All of the things that the brain is responsible for – physical and mental – are part of brain health. While often spoken about separately, mental health is a central part of brain health – they are not separate or distinct.

Mental health is brain health.

Understanding this can help to reduce the stigma that continues to be associated with mental illness, which, like any physical disorder or disease, is a health problem and requires appropriate treatment.

One of most important things that people don’t often realize is that the three major brain conditions of our lifetime; stroke, dementia, and depression, are all inter-related. They are all happening in the same organ, and if person has been diagnosed with one of those three conditions, their risk of the other two conditions increases.

That is to say: if an individual has a stroke, it increases their risk of having post-stroke depression and developing dementia; if someone has dementia, there is an increased risk of developing depression and having a stroke; and having clinical depression, increases the risk of going on to have stroke and/or dementia.

What affects brain health

Any disruptions to the brain can affect the way it works. The brain is an incredibly vascular organ – there are a rich supply of arteries and veins that help with the delivery of nutrients to the brain, as well as the removal of toxins and by-products of metabolism, to keep it healthy.

When that blood flow is interrupted, it affects brain function and that results in changes in the way information travels along the brain’s pathways. This can impact how we move, how we sense things like hearing or touch, the way we think about the world and people around us, how we perceive a situation, and how we behave.

It is important that brain conditions are understood and treated from multiple perspectives at the same time. Traditionally, the various medical specialties that deal with brain conditions would treat disorders individually; for example, if a person has a stroke and needs a blood clot removed, they will be seen by a neurosurgeon or neurologist. If a person has depression, they will be treated by a psychiatrist. If a person has dementia, they might see a neurologist or a psychiatrist.

But the new way of understanding and treating brain conditions involves a broader and more collaborative approach.

A multi-disciplinary approach to brain health

Sunnybrook’s Garry Hurvitz Brain Sciences Centre will connect brain health experts from across medical disciplines in the same building.

Bringing brain specialists together to collaborate with one another will help enhance a patient’s treatment, education, and will pave the way for possible new discoveries of the causes and potential treatments of brain conditions.

For stroke, depression, dementia, and other brain conditions, including sleep disturbances, anxiety, Amyotrophic Lateral Sclerosis (ALS), tremor, and others – having a broad range of the brain specialities and disciplines, including neurology, neurosurgery, psychiatry, psychology, and more, working together for improved patient care, is really the way of the future.

For more information about brain health:

• Learn more about Sunnybrook’s Garry Hurvitz Brain Sciences Centre
• Q & A with Dr. Levitt about Sunnybrook’s Garry Hurvitz Brain Sciences Centre
• Learn more about the Hurvitz Brain Sciences Program at Sunnybrook

If you need help in an emergency, please call 911 or visit your local emergency department.

If you’re feeling like you’re in crisis or need somebody to talk to, please know that help is also available through community resources:

• Find a local crisis resource at sunnybrook.ca/gethelp
• Crisis Services Canada
  • Phone: 24-hour, toll-free 1-833-456-4566
  • Text: 45645 (4:00 p.m. – midnight Eastern Time)
• Kids Help Phone
  • Phone: 24-hour, toll-free, 1-800-668-6868
  • Text: 686868 (24 hours, 7 days a week)

The post Why mental health is brain health appeared first on Your Health Matters.

There are greater levels of stress and anxiety, and for teenagers and young people dealing with mental health and addiction issues, the pandemic may be amplifying and exacerbating the challenges they were already experiencing.

Impact on mental health and addiction resources

This is a time like no other. Youth who haven’t necessarily struggled before and who may not have developed a mental illness, may still be affected by the changes happening around them. Individuals already dealing with mental health concerns, and who have a tendency towards depression and anxiety, could get see these emotions escalate.

There has been an increase in virtual care as a result of physical distancing measures, and some mental health resources that were accessible pre-COVID-19 may have been suspended or put on hold indefinitely. It can be frustrating, upsetting and unsettling to not have access to resources as usual.

Experts with the Family Navigation Project (FNP) at Sunnybrook have been helping families navigate the health care system during this crisis, and although online and telephone supports in the community are different from in-person services, it’s important to note that virtual interactions in some circumstances may provide convenience and an opportunity to get help.

If you or someone you know is in severe emotional distress, please call 911 or visit your local emergency department.

Addiction issues during COVID-19:

Physical distancing and stay-at-home orders don’t necessarily mean that alcohol and drugs aren’t readily available. In some communities and situations access to substances may have increased.

Increased access to substances

With youth spending more time at home, there is the possibility that alcohol in the family home is being accessed, along with old or current prescription medications. In these cases, remove visible reminders of addiction, if possible. Substances may also be accessed online or from suppliers who do not respect physical distancing.

Increased use of alcohol and drugs

There are many factors contributing to the elevated levels of stress and anxiety: the lack of daily structure, no school, job loss, boredom and feelings of isolation, and can lead to a potential increase in substance abuse. Using substances as a way to cope with stress, which is typically problematic or dangerous, has the potential to lead to dependency or misuse.

Potential impact on immune system

Did you know excessive use of these substances can weaken the immune system and put a person at higher risk of infection? Alcohol and drugs impact different parts of the body in different ways. Sometimes they can lead to a person ignoring health needs such as food and water. These factors can all suppress the immune system and put an individual at a heightened risk of illness.

Withdrawal

In some circumstances accessibility to substances may be reduced and an individual who is addicted may go through withdrawal from a substance. Withdrawal can lead to behavioural changes, such as mood swings, and/or physical symptoms such as seizures that can potentially be dangerous. If you have concerns about any withdrawal symptoms contact your healthcare provider or in an emergency call 911.

Warning signs

Here are some examples of warning signs that families can watch out for in their youth that may signify a greater concern and need for action:

• Sleep: Are youth sleeping more or less? Both could be a sign of elevated levels of depression or anxiety.
• Withdrawal from activities: Is your child not engaging in activities that once brought them joy? Are they withdrawing from family activities?
• Self-harming behaviours: cutting, scratching or biting the skin, hair pulling, overdosing

Strategies for families

For families and youth already using mental health resources and strategies before COVID-19, it is important to remember they still have those tools available. It is a matter of adapting those strategies to this present situation.

Here are some ways to work together and how to find help:

• Communication and validation: Acknowledge that this is a difficult time for everyone and that the additional stress could be exacerbating pre-existing mental health conditions. Be open to discussion about what your family is experiencing and how to deal with it together.
• Reach out to trusted family members and friends: They can help support you through this time and potentially help find resources and information.
• If you need help, get help: Emergency services and crisis lines are still available. FNP is also available for families that live in the Greater Toronto Area who have youth between the ages of 13 to 26 and can help families find the resources they need. Most mental health walk-in clinics are available virtually.

It is understandable for individuals and families to feel alone in these changing times. Many families are trying to navigate the same challenges and barriers.

As the saying goes, “We are all in the same storm, but not necessarily in the same boat.” We are all reacting to this pandemic in unique and different ways, but we share the stress. The bottom line is – we will all get through this together.

[mks_button size=”large” title=”The COVID-19 pandemic is a challenging time for everyone. The Family Navigation Project is still here to help.” style=”squared” url=”https://sunnybrook.ca/content/?page=family-navigation-project” target=”_blank” bg_color=”#2c55a6″ txt_color=”#FFFFFF” icon=”fa-chevron-right” icon_type=”fa” ]

For more resources and information about COVID-19 from Sunnybrook experts read our blog.

If you or someone you know is thinking about suicide or in severe emotional distress, please call 911 or visit your local emergency department.

If you feel like you are in crisis or need somebody to talk to, community resources are here to help.

Crisis Services Canada

• 1-833-456-4566 (24 hours, 7 days a week toll-free)
• Text: 45645 (4 p.m. – midnight ET)

Kids Help Phone

• 1 800 668 6868 (voice)
• Text: 686868 (24 hours, 7 days a week)

ConnexOntario: Addiction, Mental Health, and Problem Gambling Treatment Services in Ontario

• 1-866-531-2600 (24 hours, 7 days a week)

Mental Health T.O. Virtual Mental Health Counselling

• 1-866-585-6486 (Monday – Friday 9:00am – 7:00pm ET)

Toronto Distress Centre

• 416-408-HELP (4357), (24 hours, 7 days a week)

[mks_button size=”large” title=”Visit Sunnybrook’s Department of Psychiatry for more mental health resources” style=”squared” url=”https://sunnybrook.ca/content/?page=psychiatry” target=”_blank” bg_color=”#2c55a6″ txt_color=”#FFFFFF” icon=”fa-chevron-right” icon_type=”fa” nofollow=”0″]

The post COVID-19: Youth mental health and addiction appeared first on Your Health Matters.

The two biggest shifts have been our understanding of a concept called “neuro-plasticity” and a realization that alterations of “brain circuitry” might be important in depression. Neuro-plasticity refers to the capacity of cells in the brain to react and adjust to stress, injury, and other challenges that occur from a variety of sources. Brain circuitry refers to pathways (essentially electrical pathways) that exist within the brain that connect various brain structures for very specific purposes. For example, there are circuits required for movement, circuits required for complex emotional experiences, and circuits required for sensations and other functions such as balance. More and more evidence is mounting that suggests depression may be a state in which the brain is unable to adapt; in other words, it has lost its neuro-plasticity. Similarly, evidence is accumulating that depression is a disturbance in critical brain pathways or electrical circuits.

The implications of these findings are that direct treatments can enhance brain plasticity or correct failing or misfiring circuits. And, these treatments may not just reduce the symptoms of depression but may, indeed, prevent depression from returning. These treatments include such things as Deep Brain Stimulation, Trans Cranial Magnetic Stimulation, as well as surgical and other micro lesions. The next 10 years will see an explosion in these direct brain treatment models that may either replace or at least enhance current pharmacotherapy or medication treatment. These new discoveries are the most hope-inspiring developments in the field of depression treatment that we have seen in more than 50 years!

The post New directions in psychiatry and depression treatment appeared first on Your Health Matters.

Families are often the “history keepers” and can provide important longitudinal information for health care professionals. They are also able to speak to the impact of the youth’s symptoms on family life, social/occupational and educational activities. And still families find it very difficult to find a way to navigate the system for their child with a mental health and or addiction.

In response to the growing and unmet needs of families, several navigation services have opened throughout North America and beyond. There are three kinds:

• Websites and lists. There are several helpful websites that give a sense of what services are out there. They don’t necessarily help the family to select the best match and they don’t necessarily help make the connection with the services, but they are a valuable starting place. Examples include www.eMentalHealth.ca in Canada, and www.MentalHealth.gov in the US.
• Telephone or email navigation services run by families with lived experience. These services provide guidance from people who have “been in the trenches” and can provide support and guidance to families who feel lost in the system or unsure of how to even enter the system for their youth. Examples in Canada include FORCE in Vancouver at ForceSociety.com, and MentalHealthAmerica.net is a clearing house for peer and self support in the United States.
• Telephone/email or in-person navigation services run by professionals and clinicians. These services are similar to the peer support services, but have a clinically trained staff with a more intimate knowledge and connection with the health care system who can make direct referrals and connections with services. Examples are the Family Navigation Project in Ontario, and Therapeutic Placement Specialists or Educational Consultants in the US.

Families struggle, sometimes unnecessarily, to find resources for their youth with major mental illness and/or addictions. There are resources out there that can help navigate through the complex and sometimes disorganized system. Keep looking. There are trustworthy organizations and groups who can help and make a life-saving difference.

The post Services that help navigate the complex mental health system appeared first on Your Health Matters.

It is true that, like any medical condition, diagnostic labels can be applied inaccurately. And it is true that many people might be prescribed antidepressant medication, despite the fact that they don’t actually need that kind of treatment or they might be more suited to another treatment for depression. But this is also true for many medical conditions. What’s that old saying? “If you have a hammer, everything looks like a nail.”

However, the real problem is not over-diagnosis or over-treatment. The real problem is that there are hundreds of thousands of people in our communities who are suffering from major depression or clinical depression, who are in need of help, who never actually realize they are unwell or never realize help is out there – or that they deserve help.

Our research shows that of 100 people living in our community who have major depression, serious enough to interfere with their work or family life or social activity, only 45 will recognize they are in an episode of major depression. Of these 45, only half, or 22, will seek out help. Of these 22 who seek help, about half, or 12, will actually receive treatment that is standard and accepted as treatment for major depression (be that medication or counselling or light therapy, etc.) In other words only 12% of people with major depression living in our communities are receiving adequate help for their illness.

Could you imagine if I were writing about cancer and stated that only 12% of people with cancer in our communities received adequate help for their disease? There would be a huge outcry, and so there should be. We need to focus our attention on the reasons people don’t recognize signs and symptoms, and then don’t seek help and don’t receive adequate care. And, we need to encourage our governments, our funding agencies and our researchers to expand their efforts to support people who suffer unnecessarily with this disabling and devastating illness. We all need to realize that they deserve help and can find health and recovery.

If you or someone you care about is suffering in silence, reach out and get what you need. Contact your family doctor, the mental health unit of your local hospital, the Mood Disorders Clinic of a university-affiliated treatment centre or a self help organization like the Mood Disorders Association of Ontario, Canadian Mental Health Association or the National Alliance for Mental Illness.

The post Depression: get the help that you need appeared first on Your Health Matters.

About 50% of the population report changes in their mood and energy that interfere with their daily life during these times each year. In about 2-3% of the population, these difficulties are very severe and are part of an episode of depression. This recurrent annual depression is sometimes called Seasonal Affective Disorder or SAD. Women are more often affected than men, it often begins in high school, and it usually is not recognized until the late 20s or early 30s.

There are several recommendations to help prevent and manage the symptoms of SAD. Many of these recommendations are also useful for people who have seasonal difficulties, but who may not have the full symptoms of depression.

1. Diet: As people become depressed in the winter they turn to comfort foods. In addition, there are fewer fruits and vegetables available in the winter months. We often recommend that people prepare healthy food options and freeze them during the summer months and then consume them in the winter when they feel less like cooking. This maintains good levels of nutrients year round and helps to improve health and to maintain body weight.

2. Activity: Although exercise is generally helpful for everyone, planned activity throughout the winter is particularly helpful for people with seasonal mood difficulties. Indeed, activity and exposure to light together seem to have an additive effect in alleviating winter mood issues. 30-60 minutes of walking three times a week may be a central part of a regime to prevent the low mood associated with winter time.

3. Exposure to environmental light: Spending time outside is not always easy in the winter, but it can be effective in fighting low mood. Exposure earlier in the day tends to be more helpful – usually before 10 am.

4. Sleep hygiene: Maintaining regular sleep habits may also act to prevent winter difficulties. In fact, the most common time for onset of symptoms of SAD is around the time the clocks change in October. Taking care to manage your sleep at these times is critical.

5. Psychological preparation: Letting friends, family, spouse, even colleagues know about the difficulties you have with the winter and planning with them to help you with the above steps can be very useful. Although people close to you cannot “treat” the symptoms of SAD, they can help prepare foods, encourage outdoor activity, provide emotional support, etc. Importantly, they can also provide guidance regarding when you might need to seek professional help.

6. Light therapy: Light therapy is probably the most effective and well tolerated treatment for SAD (and it can help with low mood in the winter too). The best light units to use are those that have been clinically tested by reputable scientists. The typical treatment involves 30 minutes of exposure early in the morning. Tanning beds are NOT light therapy and have other serious health risks. Desk lights and dawn simulators appear to be equally effective – check out which one fits your needs and lifestyle before commencing treatment.

7. Medications: Although only a few medications have been tested in SAD, most scientists agree that all antidepressants are probably effective in treating this subtype of depression. Speak with your physician about what options are available. Medications work quickly, are very effective but are not without their side effects.

8. Other treatments: Negative ion generators are probably the most common non-light treatment recommended for people with SAD. Melatonin is sometimes recommended, but there is little scientific evidence to support its use and it does have side effects.

9. Psychotherapy: Cognitive behavioural therapy has been shown to be effective in preventing and treating SAD. Other forms of psychotherapy are probably also effective, but have not been tested as yet.

There are many management options available for people with SAD or seasonal mood difficulties and most people will find the best combination for themselves, to allow them to find relief from the “winter blues”.

If you’re feeling symptoms of depression or seasonal affective disorder, please see your family physician or health-care provider. 

The post Preventing & managing the “winter blues” appeared first on Your Health Matters.