pleasure. Dr. Cattell observed that most people are healthy enough to manage the intoxication of tinsel, spruce and incense without losing sight of maturity, but others regress firmly into childhood and find a chamber of horrors awaiting them.

The Christmas-Chanukah observances. however, cannot in themselves create an untypical mood. They only exaggerate feelings which during the rest of the year are simmering but kept repressed by the thumb of conscience. At holiday time the conscience relaxes and releases whatever malice and envy it has been hiding.

Sandor Ferenczi, a brilliant Hungarian psychoanalyst, believed that the loosening of external and internal restrictions, which accompanies a holiday-inspired release from routine, is frightening to some people, causing them to grow alarmed, despondent, restive and ill. Among the side-effects of festive easing of the conscience are an aroused sexual appetite and an interest in aberration.

The period surrounding Chanukah, Christmas and New Year’s Day is not only the most chaotic of the year but the most permissive of exuberant behavior. As a consequence it can exert a most disastrous effect on people who are confident only when they are under the control of a routine-filled life. Dr. Jules Eisenbud, a New York psychoanalyst, observed in a paper, Negative Reactions to Christmas, that this season permits “social sanction to forms of enjoyment which at other times must be held to a judicious minimum.” Another psychoanalyst, Dr. L. Bruce Boyer, added, “It is to be expected that the degree of neurotic response to such an intense holiday release would be frequent and severe.”

Psychiatrists arc collecting an interesting dossier of Holiday Syndrome case histories. One of them describes a woman engineer who was exhibitionistic, aggressive and convinced she was unwanted. At Christmas she always felt especially forlorn. “I used to feel that if I didn’t find something wonderful that Christmas, I’d find it another,” she told her doctor. The “something wonderful” was proof that her parents loved her, a gift that was perpetually withheld.

Another woman expressed hatred of her preferred brother only when Christmas approached, a malevolence that always surprised and terrified her. A psychiatrist drew out the underlying cause. As a child, the woman had always felt that her parents favored her brother. This feeling became particularly poignant at Christmas, and in later years, although she had long since forgotten the supposed favoritism, the coming of Christmas revived the hurt.

A department store buyer who also grew up with a much-favored brother became savage in her business relationships with men during the Christmas season and twice was fired because of it. Her doctor discovered she had once asked Santa Claus to change her into a boy so her parents would like her better. The collapse of this confidently expected miracle left her with an annual vendetta against the masculine sex.

A salesman who loathed Christmas traced it to an event when he was nine years old. He discovered a new bicycle hidden behind his house and assumed it was intended for his Christmas gift. When it went instead to his younger, handsomer and more clever brother, he formed a distrust for Christmas that thirty years of living hadn’t healed.

A strongly religious woman went to a psychiatrist when she realized she hated Christ every year at Christmas. She was blaming the Baby, it turned out, for her own emotionally barren childhood. A beautiful young girl began to quarrel viciously with her boy friend at Christmas, becoming demanding and petulant. Her father had deserted her mother, an absence the girl felt most acutely at Christmas and which ever after prodded her apprehension that all men eventually desert their wives.

The Utah psychiatrists studied the case of a man who was so wretched in his home town at Christmas time that he fled to a nudist camp. One father, otherwise a responsible citizen, passed bad cheques every Christmas. Another, who delighted his family with his choice of birthday and anniversary gifts, always refused to do any Christmas shopping at all. A divorcee who felt sentimental about Christmas couldn’t endure being alone then — she cried and broke out in hives.

“Some of the ordinary unhappiness at Christmas is related to the turbulence in the family,” explains Dr. MacLeod. “Quite a few people are sensitive to the strain of household upheaval and are upset by it. The home becomes unfamiliar, which disturbs and worries everyone. You’ll notice that children react by contracting some kind of ailment. We now know there is a definite connection between emotions and the body’s ability to defend itself against some of tile causes of illness.”

Whatever causes it — lack of sunshine, childhood jealousy, confusion, old wounds or apprehension because the lid is off — the Holiday Syndrome is now drawing considerable medical attention. The chief benefit so far is that those who endure the strange malady of loneliness in the midst of gladness, ire instead of awe, know at least that they are not oddities, but members of a substantial group.

They have some practical solutions to ponder. Some families have stopped sending Christmas cards and others exchange few gifts or none at all, investing the resultant saving in CARE packages or local givings. Some individuals have overcome their aversion to Christmas by rooting out their prized collection of old injustices. There is an evident trend toward quieter, sweeter family celebrations, a tendency to savor that has been accelerated by current portents of doom. With the hustle out, it’s astonishing what remains — a sense of holiness, for one, and peace, and even joy.

Repost from: http://www.macleans.ca/archives/how-to-be-merry-even-though-its-christmas/

What Not To Say To Those Struggling With Mental Illness.

For those who are grieving, the holidays are hardly “the most wonderful time of the year.” Not only are they navigating their pain, they’re doing it during a time that’s supposed to be joyous.

Loved ones often try to alleviate some of the grief a person may be feeling by offering helpful phrases or advice, but what may seem like a supportive statement could actually be exacerbating a person’s sadness, Dan Reidenberg, chair of the American Psychotherapy Association, told The Huffington Post.“Certain statements don’t take into account what the grieving person is feeling,” Reidenberg said. “They end up really focused on the person who isn’t grieving.”

Take a look at advice from Reidenberg and a couple of additional experts and avoid these common pitfalls:

1. “Smile, it’s the holidays.”

While this is a good intentioned way of trying to cheer someone up, it may come across as invalidating.

“Statements like these end up sending a message to the grieving person ‘hide your sadness’ or “’it’s not okay to be sad,’” Reidenberg said. “This hurts them, makes them feel more alone and that their grief might somehow be wrong.”

2. “Next year will be better.”

Grief often makes the future look foggy.

“The holidays are filled with memories of good times, happy times, when loved ones and friends shared experiences and made memories together,” Reidenberg said. “Those are now in the past for the person grieving and that is very hard on them.”
Include the individual in your holiday preparations and just spend quality time with them when they need it, Reidenberg suggested. A supportive presence goes further than you think.

3. Any questions about the details of the death.

Curiosity should be stifled in this case, according to Nancy Marshall, a licensed professional counselor and author of Getting Through It: A Workbook for Suicide Survivors.

“Don’t force anyone to tell the story over and re-expose the trauma,” Marshall told HuffPost. “Your right to the ‘news’ does not trump their need for well-being.”

4. “Let’s try not to think about them right now.”

“People have a hard time being around someone who is sad and grieving, so they often try to take their mind off it or somehow make it better and the reality is that sometimes it just can’t be better,” Reidenberg said.

Acknowledging a person’s loss is crucial. Instead, try asking the grieving individual about any traditions they used to love to do with the person who passed, Reidenberg advised. Allow the person to guide you on how much or little they want to discuss.

5. “They’re in a better place.”

It’s easy to default on cliches, but they often come across as impersonal. Phrases like “everything happens for a reason” and “they’re in a better place now,” can often make a person grieving feel even more isolated if they aren’t at a place where they can accept what happened yet, Reidenberg said.

Try saying something like “I can’t imagine how you must be feeling” or “Is there anything I can do for you?” instead. And never underestimate the power of saying that you’re sorry this happened to them.
Ultimately, grief will subside but your support through the process is vital for the person who is in pain.
“It certainly will never be ‘okay’ that this happened, but time will pass and the sharpest pain will recede from consciousness,” Marshall said. “Always be compassionate with yourself as an observer and with your friend who experienced a horrible loss.”


Reposted from: http://www.huffingtonpost.com/entry/what-not-to-say-to-people-who-are-grieving-at-the-holidays_us_585be878e4b0de3a08f448e1

Michael Phelps on Life After Swimming and His Battle With Depression.

The most decorated Olympian of all time wants you to know he has bad days — some very bad days — just like so many people. “I’m not a superhuman,” Michael Phelps tells LIVESTRONG.COM. “I’m a human being who was very fortunate to find something that I love and find something that I’m good at and really never give up. But, really, that’s it.”

While he made success in the pool look easy, a shadow hung over the star athlete for years as he battled depression. Now Phelps is sharing more about his mental health issues. “These are things that have been a part of me for so long,” he says. “I just decided it was time to open up and talk about some of the struggles I’ve had in my life. Just being able to get out and talk about it and communicate about it — almost become vulnerable — I think is something that will help a lot of people,” Phelps, who will appear in a new documentary titled “Angst” to talk about his depression and being bullied, tells LIVESTRONG.COM.

Since retiring from swimming with 23 gold medals after the Rio Olympics in 2016, Phelps has had to readjust his routine and figure out what’s next for him. “For a long time, swimming was that thing that got me out of bed every morning early to go and jump in a freezing-cold pool. But now, kind of starting the next chapter for me, I’ve been asking myself where I want to be and what I want to do.”

Those next steps include working on a cause close to his heart: water conservation. “I obviously grew up in water and in around water for a very long time,” Phelps, a global ambassador for Colgate’s Save Water campaign, says about the world’s most vital resource. “I think it’s little small things that we can do together — no-brainers like not leaving the faucet running when you brush your teeth [and taking] shorter showers.”

His life at home with his wife, Nicole Johnson, is also becoming more of a focus, as their son, Boomer, is now 17 months old and they are about to become parents for a second time. But Phelps says he would never force his kids into the athlete life. “For me, I had an awesome mom growing up who was just so supportive of everything that we did,” Phelps says. “If I wanted to quit swimming, she was fine with it because she wanted us to follow our hearts. The only thing I’m adamant about is that [Boomer] has to learn to swim. Other than that, he can play another sport, whatever makes him happy.”

Reposted from: https://www.livestrong.com/article/13590348-michael-phelps-on-life-after-swimming-and-his-battle-with-depression/?utm_source=facebook.com&utm_medium=referral&utm_campaign=Keywee&kwp_0=599482&kwp_4=2116520&kwp_1=884107