Six strategies to deal with stress

There’s no doubt about it, life can be stressful. Regardless of your age, gender, ethnicity, socioeconomic status or lifestyle, you have probably experienced a stressful situation at some point, and the way you choose to deal with it can drastically impact your health.

“Stress is a normal physical response to alert the body of possible danger or imbalance,” says Dr. Jacqueline Sze, Psychiatrist at The Scarborough Hospital. “In small doses, it’s an important reaction, but if you are consistently feeling overwhelmed, stress can cause major damage to your health, mood, productivity and relationships.”

If a person feels threatened, the brain releases a flood of stress hormones, such as adrenaline and cortisol, which trigger the body to take immediate defensive action known as the ‘fight or flight’ response. A person in this state can experience physical changes that include increased strength and stamina, better reaction time, and enhanced focus to defend against impending danger.

However, any stress beyond this initial reaction stops being helpful and can seriously affect a person’s quality of life.

Dr. Sze discusses some of the main ways you can minimize the harmful effects of stress.

1. Determine what is stressing you out. Stress can affect your work or personal life to the point where it becomes a part of your personality. If you are unsure of the specific source of your stress, start a journal documenting your emotions, responses and reactions to stressful situations.

2. Determine how you currently handle stress. Many people can turn to unhealthy coping mechanisms when dealing with stressful situations. Stress can impact your eating and sleeping habits, and can also lead to alcohol or drug abuse.

3. Develop a healthy way to manage your stress. Experts say you can do two main things to impact your reaction to a stressful situation—change the situation or change your reaction. You can remove the stressful situation or person from your life, or you can change the way you feel and act toward the situation.

4. Exercise regularly. Physical activity naturally increases a person’s endorphins, feel-good hormones, to lower stress. The rhythmic motion of running, walking or cycling can help you forget the daily irritants in your life, and focus on yourself and your body. Exercise also helps to improve quality of sleep, boost self-confidence and provide a sense of control, all of which play a role in stress reduction.

5. Actively engage in relaxation and stress reduction activities. Yoga, deep breathing exercises, meditation or tai chi can help you learn techniques to activate your natural relaxation response. A sense of deep calm transitions your body away from its stressful state to help you achieve balance even for those with a hectic lifestyle. Simply laughing can also drastically lower your stress level as can healthy hobbies and quality time spent with your loved ones.

6. Develop a strong social support system. Meaningful relationships with family and friends can greatly enhance mental and physical health. Studies have shown that support from loved ones can relieve harmful levels of stress, improve heart health and immune systems, lower blood pressure and cholesterol, and ultimately help you lead a longer and more fulfilling life.

Remember that stress disrupts almost every system in the body and long-term exposure to unhealthy levels of stress can lead to serious health conditions, including high blood pressure, a lowered immune system, heart attack and stroke. It can even play a role in infertility as well as speed up the aging process.

When does a diet become an Eating Disorder?

Many of us have experimented with crash diets, trendy exercise routines, calorie counting and a love-hate relationship with the bathroom scale because we may be dissatisfied with our bodies. But when does common concern become an obsession, and ultimately lead to an eating disorder? 

“An eating disorder begins to develop when an individual demonstrates goal-directed behaviour to lose weight, even when they are already clinically underweight,” says Joanna Blanchard, Mental Health Therapist at The Scarborough Hospital. “Pressure can come from media images that have likely been manipulated, and individuals aim for the physically impossible.”

However, many people are exposed to the same media, but do not develop an eating disorder. While societal and familial pressures or existing mental health issues such as depression can play a role in developing this mental illness, the direct cause remains unknown.

Some signs that an individual may be struggling with an eating disorder include:
• Restricted calorie intake
• Excessive exercise
• Excessive use of laxatives and/or diuretics
• Rapid weight loss

Often considered a ‘women’s disease,’ research shows that over the past few years, eating disorders such as Anorexia Nervosa and Bulimia Nervosa are affecting an increasing number of men.

“Traditionally men aspired for a muscular figure, but the modern male model is slim, which can put pressure on men to lose weight,” says Stephanie Luke, Child and Youth Worker at TSH.

Stephanie adds that athletes, who gain a competitive edge from weight control, are a high risk group. For example, wrestlers are seven to 10 times more likely to develop an eating disorder from a constant pressure to maintain a specific weight range.

Despite the goal, an eating disorder is the most lethal mental health disorder. It damages normal body functions, which can lead to several physical conditions including malnutrition, dehydration, esophageal damage and heart failure.

To learn more about eating disorders and other health and nutrition topics, please join us for the It’s Time to Talk Speakers’ Series, “Food for Thought: You Are What You Eat,” on March 1. Click here for more details.

Incontinence myths and facts

Although millions of Canadians experience some form of incontinence on a daily basis, it’s still a condition that is often misunderstood.

“There continues to be an enormous amount of stigma associated with incontinence and it can take a serious emotional toll on those living with the condition,” said Dr. Nick Logarakis, Chief of Urology at The Scarborough Hospital.

Much of this stigma stems from the myths that surround incontinence. Dr. Logarakis offers some of the most common misconceptions about incontinence and the truth behind them.

Myth: Incontinence is a disease.
Fact: Incontinence is a symptom of something else going on in the body. It’s important to talk to your doctor, who can help to discover what’s causing the incontinence.

Myth: It’s mainly seniors who experience incontinence.
Fact: Incontinence affects men and women of all ages. For instance, it’s estimated that 10 per cent of six-year-olds have bladder control problems and at least one in three women over 40 experiences incontinence.

Myth: Incontinence is just part of aging.
Fact: Although changes that occur naturally in the aging body may contribute to incontinence, aging itself does not cause incontinence and it should not be accepted as a part of getting older.

Myth: You just have to live with it if you have incontinence.
Fact: In most instances, incontinence can be cured, treated or successfully managed. There are a variety of options for managing incontinence, but their success depends on receiving the right diagnosis and underscores the importance of speaking to your doctor.

Common myths about substance abuse and addictions

The figures are staggering—worldwide, over 76 million people have an alcohol use disorder, more than 15 million have drug use disorders and one-third over the age of 15 smoke tobacco. In Ontario alone, about 332,000 people have a gambling addiction. Despite the prevalence of these issues, knowing how to approach a friend or loved one about a substance abuse or addiction problem can be challenging.

Roberto Mazzei, Social Worker in the Outpatient Mental Health Program at The Scarborough Hospital, points out that it’s important to be aware of the common myths that surround substance abuse and addictions. These myths include:

• Addiction is a lifestyle choice.
• It’s easy to see the signs of addiction.
• Someone has to hit rock bottom before treatment will work.
• Drug and alcohol addiction happens to people in lower socio-economic classes.
• People with some addictions are able to stop their substance abuse after their first course of treatment.
• Addiction only affects the person addicted.

When discussing a substance abuse or addiction problem, Mazzei recommends not to argue or judge the individual and not to push for treatment. Instead, find out what they like about their behaviour and the benefits it provides them versus the costs.

Talking to your family doctor or someone you trust in the community can often be a good first step when seeking help for yourself or someone close to you.

The Ontario government also has resources for people and their families affected by substance abuse and addiction issues, including the Drug and Alcohol Helpline (1-800-565-8603), and the Ontario Problem Gambling Helpline (1-888-230-3505).

Would you recognize signs of mental illness?

If you or a loved one were experiencing symptoms of mental illness, would you know? Advertising and education have made awareness of the signs and symptoms of stroke and heart attack more top of mind than ever before, but mental illness can bring with it stigmas that make understanding and acceptance more difficult.

To help spread the word about the warning signs of mental illness, our own Mental Health staff at The Scarborough Hospital shared a list of common symptoms of mental illness, along with some suggestions for seeking the necessary help.

Symptoms:

Changes in a person’s thinking, mood and behaviour that cause distress may be a sign of mental illness, and while they may vary from person to person, common symptoms include:

• Feeling sad (depressed) for a long period of time
• Increased worry/anxiety
• Isolating yourself from friends and family
• Loss of interest in things you once enjoyed
• Hearing or seeing things that others cannot
• Difficulty coping with daily stressors
• Drug or alcohol abuse
• Highs and lows in mood
• Difficulty focusing on tasks
• Eating or sleeping more or less than usual
• Crying spells
• Paranoia
• Not caring for self

Getting Help:

If you or a loved one need help, start with your family doctor. They can help you with your current issue and refer you to appropriate resources by giving you information on community agencies, or writing a referral for an outpatient hospital. If you do not have a family doctor, a walk-in clinic physician can also provide referrals.

When is it an emergency?

IMMEDIATE help is required if:

• You feel you may hurt yourself or other people
• You are afraid that someone else may hurt themselves or another person
• Someone you know is unable to take care of themselves but is refusing to seek help

Who to contact in an emergency:

- The Emergency Department of your nearest hospital
- The Mobile Crisis Program (24 hrs/day, 7 days/wk)

• Scarborough and East York 416.495.2891
• Downtown Toronto 416.929.5200
• North York and Etobicoke 416.498.0043

- Call 911 to dispatch the Mobile Crisis Intervention Team (MCIT)

Memory screening can help with early diagnosis of dementia

Early detection of Alzheimer’s Disease and other dementias can lead to appropriate interventions, such as medical treatments, social services, and advanced care planning. The key to an early diagnosis is the use of memory screening.

“Memory screening is about the storage and retrieval of information,” explains Jacqui Robinson, Occupational Therapist, GAIN (Geriatric Assessment and Intervention Network) Clinic at The Scarborough Hospital. “We start with three or five words, and ask the patient to remember those words while doing other tasks. As an OT, I cannot diagnose dementia, but I can probe to determine specific memory problems. Once I have identified thinking changes, I collaborate with the rest of the team so that we can provide diagnoses and recommendations.

“We also look for patients who are repeating the same story or question over and over again, which can be a sign of dementia.”

June 14 is National Memory Screening Day, and the interprofessional team of healthcare providers at TSH’s GAIN Clinic offer the following early signs of changes in thinking:

• Changes in memory – forgetting how to do something you’ve done all of your life, like following a recipe or a simple repair job around the house.
• Changes in language – increasing word-finding problems or difficulty reading the newspaper or books.
• Changes in judgement, such as wearing clothing that’s not appropriate for the weather (i.e., going out in a snow storm with only a sweater).
• Misplacing things in strange places (car keys in the fridge, for example).
• Changes in personality, such as acting out of character, withdrawing from people or social situations.
• Changes in driving proficiency – increases in “close calls” and/or fender benders, stopping at a green light, etc.

Seven ways to beat Seasonal Affective Disorder (SAD)

Have you ever noticed a change in your mood as the temperatures drop and the snow falls?  You may be experiencing Seasonal Affective Disorder, also known as SAD. Bad weather can have an impact on your mood.

SAD is related to a lack of exposure to sun in the fall and winter months. A form of depression, SAD can affect your ability to concentrate, your cravings for sweet and salty foods and your sleeping habits. There are different severities of SAD, with approximately 15 of every 100 people experiencing it in its lesser form.

Dr. Stephen Barsky, a psychiatrist at The Scarborough Hospital, offers ways to conquer these winter blues:

1. Get your daily dosage of Vitamin D. Since we often receive Vitamin D through exposure to the sun, it’s common for levels of this essential vitamin to be low during the winter months. Check with your doctor to see if increasing your Vitamin D levels is appropriate for your health needs.
2. Exercise regularly. Exercise has been proven to help reduce stress levels and increase your mental and physical well-being, Movement can help to conquer your SADness through increasing serotonin levels.
3. Keep track of the food you eat and the hours you sleep. Maintaining a balanced diet is important. People with SAD often crave unhealthy snacks and sleep long hours to avoid the cold weather. Consume whole grains, fruits and foods that are high in omega-3 fatty acids, such as fish and olive oil.
4. Increase your exposure to sunlight. Open blinds during the day and rearrange your office work space so that you are exposed to sunlight. You can also remove tree branches or transplant trees that block windows.  Sometimes, “Light Therapy,” exposure to bright lights indoors, can also help.
5. Learn to appreciate the winter season. Engage in winter sports, including skiing, skating, snowshoeing and hiking. Enjoy time outside with young children by building a fort or snowman. 
6. Escape the cold with a winter vacation to a sunny destination. This, however, may only be a temporary fix.
7. Extreme cases of SAD may require special medical attention. Consult your doctor to see if medication is the right choice for you.