Chapter Closed.

Ah, finally I can sit in peace and focus on writing a blog post. I can’t believe i’m already back in schools ready for round 2. Summer seems like a blur and it’s probably because of all the schooling and work I had to undertake to get caught up.

I’m proud to say i’m finished my Master’s (at least until Results day in November). All 14,998 words. I must say finishing my physiology course and having to jump straight into finishing my dissertation was a rough go. Why I thought it was a good idea to work 40-55 hours a week is beyond me, but somehow I did it. To but it into context, it took me 2 DAYS to sort through all the footnotes, citations, and bibliography and organize it all. While it’s now finished I have not yet had the courage to go back over and look at the hard copies I had printed out of fear knowing there will obviously be mistakes. While I realize work at the Master’s level does not have to be publishable, the perfectionist in me would go bonkers knowing it’s there. So to not throw myself in a downward spiral of total despair i’ve decided to withhold looking (plus i’m over writing it and thinking about it for the time being).

I think the one things i’m grateful for having done medical ethics as my Master’s is for the expansion in the way I think about things. To understand ethical decision making models and work through it. There’s no right or wrong answer in every case and going into clinical practice I know there will not always be things that line with my personal values. It’s how I can hopefully align those two differing values that will work to prevent increasing my own moral distress and prevent burn out. I also want to help my patients walk through difficult situations where things aren’t always clear and help them work through their own ethical dilemmas.

I must say while i’m excited for problem-based learning this year (largely because of it’s focus on ethics!), I am weary of pathophysiology, pharmacology, and bio-stats. It’s a bit hard to fathom how I made it knowing 30 people (our of a class of 120) were not able to move forward into second year because of failing courses by such a small margin in most cases (1-2%). I know I worked my butt off to be in the position I am, but at the end of the say all of us came into this program as highly intelligent individuals. I also knew when to ask for help when I was struggling whether seeing accommodation for my depression and anxiety, seeking out additional tutoring sessions to understand biochemistry, or even buying additional resources to bulk up my knowledge, but I also realize I was fortunate in having had previous undergraduate experience. In any program failure happens, but I think on some level it’s a wake up call to know that failure does happen and sometimes its not the smartest people that advance but those that put in the work, but its hard not to feel anxious when it is a reality.

I think of the thoughts that has been on my mind most recently have been the concepts brought up in the book ‘Lean In’. I’ve been thinking a lot about where my nursing journey will be taking me, particularly where my interests lie. I’ve found myself to always be interested in maternity, but lately due to my community placement i’ve really enjoyed working with kids. I know in my heart clinical nursing isn’t always something I will be passionate about, shift work can be incredibly draining and not conducive to raising a family, which is why I think clinical ethics will be one option I am eager to explore.

I want to make a difference. I want to lead. I want change. I want to succeed.  Those are my mantras in life. I’ve spent a lot of time thinking about how growing up as a female I’ve seen young males groomed to be in positions of leadership. Yet i’ve noticed females have always lagged behind. A clear example that comes to mine was having someone so close to me tell me he “could never be with someone that made more than him”. As in the male always had to be the bread winner, keep in mind this is the same person that felt emasculated having a female choose to not change her last name to his. To be honest, having read ‘Lean In’ I can say i’ve been put in a positions where I felt I could not advance myself because I was a female and had to ‘follow’ these societal norms that seem to exist.

Its incredibly distressing to see the number of female students pursuing post-secondary education but yet is not reflective of the board room. How as a female I am penalized for choosing to have children, even though in most cases its a decision made by both the male and the female and because of this I lose out on the same opportunities that would be extended to my male colleagues. To be fair, it’s also unfair that males are also looked down upon to take advantage of paternal leave to spend time with their children and raise them in an equal manner.

I think another thing that irks me is when people think that females are bossy for being assertive but when males act in the same manner they are seen as “leaders”. I’ve ALWAYS been ambitious and motivated to improve my self and make a difference at some level.  Yet, i’ve noticed sometimes people can find me intimidating because of a number of factors whether it was my upbringing, my education level, or even my goals for the future. On some level, I used to let that control me and it destroyed my self-esteem, making me question my values, goals, and self-worth. It’s taken time but slowly i’ve found myself returning back to normal and feeling excited about where the future will take me. I realize now RN positions in Ontario are limited, particularly in places I want to hopefully live, but I also know Canadian nurses are so highly regarded that the world is really my oyster and with so much to explore I sometimes find myself not knowing where to start.

I’m grateful to have had many great mentors along the way who have helped guide me down this path and shaped my goals for the future. It wasn’t until recently that i’ve reach back out to some of my most notable mentors and thanked them for the opportunities they provided me and the guidance and support they showed me in pursing my Master’s and for peaking my interests in nursing. I’m incredibly lucky to have had an enriching undergraduate experience in being well supported by a caring academic advisor (who i’m still in touch with), my fourth year practicum supervisor, my professional ethics professor, my profs in the UK, and the director of the health studies program who have all played important roles in who I am now. I think one of the most important things as not only a female, but also a person, is to find someone you look up to and connect with them and don’t be afraid to reach out to people in areas your interested in. It’s important to have that support and to know that while all our paths may not be the same, having someone in your life in that position can make a huge difference on days where you may not feel capable of reaching your goals (ie. working through pathophysiology).

My path to nursing school has not been conventional and i’ve hit many bumps along the way (ie. my battles with depression and anxiety), but I hope my journey can inspire other young people to know that life is full of funny twists and turns. It’s also helpful to know someone else feels the same way sometimes and that we aren’t alone in our journeys. In some ways its therapeutic to read about the experience of others when a lot of the resources out there for mental illness are inadequate in meeting the needs of an individual seeking help.

In time I hope to be more open about my experiences throughout nursing school and clinical practice in helping to fuel passion in other individuals whether it be in medicine or any other field, particularly in girls where opportunities to lead are not always high on the list. We need more people seeking to lead and make a difference in a world where we have people like Trump in power and in this regard we need to encourage and teach females that we can’t let someone with such disgusting views limit our visions.  I want to be part of the movement that encourages and evokes positive changes. We need to empower people to think, we need to promote opportunities to those disadvantaged, and we need to spark innovation, creativity, and entrepreneurship in a world where technological advances are taking opportunities away from people.



Human antidepressants building up in brains of fish in Niagara River.

Researchers studying fish from the Niagara River have found that human antidepressants and remnants of these drugs are building up in the fishes’ brains.

The concentration of human drugs was discovered by scientists from University at Buffalo, Buffalo State and two Thai universities, Ramkhamhaeng University and Khon Kaen University.

Active ingredients and metabolized remnants of Zoloft, Celexa, Prozac and Sarafem — drugs that have seen a sharp spike in prescriptions in North America — were found in 10 fish species.

Diana Aga, professor of chemistry at University at Buffalo, says these drugs are found in human urine and are not stripped out by wastewater treatment.

Could affect fish behaviour

“It is a threat to biodiversity, and we should be very concerned,” Aga said in a release from the university.

Niagara Falls Park Bridges

Fish in the Niagara River show concentrations of antidepressants in their brains higher than levels in the river itself. (David Duprey/The Associated Press)

“These drugs could affect fish behaviour. We didn’t look at behaviour in our study, but other research teams have shown that antidepressants can affect the feeding behaviour of fish or their survival instincts. Some fish won’t acknowledge the presence of predators as much.”

The Niagara River, which carries water from Lake Erie to Lake Ontario, is already under stress, with reports this summer of untreated wastewater released into the river.

‘Fish are receiving this cocktail of drugs 24 hours a day, and we are now finding these drugs in their brains’– Diana Aga, study author

The research, published in the journal Environmental Science & Technology, found levels of antidepressants in fish brains that were several times higher than levels in the river itself, indicating that the chemicals are accumulating over time.

The study set out to look for a variety of pharmaceutical and personal care product chemicals in the organs and muscles of 10 fish species: smallmouth bass, largemouth bass, rudd, rock bass, white bass, white perch, walleye, bowfin, steelhead and yellow perch.

Antidepressants stood out as the major problem.

Rock bass had high concentrations

The rock bass had the highest concentrations of antidepressants, but several fish had a medley of drugs in their bodies.

Aga said she did not believe the chemicals were a threat to humans, as people do not usually eat fish brains. However, she was concerned about the health of fish species who are continually subjected to an influx of chemicals, as well as the delicate balance among species.

Aga said wastewater treatment plants have not kept up with the times in attempting to remove drugs from their effluent.

Between 1999-2002 and 2011-14, the number of U.S. residents using antidepressants rose by 65 per cent,  according to the National Center for Health Statistics.

Wastewater treatment focuses on killing disease-causing bacteria and on extracting solid matter but not on removing chemicals that might be found in human urine, Aga said.

“These plants are focused on removing nitrogen, phosphorus, and dissolved organic carbon but there are so many other chemicals that are not prioritized that impact our environment,” she said. “As a result, wildlife is exposed to all of these chemicals. Fish are receiving this cocktail of drugs 24 hours a day, and we are now finding these drugs in their brains.”

For some students, the transition to university can be hard on mental health.

In a few weeks, more than two million students will step onto postsecondary campuses across Canada, roughly one-quarter of them in Toronto. It’s both an exhilarating and terrifying time for young people full of big hopes and even larger expectations.

Many thrive and revel in their new-found independence. But others struggle and too often they struggle silently, because they’re afraid – or ashamed – to tell their parents, friends, or teachers that they’re anxious, depressed, or deeply unhappy.

Seven years ago, Eric Windeler launched to educate young people and their families on how best to advocate for their own mental health. It’s named after his eldest son Jack, who died by suicide in March, 2010, during his first year at Queen’s University.

Windeler believes the transition to a new life after high school and out of the family home is “one of the most exhilarating and also the most traumatic and dangerous, experiences of your life. It’s also the time that the onset of mental-health problems typically happens.” The inevitable rite of passage in a young person’s life is often fraught with stressors that both parents and their children don’t identify and can lead to a wide array of mental-health issues, including anxiety, depression, bipolar disorder and, sadly, suicide. Katie Edmonds and Nolan Anderson are among’s 2,500 student leaders who speak in Canadian schools about their own postsecondary struggles.

Edmonds, 24, was a straight-A student and competitive dancer in high school who deteriorated emotionally and physically during her first year at the University of Western Ontario in 2011, ending up hospitalized with a severe eating disorder.

Anderson, also 24, was a well-rounded athlete and solid student. He thrived during his first semester at McGill University, but fell apart in his second term.

Both have loving families, but that wasn’t enough. Parents and children have to be attuned to warning signs, they say, such as staying isolated in dormitory rooms, avoiding friends and becoming increasingly withdrawn.

How postsecondary school started

“My parents were worried about me before I went,” said Edmonds, who grew up in Courtland, Ont., close to London, and has a twin sister with whom she is very close. “There was no high-school drama. I had a good group of friends. But I’m very hard on myself when it comes to school. Good marks are never quite good enough.

“I was losing weight my last year of high school,” she said. She was going to the doctor regularly and now recognizes that she was already coping with anorexia nervosa. “My parents wanted me to go to university because they knew that’s what I wanted. But at the same time, they would have felt better if I had taken a year off.”

Anderson grew up in Mississauga, Ont., and was on his high-school student council. Going to McGill was a long-time goal. “Grade 12 was a bit of a struggle,” he said. “I was starting to have trouble keeping up with all the demands I’d put on myself and my time. I started to struggle with depression.”

His parents noticed and eventually took him to a psychiatrist. “They helped me help myself,” Anderson said. “But when I went away, I didn’t have them there.”

What happened in first year

Edmonds decided to major in biology and science, with the goal of becoming a dentist. Her roommate was her sister and she began to get marks below her usual 90s. “In first year, they were in the low 80s … not good enough for me. Everyone around me was top of their class, too. It was very hard to keep up and I lost my confidence,” she remembered.

She visited home every weekend, where she would study until 3 a.m. and then wake up at 7 a.m. “My parents were really worried. I would always say to them, ‘This is normal. Everyone is stressed.’ And I did think it was,” said Edmonds, who did confess to her sister how hard of a time she was having.

“My first semester was really positive,” said Anderson, who played varsity soccer and had a busy social life. “But it’s still a big change and it took some time for me to learn how to manage myself.”

In second semester, he began to get homesick and started skipping classes and soccer games. “I was sleeping a ton and watching a lot of TV. I thought maybe it was the winter blues, but it stretched into weeks and then months,” he said. During a visit, his parents set him up with a psychiatrist, but he missed those appointments, too. “I talked to some of my closer friends, but it’s not something you want to share too widely. It’s just awkward. I didn’t reach out to the school. I didn’t know what resources were available.”

The crash

“I weighed 100 pounds when I started at Western, and when I left, I weighed 70,” Edmonds, who is 5-foot-6, said. “I was hospitalized for five weeks, and ended up taking a year off. I saw a lot of doctors and went through a lot of different programs.” As she dealt with anxiety and depression, it was difficult to figure out what doctors – and what treatments – would help.

Around exam time, Anderson said, his mood went from depressed to manic, and he stayed up for two nights trying to make up for all of the classes he had missed.

“I wrote the exam, but after, I didn’t come down. I still felt the excitement, the adrenalin rush. And that was a huge sign I was unwell,” he said.

“For the first time in a long time, I felt really good. But I was too social. I was talking excessively. My friends finally reached out to my parents. They came and got me. They were trying to tell me I was sick, but I wouldn’t listen.”

Where they’re at now

In September, 2013, Edmonds transferred to the University of Toronto. “I wanted a fresh start,” she said. First year went all right, but by second year, she began to struggle again with balance and with her weight and mood. “I started to get very obsessive about school again in second year. I started to isolate,” she said. “So I ended up dropping a few courses and taking on a lighter coarse load to focus on myself again.”

Then, a friend invited her to a summit. “I realized there were other people out there that I could talk to,” she said. “So many of us feel we have to keep it in, which only makes it worse. Talking is the best coping mechanism for me.” She is currently enrolled in a master of biomedical engineering program at U of T.

Anderson was diagnosed with bipolar disorder and also transferred to a school closer to home: U of T’s Mississauga campus.

“I got my four-year degree in psychology in five years – due to my circumstances, it took as long as it needed to take,” he said. “There is a stigma with that, too, but that might have been self-imposed. I was my own worst critic.” Now he works full-time as a constituency assistant for an MPP.


How to avoid a mental-health crisis at university

Eric Windeler of said his basic message to parents is simple: Talk to your kids. Encourage them to speak to their friends. And start the conversations about mental health earlier – “long before Grade 11 or 12.”

Here, he and some spokespeople from his organization share some other advice.

Don’t isolate yourself

“As soon as I started to get out more – see friends and family, do volunteer work – I actually started doing better in school and my marks improved,” said Katie Edmonds, who is starting a master of biomedical engineering program at the University of Toronto

Avoid perfectionism

“Instead of putting myself down, I use it to motivate myself,” Edmonds said.

Talk as much as you can

“You don’t have to be as public about your problems as I have become, but you do have to share with people who have your best interests at heart,” Nolan Anderson said. “You need to focus on your relationships, and not with Facebook friends, but with real people that you can have real conversations with.”

Two weeks after his son Jack died by suicide, Windeler, founder of, drove to Queen’s University to talk with students in his son’s residence. “I wanted to make sure they weren’t feeling bad,” he said.

“I got talking to them and they didn’t understand that being less social, or not going to class, can be a sign. In fact, it most likely is a sign.”

Learn about mental health

“My wife and I were average in our understanding [of mental health when Jack died],” Windeler said. “If only we’d been better educated. We felt, literally, that we were the happiest healthy family out there. Our kids seemed to be thriving. After we got the phone call from the police, we couldn’t figure out how this had happened.’

Reposted from:

Ph.D. students face significant mental health challenges.

Approximately one-third of Ph.D. students are at risk of having or developing a common psychiatric disorder like depression, a recent study reports. Although these results come from a small sample—3659 students at universities in Flanders, Belgium, 90% of whom were studying the sciences and social sciences—they are nonetheless an important addition to the growing literature about the prevalence of mental health issues in academia. One key message for scientific trainees that are struggling with these types of challenges, write co-authors Katia Levecque and Frederik Anseel of Ghent University in an email to ScienceCareers, is that “you are not alone.” Beyond that, the authors encourage Ph.D. students to appreciate how important it is to take care of themselves. “Mental health problems can develop into serious threats to one’s wellbeing and career, and can have detrimental consequences in the long-term,” they write. So, if you’re struggling, it’s important to “[s]eek professional help or seek help in your personal environment, even if you think it’s probably a temporary thing.”

According to their survey, 51% of respondents had experienced at least two symptoms of poor mental health in recent weeks, indicating psychological distress. Moreover, 32% reported at least four symptoms, indicating a risk for common psychiatric disorders, which was more than twice the prevalence among highly educated comparison groups. The most commonly reported symptoms included feeling under constant strain, being unhappy and depressed, losing sleep because of worry, and not being able to overcome difficulties or enjoy day-to-day activities. The greatest predictor for experiencing mental health challenges was having difficulty taking care of family needs due to conflicting work commitments. High job demands and low job control were also associated with increased symptoms.

On the plus side, having an inspirational supervisor partially offset these risks. So did interest in an academic career, even among students who thought they had little chance of ultimately making it. Seeing a Ph.D. as good preparation for a nonacademic career and an added value for employers was also beneficial. “When people have a clear vision of the future and the path that they are taking, this provides a sense of meaningfulness, progress and control, which should be a protective factor against mental health problems,” the authors explain.

According to Nathan Vanderford, an assistant dean for academic development at the University of Kentucky in Lexington who also studies mental health in academic trainees, “[t]he study underscores what has long been presumed; that work conditions and career outlook plays a key role in the mental state of PhD trainees,” he writes in an email to ScienceCareers.

“[I]nstitutions, departments and PIs have long ignored the systemic mental health issues among PhD trainees,” Vanderford continues. “Data such as this should make the issues irrefutable and should, for ethical and moral reasons, force the hand of these entities to take on the responsibility of helping to provide PhD trainees with the support they need to navigate the very stressful journey of earning a PhD.” Levecque and Anseel point out that small steps such as facilitating work-life balance or “offering PhD students clear and full information on job expectations and career prospects, both in and outside academia,” could have a significant positive impact.

One message for PIs is that “investing in their own leadership competencies could really make a difference” for Ph.D. students, the authors add. They encourage PIs to take the issue seriously and learn how to spot signs of potential emotional distress. Gail Kinman, a professor at the University of Bedfordshire in the United Kingdom who acted as a reviewer for the paper, agrees. “PIs should look out for students who isolate themselves, who seem anxious and withdrawn, who are not meeting deadlines. Nobody would expect a PI to be able to diagnose mental health problems but they should be able to spot changes in their students and have the knowledge required to refer them for support,” she writes in an email to Science Careers.

Although the survey is specific to Flanders, many of the characteristics of working toward a Ph.D. are similar around the globe, making the findings generalizable, the authors argue. They hope the study, which has generated conversation on Twitter, will help break the silence around mental health issues in academia. “[I]t is a public secret that fear of stigma, retaliation or the expected negative impact on one’s future career often inhibits people suffering from mental health issues to make it public,” they write. This lack of visibility is problematic because feeling isolated can cause students’ mental health to deteriorate even further. It also means that there is less pressure on institutions and people in power to tackle the issue.

Rather than demonizing academia, action should be taken, the authors emphasize. As academics, “[w]e have had our share of struggles and challenges to overcome, but still think this is one of the most rewarding and meaningful careers one can have. So, if there’s a problem, let’s do something about it and make this a great place to work again. For everyone.”

Spotting Addiction.

COLUMBUS, Ohio — A former Ohio State University football player whose NFL career fell apart because of a painkiller addiction says he wants to become a college coach and help others avoid similar pitfalls now that he’s clean and has a degree.

Shane Olivea told The Columbus Dispatch he was high every day following his rookie year with the San Diego Chargers.

“At my height on Vicodin, I would take 125 a day,” said Olivea, who was briefly a Giant in 2008. “It got to the point I would take a pile of 15 Vicodin and would have to take them with chocolate milk. If I did it with water or Gatorade, I’d throw it up.”

Olivea said he obtained the pills from his own sources, including one in Mexico. He parked at an Arby’s restaurant and paid a cab driver he knew $100 to go to a Tijuana “pharmacy.”

“You could buy anything you want if you had cash,” Olivea said. “I’d go buy a couple hundred Vicodin, or by then I’d progressed to Oxycontin.”

Olivea said he spent nearly $584,000 on painkillers. He began to withdraw from teammates and his relationship with coaches and management suffered. He was benched late in the 2007 season and his weight rose to nearly 390 pounds.

Olivea’s parents worried after he became reluctant to respond to them, too. His mother organized an intervention, and the Long Island native in April 2008 checked into a drug addiction treatment center in California. He said doctors there told him he was lucky to be alive.

“They both looked at me and said, ‘We’ve never seen anybody living with that amount of opioids in you. You’re literally a walking miracle,’” Olivea said. “That was a punch to the gut.”

After being released by the Chargers, Olivea signed with the Giants while in rehab. He was released again after hurting his back.

Olivea re-enrolled in Ohio State in 2015, and graduated in December, at age 35, with a degree in sport industry.

He said he has a couple of job leads. And though he hasn’t coached before, he said his playing experience makes him think he’d do well on and off the field, including helping others thinking of turning to pain pills.

“If you got it, you can spot it,” Olivea said. “I can spot an addict in a public setting. I know the behavior. I know the tendencies. I know what he’s going to do. I’ll be able to notice somebody going down that slippery path and maybe catch them.”

Reposted from:

Biological Changes Could Be Underlying Factor For Higher Rates of Psychosis in Immigrants.

A new study could explain how migrating to another country increases a person’s risk of developing schizophrenia, by altering brain chemistry.

Immigrants had higher levels of the brain chemical dopamine than non-immigrants in the study, conducted by the Centre for Addiction and Mental Health (CAMH) in Toronto and the Institute of Psychiatry, Psychology and Neuroscience, King’s College, London. Abnormal dopamine levels are linked to symptoms of schizophrenia. Dopamine is also connected to the body’s stress response.

The study was published in the January issue of Schizophrenia Bulletin.

“Schizophrenia is still a rare diagnosis,” says Dr. Romina Mizrahi, a senior author and Clinician Scientist in the Campbell Family Mental Health Research Institute at CAMH. “But if we can understand the factors that increase the risk of this serious illness among immigrants, we can develop strategies such as social supports to mitigate this risk.”

As Canada’s population and workforce will decline without migration, a set number of immigrants are accepted into the country each year. While it’s not feasible to offer stress supports to all newcomers, the approach of identifying those at highest risk and offering evidence-based interventions to prevent schizophrenia is one that Dr. Mizrahi applies to her work with youth, as Head of the Youth Psychosis Prevention Clinic and Research Program.

The current study involved a type of brain imaging called positron emission tomography (PET), and applied two different approaches to examining dopamine levels.

In Toronto, 56 study participants were given a mild stress test to see its effect on dopamine release. People with schizophrenia, and those at high risk, release more dopamine with this test when compared to a matched healthy group of participants. Among the 25 immigrants in the study, dopamine release was higher than 31 non-immigrant participants. This increase was related to participants’ experiences of social stress, such as work overload, social pressures or social isolation.

The London researchers showed that the synthesis of dopamine was higher in immigrants. This increase was related to the severity of symptoms among those considered at high risk of developing schizophrenia, and did not occur among non-immigrants at high risk. In total, 32 immigrants and 44 non-immigrants were involved in this part of the study.

Dr. Mizrahi emphasizes that not everyone with high dopamine levels will develop schizophrenia, nor will the vast majority of migrants.

Yet it is well-established through population studies in Canada, the U.K. and Western Europe that the risk of developing schizophrenia is higher in immigrants and their children than non-immigrants. Stress – particularly related to perceived discrimination, social isolation and urban living – is believed to increase this risk. The role of stress also appears to be supported by the current findings on brain dopamine levels.

“This is a first step in integrating social science and biological research,” says Dr. Mizrahi. “A next step would be to help regulate stress among higher risk immigrants through social support programs, and see if this reduces dopamine in the brain and prevents psychosis.”

Reposted from:

Neo-Liberalism And It’s Impact on Mental Illness.

What greater indictment of a system could there be than an epidemic of mental illness? Yet plagues of anxiety, stress, depression, social phobia, eating disorders, self-harm and loneliness now strike people down all over the world. The latest, catastrophic figures for children’s mental health in England reflect a global crisis.

There are plenty of secondary reasons for this distress, but it seems to me that the underlying cause is everywhere the same: human beings, the ultrasocial mammals, whose brains are wired to respond to other people, are being peeled apart.Economic and technological change play a major role, but so does ideology. Though our wellbeing is inextricably linked to the lives of others, everywhere we are told that we will prosper through competitive self-interest and extreme individualism.

In Britain, men who have spent their entire lives in quadrangles – at school, at college, at the bar, in parliament – instruct us to stand on our own two feet. The education system becomes more brutally competitive by the year. Employment is a fight to the near-death with a multitude of other desperate people chasing ever fewer jobs. The modern overseers of the poor ascribe individual blame to economic circumstance. Endless competitions on television feed impossible aspirations as real opportunities contract.

Consumerism fills the social void. But far from curing the disease of isolation, it intensifies social comparison to the point at which, having consumed all else, we start to prey upon ourselves. Social media brings us together and drives us apart, allowing us precisely to quantify our social standing, and to see that other people have more friends and followers than we do.

As Rhiannon Lucy Cosslett has brilliantly documented, girls and young women routinely alter the photos they post to make themselves look smoother and slimmer. Some phones, using their “beauty” settings, do it for you without asking; now you can become your own thinspiration. Welcome to the post-Hobbesian dystopia: a war of everyone against

Is it any wonder, in these lonely inner worlds, in which touching has been replaced by retouching, that young women are drowning in mental distress? recent survey in England suggests that one in four women between 16 and 24 have harmed themselves, and one in eight now suffer from post-traumatic stress disorder. Anxiety, depression, phobias or obsessive compulsive disorder affect 26% of women in this age group. This is what a public health crisis looks like.

If social rupture is not treated as seriously as broken limbs, it is because we cannot see it. But neuroscientists can. A series of fascinating papers suggest that social pain and physical pain are processed by the same neural circuits. This might explain why, in many languages, it is hard to describe the impact of breaking social bonds without the words we use to denote physical pain and injury. In both humans and other social mammalssocial contact reduces physical pain. This is why we hug our children when they hurt themselves: affection is a powerful analgesic. Opioids relieve both physical agony and the distress of separation. Perhaps this explains the link between social isolation and drug addiction.

Experiments summarised in the journal Physiology & Behaviour last month suggest that, given a choice of physical pain or isolation, social mammals will choose the former. Capuchin monkeys starved of both food and contact for 22 hours will rejoin their companions before eating. Children who experience emotional neglect, according to some findings, suffer worse mental health consequences than children suffering both emotional neglect and physical abuse: hideous as it is, violence involves attention and contact. Self-harm is often used as an attempt to alleviate distress: another indication that physical pain is not as bad as emotional pain. As the prison system knows only too well, one of the most effective forms of torture is solitary confinement.

It is not hard to see what the evolutionary reasons for social pain might be. Survival among social mammals is greatly enhanced when they are strongly bonded with the rest of the pack. It is the isolated and marginalised animals that are most likely to be picked off by predators, or to starve. Just as physical pain protects us from physical injury, emotional pain protects us from social injury. It drives us to reconnect. But many people find this almost impossible.

It’s unsurprising that social isolation is strongly associated with depression, suicide, anxiety, insomnia, fear and the perception of threat. It’s more surprising to discover the range of physical illnesses it causes or exacerbates. Dementia, high blood pressure, heart disease, strokes, lowered resistance to viruses, even accidents are more common among chronically lonely people. Loneliness has a comparable impact on physical health to smoking 15 cigarettes a day: it appears to raise the risk of early death by 26%. This is partly because it enhances production of the stress hormone cortisol, which suppresses the immune system.

Studies in both animals and humans suggest a reason for comfort eating: isolation reduces impulse control, leading to obesity. As those at the bottom of the socioeconomic ladder are the most likely to suffer from loneliness, might this provide one of the explanations for the strong link between low economic status and obesity?

Anyone can see that something far more important than most of the issues we fret about has gone wrong. So why are we engaging in this world-eating, self-consuming frenzy of environmental destruction and social dislocation, if all it produces is unbearable pain? Should this question not burn the lips of everyone in public life?

There are some wonderful charities doing what they can to fight this tide, some of which I am going to be working with as part of my loneliness project. But for every person they reach, several others are swept past.

This does not require a policy response. It requires something much bigger: the reappraisal of an entire worldview. Of all the fantasies human beings entertain, the idea that we can go it alone is the most absurd and perhaps the most dangerous. We stand together or we fall apart.

Reposed from:

Delirium, Dementia, and Depression in Older Adults: Assessment and Care

One of the things I am most proud of in being a McMaster student is being taught in an evidence based manner. All the course work we are given, lectures, and clinical case studies are all based off of current evidence. Therefore, one of the new goals I have in advocating for mental health issues is to share some of the evidence based research I have come across. Working in my Problem Based Learning class I have come across a vast amount of literature pertaining to mental illness.

I have decided to share some of the resources I have accessed in order to help allow people who may not be familiar with searching textbooks, databases, and best practice guidelines,  in hopes that it will make the information a lot more accessible.  The first source of evidence I chose to share is from the Registered Nurses’ Association of Ontario and an update to their Depression guidelines.

As the RNAO points out this guideline “is to be used by nurses and other members of the interprofessional health-care team to enhance the quality of their practice pertaining to delirium, dementia, and depression in older adults, ultimately optimizing clinical outcomes through the use of evidence-based practices.”