‘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

Players from NHL, junior leagues seeking brain scans without team involvement.

More than 200 current and retired National Hockey League players have taken concerns about existing or potential brain injuries into their own hands by visiting a neurosurgeon in Kingston, Ont., for MRI brain scan procedures.

Dr. Douglas James Cook says at least 120 former and some 80 active NHL players have undergone the scans over the past two years. He said that about 50 active players combined from the Ontario Hockey League and Western Hockey League have also been tested at Queen’s University over the same time frame.

The tests have not been done with the oversight or formal participation of any of the active players’ teams, Dr. Cook said in a series of interviews with TSN.

“Some guys come because teammates tell them about it,” Dr. Cook said. “Some players bring a teammate with them and then when they come for a follow-up say, ‘Can I bring these other two players with me? I think they might be interested.’”

TSN could not independently corroborate the number of NHL players who have had the tests completed.

Dr. Cook, who operated twice on Tragically Hip lead singer Gord Downie after his brain cancer diagnosis, said the technology used to measure the flow of blood through the brain’s millions of blood vessels is new and that his methodology for analyzing the data collected is unique.

Following a brain injury, Dr. Cook said, the flow of blood can accelerate through damaged or stressed parts of the brain as the brain directs oxygen-rich blood to the affected areas. In other nearby parts of the brain, blood flow can slow if it is redirected to injured areas in need of repair.

“We simplify it for players,” Dr. Cook said. “We explain that there are areas of stress in the brain after an injury and that there are changes in blood flow that we can monitor in those areas of stress.”

Dr. Cook said he’s discovered blood flow abnormalities in the brains of about one-quarter of the roughly 80 active NHL players he has examined.

“Unfortunately there are a number of them,” he said. “They just are not comfortable telling anyone about it.”

Dr. Cook said he’s talked about his testing with some NHL team owners and is hoping to meet with the NHL Players’ Association to discuss the testing. The NHL Alumni Association has also been involved in helping to build awareness of the tests, he said.

NHL Alumni Association president Glenn Healy declined to comment.

“We think this is exciting but it’s also controversial,” Dr. Cook said. “From the players’ perspective, some are concerned about what we might find out, what we might see. Some people don’t even want to know what’s going on in there. They know that they have accumulated damage and don’t necessarily want to face it. And obviously there are always concerns from the owners’ side. …  We worry the [NHL] perspective and perhaps the owners’ perspective is that this … is potentially damaging for the reputation of the league.”

The active players who have been tested include some of the NHL’s top young stars, a source told TSN. Their identities have not been made public and Dr. Cook declined to identify any players involved in the tests, citing privacy rights.

Toronto neurologist Dr. Charles Tator once taught Dr. Cook when he was in medical school at the University of Toronto and calls the 39-year-old Cook a rising star in the field of neurology.

“He was very inventive when he was working in my lab. He’s smart and well trained and he’s an expert on blood flow. … He told me about this project at least a year ago. … He’s a clever guy and has attracted their [NHL players’] interest. There is word of mouth and players encouraging their colleagues to go. That’s the way it happens.”

Dr. Tator said he has also examined NHL players in his Toronto office, but said he’s worked with far fewer players than Dr. Cook.

“Many players are capable of independent thought and they are concerned and sometimes they are pushed into seeking other opinions from their families if their families detect some alteration in behaviour,” Dr. Tator said. “Despite the best efforts of the NHL officials to play down concerns, there is concern among players’ families. They are thinking more about it. And this is escalating as time goes on.”

After finishing his residency and PhD in Toronto, Dr. Cook moved to California and worked at Stanford University, establishing himself as an expert in cerebral blood flow. In 2013 he returned to Canada and began working at Kingston General Hospital.

Using the nearby Queen’s University MRI machine costs about $600 an hour, Dr. Cook said. Players are not charged for the exams. The costs are covered with funding from Queen’s and from a family foundation whose administrators want to remain anonymous.

In Kingston, Dr. Cook said that the brain scans take about 45 minutes. Patients lie down inside the MRI machine and put on a facemask known as a rebreathing machine, which controls the amount of inhaled oxygen and carbon dioxide.

Dr. Cook said the MRI is then able to identify areas of the brain that have been damaged.

“We’re looking at the brain’s vascular physiology following injury,” Dr. Cook said. “There are patterns of impairment that are recoverable and there are patterns of impairment that set in and become more permanent. So we are using this as a technique as a way to detect concussion and also to identify the chronic syndrome that we see in older athletes as they age – issues like sclerosis, scar tissue, impaired vessel function and flow. It’s an exciting technology in a lot of ways.”

Dr. Cook said he began examining patients with suspected brain injuries four years ago and has received about $1.5 million in funding so far. After researching military personnel with a grant from the Canadian Institute for Military and Veteran Health Research, the Canadian Institutes of Health Research and the Natural Sciences and Engineering Research Council offered funding for a study of varsity football players at Queen’s.

Brain injuries and concussions are perhaps the most polarizing issue facing the NHL. On one hand, the NHL’s critics, who include nearly 200 former players who are suing the NHL, say the league has not done enough to educate and protect players from the long-term consequences of repeated head trauma. They point to NHL internal emails that show senior league officials have scorned independent medical experts who scrutinize or critique the NHL’s medical decision making.

For its part, the NHL has argued that any interested players could seek out medical journals and do their own research about the impact of brain injuries. Moreover, its officials point out that the NHL was the first pro sports league in North America to introduce baseline neurological testing for its players.

Reposted from: https://www.tsn.ca/players-from-nhl-junior-leagues-seeking-brain-scans-without-team-involvement-1.1014879

Grieving mother launches drive to reform emergency psychiatric units.

By late November, Ottawa wedding photographer Ryan Parent was in crisis. He was struggling under the weight of depression and anxiety, a burden made worse by his fear of returning to hospital.

Parent, 37, had gone to The Ottawa Hospital in June because a friend was alarmed by his manic behaviour and by his online posts about the Earth being flat.

In the emergency department, doctors referred him to the hospital’s Psychiatric Emergency Services (PES) unit for a more thorough assessment.

Both the General and Civic campuses have secure PES units inside their emergency departments. The units feature spartan, windowless rooms to limit the visual stimulation of patients. They’re designed to ensure that both patients and staff are safe while the individual is assessed and a mental health referral is made.

Parent spent 56 hours in one of the rooms at the General campus, waiting for a bed to open up on the hospital’s psychiatric ward. Ryan’s grandmother, Ruby Parent, visited him in the PES unit on June 3. She said his room opened to a small anteroom, from which a locked door led to the hospital hallway. The anteroom featured a window with bars through which patients could speak to a nurse.

This is a picture that Ryan Parent took of his room at The Ottawa Hospital’s PES unit. OTTWP

Ryan, she said, was well treated by staff and received permission to go for a walk. “But it was not a nice place, it was just like a cave,” she said, “and I think it must have been very despairing for him.”

A bed did not become available, so Parent was eventually discharged without a new diagnosis. At home, he told his mother he would never go back to what he called “that jail cell.”

“He said it was the most traumatic time of his life,” said his mother, Ellen Parent.

Ryan continued regular visits with an outpatient psychiatrist, but his mental state declined that summer. His fear of returning to The Ottawa Hospital mounted.

On the evening before he died, Ryan was in a paranoid state. He closed all the blinds, set the family’s home alarm system and discussed with his mother his fear that he had done something wrong, and would be locked up. They talked about going back to the hospital for help the next day.

“On the morning of his death, Ryan came into my room and said that he loved me but that he didn’t want to go back to the hospital,” Ellen Parent said. She told Ryan that was OK.

Ryan returned to his room. Later that morning, Parent discovered him slumped in his closet. He had hanged himself.

“My son who so badly wanted to live took his own life,” said Parent, who firmly believes her son’s experience in the PES unit played a role in his death.

“I do feel strongly about the fact that the ‘cell situation’ prevented Ryan from seeking more help — he was left with feelings of hopelessness and unrelenting fear. … I’m not saying that was the cause of his suicide, but he became terrified of the hospital.”

Ryan Parent is not the only patient who has been unsettled by the hospital’s secure and sterile PES unit. This newspaper spoke with two other psychiatric patients who were also disturbed by their experiences in the units.

But Dr. Katharine Gillis, head of The Ottawa Hospital’s department of mental health, defended the PES units as state-of-the-art.

She said they were created to give patients a private, safe and calming environment where they could be assessed by a dedicated team that includes psychiatrists, mental heath nurses and social workers. Previously, Gillis said, people who were having a mental health crisis were assessed in boisterous emergency departments, often in cubicles that offered little privacy.

Many people who come into the PES unit, she noted, are having an acute mental health crisis. “You have individuals who are really struggling: They’re over stimulated; they’re sensitive to their surroundings, to people being around,” Gillis said. “So we deliberately, in crafting these types of spaces, aim to have them provide low stimulation.”

Security measures, she said, are tailored to the individual. “When we think about a good patient experience, I think safety is an essential component.”

Although she could not speak to the specific details of the Ryan Parent case, Gillis said secure, low-stimulation PES units are now a standard hospital feature. “These elements may potentially appear unusual to someone who may see it, but these things are really part of what we want for this very acute, agitated phase,” she said. “This is not unique to The Ottawa Hospital.”

Dr. Gillis said there’s no defined limit of time for a patient stay in the PES unit. Staff will take the time they feel is appropriate to make a good assessment, she said, while keeping patients reassured and informed about the process.

“Our patient guiding principles are respect, compassion and safety,” she said.

Ellen Parent, however, contends the units are inhumane; she wants to see them eliminated.

“I feel it’s my duty to try to prevent anyone else from every going through that experience again,” she said. “A patient in distress does not need to be put in solitary confinement for hours on end.”

Ryan is not the only patient who has expressed concern about the units.

Joanne, 34, said she was three months pregnant and extremely depressed when she went to The Ottawa Hospital in April 2016. She went to the emergency department and explained to medical staff that she could not stop crying. She said she was having suicidal thoughts.

Joanne said she was sent to the PES unit for a psychiatric assessment. She spent 24 hours in the unit before being transferred to the hospital’s psychiatric ward.

“It was a very scary experience,” Joanne said of her stay in the PES. “It honestly felt like a jail cell.”

Joanne would spend two months in hospital and be diagnosed with depression, an eating disorder and obsessive-compulsive personality disorder. But it is her time in the PES that bothers her most.

“I would like them to remove it or at least don’t make it seem like we’re in jail,” said Joanne, who gave birth to a healthy son late last year. “We have mental illness, but we didn’t ask for that.”

Another psychiatric patient, Deanna, has twice stayed in the PES unit. She suffers from anxiety, post-traumatic stress and chronic pain. She called the unit “a dungeon.”

Deanna said her shoes, clothes and phone were taken when she entered the unit. She had to obtain permission to go outside for a smoke, and was accompanied to the bathroom by staff. (Gillis said security measures are individualized based on an assessment of each patient’s condition.)

Deanna said she felt so humiliated and isolated after her second stay in the PES that she has vowed not to go back.

Now 34, Deanna said the psychiatric ward is a more “humane” place where patients can wander around — the ward’s doors are secured — and visit a common area to read, watch TV or talk. She said she’d like to see the PES units revamped along similar lines.

“I don’t want to be treated like I’m an inmate down at Innes (the Ottawa-Carleton Detention Centre on Innes Road),” she said.

Parent contends psychiatric patients should be treated like anyone else who comes into the hospital, and assessed in the emergency department, not sent to a unit that can magnify their sense of isolation and paranoia. This is the situation at most other Ottawa area hospitals, including the Queensway Carleton Hospital, where a crisis-intervention team assesses acute mental health patients in regular emergency department cubicles.

“It’s just so wrong to send vulnerable people into that cell kind of situation, it has to stop,” Parent said. “I think every day of the people being put in there.”

Gillis said the hospital will be consulting with its patient and family advisory group before designing a PES unit for the new Civic campus, which is expected to open in 2026.

Resposted from: http://ottawacitizen.com/news/local-news/grieving-mother-launches-drive-to-reform-emergency-psychiatric-units

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.”

We’re Working Nurses to Death.

By: Jason Silverstein

Nurses do the work that neither hospitals nor patients could live without, which comes at an ever-increasing physical and emotional cost, as they are expected to aid sicker patients for longer hours with less support.

Otherwise, nursing could easily be the best job in the United States—the Bureau of Labor Statistics estimates more than 400,000 new jobs will be created by 2024. In five states, the average pay clears $85,000, with nursing jobs in California crossing into six figures.

Those numbers are no surprise to those who are aware of how much older the nation’s old are, and how much sicker they are, too: By 2030, there will be 70 million people over the age of 65, of which an estimated 14 million will have Alzheimer’s and more than 50 million will have at least two chronic health conditions.

But just as the need for nurses is increasing, so too is the price for devoting one’s life to the direct care of strangers. Nearly a quarter of hospital and nursing home nurses aren’t satisfied with their jobs, according to one study, and more than a third feel burned out. “Burnout is an occupational hazard in nursing,” says Jeanne Geiger-Brown, dean at Stevenson University’s School of Nursing and Health Professions. “It is hard to generate a lot of caring about other people, because you are so depleted yourself.”

Burnout, of course, is caused by overwork, but what causes overwork is more complicated and reveals how the cost-cutting priorities of hospitals force their nurses to pay an emotional tax.

“What’s causing the overwork is the increased acuity of patients,” says Susan Letvak, a professor at the University of North Carolina at Greensboro School of Nursing. “You are only in a hospital if you are so acutely sick that you can barely move. The minute you can move, you are kicked out the door.”

“The push is to get everybody out of the hospital as fast as we can,” echoes Bernadette Melnyk, dean of the College of Nursing at the Ohio State University and the university’s Chief Wellness Officer. Melnyk and her colleagues recently published a paper that shows depression among nurses is associated with both burnout and medical errors.

Getting people out of the hospital “quicker and sicker,” as a few Harvard health policy researchers explain, is a response, in part, to Medicare’s prospective payment system, which pays a fixed amount for a diagnosis no matter the length of stay, and the need for open hospital beds. If that formula seems designed to create higher rates of readmission, well…yeah. Even so, there’s also a financial incentive to avoid having people readmitted.

How does the quicker and sicker approach add up for nurses? Physically, it means the shifts themselves are much harder, especially since shifts are often twelve hours to begin with, which itself is a risk factor for burnout and mistakes in a place where patient alarms are constantly sounding. “It’s not healthy for the nurses, it’s not safe for the patients,” Melnyk says.

Emotionally, the quicker and sicker model means the long hours are engineered to be less fulfilling. “It’s not very satisfying to just put bandaids on people who are really quite ill,” Geiger-Brown says.

When the hospital is successful at turfing patients to home or anywhere else, you might expect nurses to benefit somewhat: Fewer patients on a given day could mean a slower shift and a chance for a break. But that’s not how it often plays out.

“Minimum is maximum staffing,” Letvak says. “We don’t have any easy days anymore. If the [patient load] is low, which happens all the time, they send the nurses home, instead of them having a light afternoon. How few do we need? That’s all that you’re getting. Every time you are at work, it is a bad day. There really isn’t a chance of having a lighter day anymore.”

Yet nurses should have the lightest days possible—like air traffic controllers, they do a job in which we accept no room for mistakes. Suppose you know that the ideal number of patients for a nurse is four—would you want to be number five?

While it may seem like a water is wet revelation to say nurses should care for fewer patients rather than get sent home, take a look at the work of Linda Aiken and her colleagues at the University of Pennsylvania. They have shown just how many lives are on the line when nurses are overworked. Give a nurse just one patient beyond four and the chances of that patient dying shoot up 7 percent and the chances of that nurse getting burned out climbs an astonishing 23 percent.

Overworking nurses extinguishes their lifesaving impact. Aiken and her team have shown elsewhere that every ten percent increase in the proportion of nurses with bachelor’s degrees lowers the risk of death for patients by five percent. A study by a different group found that a 10 percent increase in registered nursing staff saves five lives for every 1,000 people discharged. (If five saved lives doesn’t sound like a lot, try replacing “five” with five names of your loved ones.)

And while nurses care for a sicker and older population in an environment that is a burnout and depression generator, they may avoid mental health care for themselves, fearing that a hospital concerned first-and-foremost with the bottom line will use a mental health diagnosis against them.

“Think about the legalities,” says Letvak, who teaches on law and policy. “If a nurse made an error and something were to come out that they had depression, and then you can see the research that links depression and errors, that nurse just exposed herself to potential liability.”

Reposted from: https://tonic.vice.com/en_us/article/43nkjd/nurses-overworked-stressed-burnout?utm_source=vicefbus

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/