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Learn What Causes Panic Attacks & Disorders

In today’s world, it’s not uncommon to find yourself feeling overwhelmed. Intense worries and fears about work, home life, and other stressors can take a toll on your body and mind. However, if you ever find that these fears get so intense at certain times, manifesting in the form of panic so much so that they start to interfere with your daily functioning, you may be living with panic disorder.

What is a Panic Disorder?

According to the Canadian Mental Health Association, approximately 4% of Canadians will deal with the symptoms of panic disorder at least once in their lifetime. Panic disorder is characterized by the occurrence of frequent, unanticipated feelings of extreme fear and anxiety, called panic attacks, which often come along with physical symptoms. While panic disorder can feel insurmountable and debilitating, there are several treatment options available to help people learn to cope with their fears and anxieties and recover from the disorder.  

What is a Panic Attack?

In order to accurately describe panic disorder, we must first understand what a panic attack is. In its simplest form, a panic attack can be described as a sudden swell in feelings of powerful fear or discomfort. Panic attacks are often accompanied by physical sensations which can include sweating, an increased heart rate or pounding heart, feelings of shortness of breath or choking, chest pain, trembling, chills or feeling too hot, nausea, numbness or tingling.

People undergoing a panic attack might also experience feelings of derealization (feeling like their surroundings are no longer real) or depersonalization (feeling like they are separated from their body). The fear of dying is also sometimes present during panic attacks. Only four of the symptoms above are needed to qualify as a panic attack. Typically, symptoms will rise to their peak intensity within a few minutes of occurring and then come back down to normal levels.

What are the Symptoms of a Panic Disorder?

People with panic disorder can experience powerful fears and worries over the possibility of having other panic attacks in the future and the possible consequences they may lead to. People report feeling afraid that they may lose control, experience a heart attack, or feel like they are “going crazy”.

Panic disorder can also move people to engage in avoidant behaviours, in order to feel sheltered and protected from situations in which they might have another attack. Avoidance of these situations can greatly decrease an individual’s quality of life, causing them to miss social events or discontinue engaging in exercise. Importantly, avoidance can also prevent a person from discovering that the situation or event they fear is not as dangerous as it seems in those panicky moments.

What Causes Panic Attacks?

Panic attacks can come on completely unexpectedly. In other cases, someone may experience a panic attack in a certain setting and then continue experiencing them whenever they find themselves in that same situation. However, not everyone who experiences feelings of anxiety and panic will go on to develop panic disorder.

There are a few factors that can lead to the development of panic disorder, which include biological, psychological, and social influences that, when coupled with a specific circumstance, can intertwine and lead to these overwhelming instances of panic. Firstly, our biological makeup, passed on from our parents, can play a role in how we react to situations.

Studies have shown that a more anxious temperament, or our individual nature and how we react to situations, can be passed down to us through our genetics. Take a look around. If you find that members of your family also have a tendency to panic in response to stressful situations, then some of your anxiety might be a factor of your genetics.

Biological Influences that Cause Panic Disorders

However, temperament is not the only biological explanation for this kind of anxiety disorder. It is well understood that feelings of anxiety can be influenced by our brain structures and how they communicate. One of the main systems involved in anxiety is our limbic system. Sitting in the middle of the brain, the limbic system’s primary responsibility is to aid in communication between the upper part of our brain, the cortex, and the brain stem below.

The brain stem uses the limbic system to relay information about how our body is reacting to the environment around us. Any changes within the body that may result in our lives being in danger, such as heavier breathing or a pounding heartbeat, are noted and sent through the limbic system to the cortex so that we can act accordingly to increase the odds of our survival.

Reactions to Panic Attacks

In someone with a typical level of reactivity to stress, the limbic system would not be as susceptible to feelings of panic. However, people who have over-reactive limbic systems have been shown to be more prone to experience panic. The amygdala, two, small, almond-shaped organs located within the limbic system, are there to function like the smoke-detectors of the brain.

Their sole job is to scan the environment and decide, immediately and based on past experience, whether any new circumstances are ‘safe’ or ‘dangerous’. Trauma and other life events can cause the amygdala to become hypersensitive and more likely to sound the alarms even when danger is not present. Trauma can also hinder higher-level structures of the brain, like the cerebral cortex, interfering in their ability to calm the limbic system and return the body to a state of rest.

It is also important to note that certain lifestyle factors, such as smoking cigarettes, especially throughout the formative teenage years, can lead to this tendency of our brain to panic. Nicotine use in adolescence has been associated with higher levels of emotional reactivity and the development of panic disorder in adulthood. Its addictiveness and the way in which it increases bodily symptoms and respiratory system issues can increase our biological vulnerability to developing panic disorder.

Psychological Influences for Panic Disorders

Our individual psychological makeups can also influence whether or not we develop panic disorder. For example, we might experience a sense of extreme fear in response to a truly dangerous situation, like encountering a large, snarling or angry-looking dog. This response would be called a true alarm because our body would be correctly identifying a genuine threat.

The brain might then associate the internal sensations we felt and the circumstances of the dog or environment with the sensation of fear, such that some, susceptible people, like those who may not have had much prior experience with dogs, might then begin to fear all dogs, places that are similar to the one where the snarling dog was encountered, or any situation where their body reacted in the same way as in that original one.

The tricky thing with panic attacks is that after the first attack, your body may start to associate internal cues with the immense fear and overwhelming feelings of a panic attack. So, in situations like engaging in vigorous exercise and having your heartbeat increase may lead you to feel like you are experiencing the same intense danger that leads to panic. Internal and external cues can trigger unexpected panic attacks that can become an unwelcome interference in our daily functioning.

Social Influences that Cause Panic Attacks

The more that false alarms are associated with our learned, true alarms, the more likely it is for sufferers of panic disorder to come to believe that any physical symptoms are dangerous and should be avoided. Many people can become hyper-aware of how they are feeling in terms of their physical symptoms and may try to avoid situations that can trigger them entirely.

It is important to keep in mind that panic is usually an evolutionarily beneficial response to danger. Meaning that when we perceive a threat in our environment, it’s good for our body to register it and become fearful of the situation. This fear triggers an alarm in our brains, telling us to defend ourselves or get going. More specifically, our autonomic nervous system, responsible for controlling our breathing and heart rate outside of our conscious awareness, sends messages to our bodies to get ready for fighting or fleeing.

When this response occurs in proportion with a perceived threat, it is completely beneficial. However, in the case of a panic attack, people can experience these strong feelings of fear and anxiety over a threat or just the thought of a threat that may not actually be detrimental to their survival. Our evolutionary stress response can start to react to everyday stress in a way that can end up making us feel scared and too overwhelmed to function.

How to Treat a Panic Disorder

Luckily, panic disorder is extremely treatable. Psychological therapies have been shown to act as effective and long-lasting treatments for panic disorder and are often used in conjunction with medications to help people who experience frequent panic attacks. More specifically, cognitive behavioural therapy (CBT) can help individuals overcome feelings of panic and get them back to a higher level of functioning.

CBT is based on the understanding that our thoughts, feelings, and perceptions can greatly affect our behaviour. Through CBT, psychologists and psychotherapists can help people work to change the patterns of thought that may lead them to panic in certain situations, ultimately changing their behaviours for the betterment of their mental, physical, and emotional health.

Research has shown that people with panic disorder are often more prone to holding self-defeating beliefs which can lead to decreases in self-esteem and increases in anxiety. These negative patterns of thought have been shown to be associated with increased instances of panic attacks.

Medication therapies such as benzodiazepines and selective serotonin reuptake inhibitors (SSRIs) can also benefit individuals in the short term. Although, it has been shown that medication alone can lead to higher relapse rates for panic disorder when individuals stop taking the drug.

Positive Self-Talk to Treat Panic Disorders

CBT provides the tools to help individuals cope with these thoughts and their symptoms through a simple, two-step practice. The first step taken to help someone with panic disorder involves teaching them how to recognize and challenge the negative thoughts that lead to their increased anxiety and apprehension. Psychologists can help people identify the habitual thought patterns that they routinely fall into. Becoming aware of how our thoughts influence our behaviour can help us change how we think for the better.

How to Develop Skills to Cope with a Panic Attack

The second step CBT emphasizes involves providing and implementing coping skills that will help those with panic disorder reduce their stress and anxiety levels and help them physically get through a panic attack.

People are often not able to control when they have a panic attack, but with the help of CBT, they can control how they get through it. CBT can help individuals become more comfortable with the stimuli that usually bring about panic through controlled exposure, leaving them feeling stronger and more capable of coping with the feelings of fear and acute anxiety.

Relaxation Techniques for Panic Attacks

CBT can also provide people who have panic disorder with skills to help them relax their body and calm the physical symptoms that usually arise during episodes of panic. Learning how to engage in calm breathing and meditative exercises can greatly reduce heart rate and built-up tension in the body, lowering the discomfort caused by panic attacks without flat-out avoidance. Decades of clinical research has shown that CBT is an effective treatment option for treating panic disorder.

Types of Anxiety Disorders

Anxiety Disorders: Our Complete Guide

Throughout the course of human history, our bodies have adapted to deal with different kinds of stress. Our fight or flight response, governed by our autonomic nervous system which works outside of our conscious awareness, was originally designed to help us avoid dangerous and possibly life-threatening situations.

However, in our current society, our overall stress system will react to any kind of stress we experience, most of which don’t put our lives in immediate danger but can still cause fear and feelings of anxiety.

Although our body’s reaction to stress can motivate us to perform well at work and school, it can sometimes appear in situations where there is no real threat present, causing a disproportionate amount of anxiety, fear, and avoidant behaviours, which can manifest in a specific anxiety disorder.

What are the Different Types of Anxiety Disorders?

There are several different types of anxiety disorders. This includes generalized anxiety disorder (GAD), social anxiety disorder, panic disorder, and specific phobias such as agoraphobia.

common types of anxiety

While these disorders differ in terms of what brings about their symptoms, they are all generally characterized by feelings of anxiety which can be officially defined as a negative state of mood that has the power to cause uneasiness, tension, and apprehension about specific events.

What Causes Anxiety Disorders?

There are a few different explanations for the development of anxiety disorders, the first of which is biological. Our individual genetic makeup passed on from our parents to us can create vulnerabilities that have the possibility of predisposing us to develop an anxiety disorder if specific psychological and social factors are also in play in our lives.

Additionally, anxiety can also be related to the dysregulation of certain neurotransmitters which are the chemical messengers in our brain that send information throughout our nervous system. Gamma-aminobutyric acid, more commonly known as GABA, is a crucial neurotransmitter when it comes to inhibiting feelings of anxiety.

The Connection Between Your Brain and Anxiety Disorders

Dysregulation in the levels of GABA in the brain has been shown to be associated with higher levels of anxiety. In addition to how our brain sends chemical signals, its structure can also play a role in anxiety. Recent research has suggested that people with anxiety disorders have a more responsive limbic system than those without.

What Causes Anxiety

Our brain’s limbic system is composed of the main structures involved in emotion, memory, and regulating how alert we are at a given moment. According to brain studies in which the activity of the brain is measured using imaging devices, people who suffer from anxiety have brains that are very sensitive to stimulation.

Anxiety Disorders and Early Life Experiences

However, biological explanations of anxiety are not the sole contributors to its development, psychological contributions can also play a big role in this process. Our early life experiences can shape the way in which we learn to respond and cope with uncertainty.

At a young age, it is important for children to learn that they can rely on and trust their caregivers as a secure base, all the while exploring and learning how to cope if they experience situations that are out of their control.

People whose caregivers hover over them and protect them from hardship can have less opportunity to learn to cope with uncontrollable events or difficulties and can become more vulnerable to developing anxiety in later life.

Social Events and Anxiety Disorders

Social events can also further influence anxiety. Stressful events in relation to school, work, marriage, divorce, injury or illness can also make someone more vulnerable to experiencing anxiety symptoms. Overall interactions between biological, psychological, and social vulnerabilities don’t necessarily cause anxiety but they do have the capacity to place someone at an increased risk for developing a type of anxiety disorder.

Symptoms of an Anxiety Disorder

Anxiety disorders can manifest with many different symptoms. GAD is a condition characterized by excessive and uncontrollable worrying, fear and apprehension about many daily life events or activities.

Living with Anxiety

In order to be diagnosed with GAD, an individual must experience at least three of the following symptoms in relation to their worry, these include feelings of restlessness, irritability, being easily fatigued, muscle tension or soreness, difficulty sleeping, and problems trying to concentrate.

They often worry extensively about things such as their responsibilities, job performance, their health or the health of others, school, or just typical life events throughout most of the day regardless of how big the supposed risk these things pose to them.

It may be so difficult to tune out the worries to the point that they can cause significant distress in an individual’s life. Many people with GAD can also experience further physical symptoms like sweating, diarrhea, or nausea.

What is Social Anxiety Disorder?

Social anxiety disorder, also known as social phobia, is characterized by the irrational fear and anxiety regarding being in social situations. Individuals with this disorder often worry about embarrassing themselves in front of others because they fear rejection.

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People with this disorder experience inescapable and out of proportion fear when presented with a social situation where others may judge them. In order to be diagnosed, social anxiety must typically last for six months or more.

What is Panic Disorder?

Panic disorder is a condition in which people experience unanticipated and recurrent panic attacks in relation to feelings of fear, terror or anxious apprehension of a situation that poses no real threat. Panic attacks are characterized by strong feelings of fear or discomfort that arrive unexpectedly and reach a peak in the span of a few minutes.

What are the Symptoms of Panic Disorder?

These occurrences include at least four or more of the following symptoms, heart palpitations or accelerated heart rate, sweating, nausea, shortness of breath or feelings of being smothered, trembling, feelings of choking, chest pain, dizziness, chills or hot sensations, numbness or tingling, fear of losing control or dying, and feeling detached from oneself or experiencing feelings of unreality.

anxiety disorder symptoms

A diagnosis of panic disorder is made when someone has a panic attack and in the month following also experiences either pervasive worry about having another attack and its possible consequences or a change in their behaviour in order to avoid further attacks (e.g., avoidance of certain situations). The important characteristic of panic disorder is the unexpected nature of the attacks.

How is Panic Disorder Different From Other Anxiety Disorders?

Those who experience other sorts of anxiety disorders may also have panic attacks, but they are usually regarding a certain situation or event, those with panic disorder often have no way to predict when an attack will happen and are afraid of the attack itself.

Panic Disorder and Agoraphobia

Panic disorder often occurs in conjunction with agoraphobia, a condition characterized by fear and anxiety about two or more of the following circumstances which include using public transportation, being in open or enclosed spaces, standing in line or being in a crowded area, or being outside or home alone.

People with agoraphobia avoid specific situations because they fear that may not be able to get out of them or get help if they experience panic. In order to make a diagnosis of agoraphobia, the fears must typically last for a period longer than six months and must be persistent and excessive compared the actual threat posed by the situation.

Much like generalized anxiety disorder, panic disorder and agoraphobia can result from biological and psychological vulnerabilities coming into contact with social factors and experiences.

Learned Alarm and Panic Disorders

When people start to associate these internal cues (e.g., heart beginning to pound) with panic attacks, the next time they experience the sensation (e.g., heart rate increasing with exercise) they may think that they are having a panic attack. This form of conditioning, or the association of a reaction to an event, can lead to the development of a learned alarm, or a cue associated with panic.

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This learned alarm, coupled with a psychological vulnerability to assume that your heart beating fast means that something terrible is happening to your body can cause a rush in anxiety resulting in a panic attack and the further development of panic disorder.

Phobias and Anxiety Disorders

In addition to agoraphobia, more general phobias can form when someone develops an irrational fear about an object or situation that restricts their capacity to live their daily life normally. Interaction with that object or situation incites instant anxiety or a fear response and people often try to avoid it or must endure it with these intense feelings of anxiety.

Like agoraphobia, specific phobias are lasting and tend to persist for about six months or more. Some of the most common phobias focus on certain animals (e.g., spiders, dogs, etc.), the environment (e.g., heights, water, etc.), blood-injection-injuries (e.g., needles, medical procedures, etc.), or specific situations (e.g., flying, being in an enclosed space, etc.).

Developing a Phobia

Phobias can be acquired by an individual directly undergoing or observing someone directly undergo a traumatic event related to the phobia. They can also develop through just being told about the dangers of an object or situation.

anxiety phobias

These factors, when paired with a psychological vulnerability to anxiety and our biological disposition to fear things that may pose a risk to our survival as humans (e.g., falling from a high height, being bitten by a poisonous snake, etc.) can cause people to develop a specific phobia.

Anxiety Disorder Treatments

Anxiety disorders can prove to be a challenge for those who have to deal with them on a daily basis. Luckily, a range of treatments exists to help people break the cycle of worrying that characterizes all anxiety disorders.

When approaching a healthcare practitioner about a possible anxiety issue, individuals will be assessed to see where they fit in terms of the DSM-5 criteria. Once a diagnosis is made, a treatment plan can be developed to ensure the best possible outcome for the individual. Treatments such as antidepressants or anti-anxiety medications may be prescribed based on the type of anxiety disorder.

Therapy for Anxiety Disorders

While medications such as these produce effective results in the short term, psychotherapy treatments such as cognitive behavioural therapy (CBT) have proven to be more effective in the long term. CBT deals directly with how anxious people deal with their fears and avoidant behaviours. Through CBT, individuals are able to work through their avoidance and discomfort on an emotional level so that they can become more familiar with their anxiety.

Treating Anxiety

CBT practitioners also help people cope with their fears by teaching them how to relax and tackle the physical tension that comes along with anxiety disorders. CBT teaches individuals how to bring up their fears and experience their worries for what they truly are, just worries!

This form of treatment gives people coping skills that they can use to confront their worry process in the future and stop it in its tracks. Research has shown that people who received CBT as opposed to those who didn’t experience a significant reduction of general anxiety disorder symptoms.   

When You Should Seek Anxiety Treatment

Overall, an individual should consider seeking out treatment if they feel like their worries are interfering with their life, becoming upsetting, or even too tough for them to regulate. They should also seek help if they’re feeling depressed, experiencing suicidal thoughts or behaviours, or if they have other mental health issues in conjunction with their anxiety.

Getting help for anxiety early, while maintaining a healthy lifestyle can prevent it from worsening in the future.

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Common Relationship Communication Problems

Relationship Communication Issues

All of us are involved in a series of relationships: intimate partners, parent/child, friendships, extended family, coworkers, etc. The truth is that relationships have wonderful times and difficult, challenging times. All relationships experience conflict. Managing conflict can make or break the relationship.

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In every relationship, you have a choice: You can work hard to drive the other person away OR you can work hard to keep that person close. Initially, it was thought that showing anger in response to anger was the cause of unstable and unhappy relationships.

Over time research has shown that arguments occurred just as often in healthy, long-lasting relationships as they did in troubled and unsuccessful relationships. The secret to a loving and lasting relationship is not in fighting less but in fighting well. Changing and improving the way you communicate during a conflict is the key to a rewarding relationship.

Common Relationship Conflicts

There are four common errors that occur during the conflict which can be changed into constructive communication with a little practice:


Criticism is global; it attacks the other person’s character. Instead of criticizing the person you care about try addressing only the specific action at which he/she has failed. Criticism: “You never remember anything! I can never count on you!” Try stating your complaint: “There is no gas in the car. I’m aggravated that you didn’t fill it up like you said you would.”


Contempt is composed of a set of behaviours that communicate disgust. It includes, but is not limited to: sneering, sarcasm, name-calling, eye-rolling, mockery, hostile humour and condescension. It is primarily transmitted through nonverbal behaviours.

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Contempt does not move toward reconciliation and it is always disrespectful. Build a culture of appreciation and genuine respect. Praise actions that you appreciate: “You really took care of that problem with the kids back there.”


Defensiveness conveys the message, “The problem is not me. It’s you.” From this position, you imply that, because the other person threw the first stone, they are responsible for the entire conflict. You avoid taking responsibility for your own behaviour by pointing to something they did prior to their complaint about you.Service Page

You do not acknowledge that which is true in what they are saying about your behaviour. Listen to what the other person is saying. Accept responsibility for even the smallest parts of the problem. Conflict happens between at least two people, both sides must acknowledge their roles in the situation.


Stonewalling occurs when intense arguments break out suddenly, and where criticism and contempt lead to defensiveness, and where more contempt leads to more defensiveness, eventually one partner tunes out. This is the beginning of stonewalling. The stonewaller acts as if he/she (research indicates that 85% of stonewallers in marriages are husbands) couldn’t care less about what the person is saying or doing.

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He/she turns away from conflict and from the relationship. Learn to recognize the signs that you are becoming overwhelmed and learn to soothe yourself. It is important to stay emotionally connected to the person that you are arguing with. The only way a resolution can be achieved is through a healthy connection with your partner.

How to Deal with Relationship Behaviour Issues

If either you or your significant other regularly engages in any of these behaviours during fights, you should learn the skills that repair damage and ensure the happiness of a successful relationship.

There are antidotes for these problem behaviours, here are some suggestions:

  1. Learn how to mirror your partner’s complaints.
  2. Scan for whatever is valid in your partner’s complaint and address that.
  3. Practice holding yourself and your partner in warm regard, even when feeling distant or during a fight.
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Dealing with Depression

Our Guide to Dealing with Depression

Almost anyone you know will use the words “I’m depressed” to describe the way they are feeling from time to time. Feeling ‘blue’ or feeling down’ is not the same as suffering from a clinical depression. Depression becomes an illness when symptoms are severe, last for several weeks, and begin to interfere with one’s work and social life.

Types of Depression

There are several types of depression: major depression, seasonal affective disorder (SAD), postpartum depression, situational depression, bipolar disorder, and premenstrual dysphoric disorder (PMDD).

Major Depression

Major depression, also known as major depressive disorder, is diagnosed when you are feeling depressed most of the time throughout the day, most days of the week. Symptoms would include a depressed mood and a loss of interest in activities, along with at least three other symptoms of depression.

Seasonal Affective Disorder (SAD)

SAD is a type of major depression that occurs during the winter months when days the days grow shorter and there is less sunlight. This type of depression typically goes away during the spring and summer months. Light therapy can benefit people that suffer from SAD.

Postpartum Depression

Women who experience major depression in the weeks and months following childbirth suffer may be suffering from postpartum depression. It’s important to distinguish between ‘baby blues’ and postpartum depression.

Anywhere from 50 – 85% of new moms experience ‘baby blues’ – this phenomenon following childbirth that lasts anywhere from a few hours to two weeks. It usually resolves untreated as the mother adjusts to the changes in her routine, hormonal fluctuations and less sleep.

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Postpartum depression generally develops within three months of giving birth and can last for years if left untreated. This condition is often accompanied by anxiety, sleep and eating disturbances, feelings of guilt and shame and thoughts of harm towards one’s self or the baby.

Situational Depression

Stressful life events, such as the death of a loved one or a divorce, can cause a depressed mood to develop. This type of depression is also known as ‘stress response syndrome’ and it responds well to cognitive behaviour therapy. Seeking help to process difficult life events can help you to process the event, manage self-care and help you to heal from the trauma and/or loss.

Bipolar Disorder

A person suffering from bipolar disorder, formerly known as manic depression, experience severe shifts in mood and energy making it difficult to function. This condition usually emerges in late adolescence or early adulthood. People often live with this condition for years without having it properly diagnosed or treated.

Premenstrual Dysphoric Disorder (PMDD)

Most women experience some sort of premenstrual syndrome (PMS) the week before their period, signs and symptoms may include: bloating, food cravings, cramps, moodiness, etc. Women suffering from PMDD experience symptoms that are more severe and debilitating; they often interfere with daily activities, work, school and relationships.

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PMDD can cause monthly episodes of hopelessness, anxiety, intense anger and conflict, loss of sleep and feeling ‘out of control’.

What Causes Depression

There is no one cause of depression. Depression usually results from a combination of recent events and personal factors. There may also be a genetic link since people with a family history of depression are more likely to experience it.

The following factors may make you more prone to experience clinical depression:

  • Specific, distressing life events: the death of a loved one, loss of job, divorce, etc.
  • A biochemical imbalance in the brain
  • Personality – tendency to worry, low self-esteem, negative or pessimistic thought patterns, perfectionists, self-critics, etc.
  • A family history of depression
  • History of trauma or abuse
  • Having had one episode of major depression increases the risk of having another
  • Chronic pain or illness
  • Drug and alcohol use

What Are Some Symptoms of Depression

Depressive illness can change the way a person thinks and behaves, and how his/her body functions. When a person is depressed, it affects both the body and the mind. It disrupts some of the body’s most basic systems, making the person feel unwell.

  • Feeling worthless, helpless or hopeless
  • Sleeping more or less than usual
  • Increased alcohol and drug use
  • Withdrawing from family and friends
  • Avoiding work, school and/or social situations
  • Increased physical health complaints, especially fatigue or pain
  • Negative thoughts – “I’m a failure”, “Nothing good ever happens to me”, “Life’s not worth living”, “It’s all my fault”
  • Eating more or less than usual
  • Difficulty concentrating or making decisions
  • Decreased sex drive
  • Overwhelming feelings of sadness or grief
  • Thoughts of death or suicide

Depression Diagnosis & Treatment

An accurate diagnosis of depression should only be made by a qualified mental health professional or physician. Psychologists, psychiatrists and family physicians are able to diagnose after a complete evaluation of symptoms, screening, assessment and history.

Depression is the most treatable of mental illnesses. Most people who suffer from depression are helped by the treatment they get, which usually includes psychological therapy and/or medication. The most effective treatment of clinical depression is a combination of Cognitive Behavioural Therapy (CBT) and medication.

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CBT helps the client to become aware of thought distortions which are causing psychological distress, and of behavioural patterns which are reinforcing it, and to correct them. A psychologist will make every effort to understand experiences from the client’s point of view; the client and psychologist work collaboratively exploring the client’s thoughts, assumptions and inferences.

Negative Thinking and Depression

The psychologist helps the client learn to test these presumptions by checking them against reality and against other assumptions. Throughout this process of learning, exploring and testing, the client acquires coping strategies as well as improved skills of awareness, introspection and evaluation. This enables them to manage the process on their own in the future, reducing the likelihood of experiencing a relapse.Blog Post

Negative thinking in depression can result from biological sources, modelling from parents or other sources. The depressed person experiences negative thoughts as being beyond their control. The psychologist provides techniques to give the client a greater degree of control over negative thinking by correcting cognitive distortions.

This type of thinking also interferes with recovery and makes the person more vulnerable to depression in the future. It is important to recognize unhelpful thoughts and replace them with more realistic thoughts.

Cognitive Behaviour Therapy (CBT) Can Help

As well as helping people manage negative thoughts, CBT also involves looking at behaviour. This includes helping people find new ways of going about their everyday life. This can include the way a person may react to certain people or situations and/or how a person might plan their day.

Learning these techniques and incorporating new activities into daily life (e.g. exercise, self-care, increasing social supports) can help recovery and prevent relapse. Some of the specific ways we help include the following:

  • Change your negative thoughts and feelings
  • Identify ways to manage your illness and stay well
  • Encourage you to get involved in activities
  • Speed your recovery
  • Prevent depression from recurring

Antidepressants and Depression

Antidepressants are medications that can help to restore chemical imbalances in the brain by allowing the nerves of the brain communicate more effectively. By targeting certain brain chemicals (serotonin, norepinephrine, dopamine), antidepressants help to regulate mood and to reduce the symptoms of depression that keep you from managing daily routines and enjoying life.

When deciding which antidepressant to prescribe, your doctor will take into consideration your depression symptoms, overall health, and any other medications you may be taking. Some antidepressant medications can cause unpleasant side effects: dry mouth, nausea, weight gain, decreased libido.

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Most side effects decrease after a week or two, if the side effects do not decrease ask your doctor to try another medication. If you are experiencing unpleasant side effects it is important to decrease your medication dosage slowly under the supervision of a physician.

Self-Help Techniques and Depression

There is a wide range of self-help techniques and therapies that can help to manage depression and prevent relapse. They are most effective when used in conjunction with psychological treatment and/or medication. It can be good to know that there are things you can do for yourself to feel better.

Fighting Depression with Exercise

Regular exercise may increase the levels of serotonin in the brain. Serotonin is a neurotransmitter involved in regulating mood, sleep, libido, appetite and other functions. Exercise can also increase the level of endorphins in the brain which have ‘mood-lifting’ properties.

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Regular exercise increases energy, improves sleep, distracts from worries and negative thought patterns. Group exercise provides social support and reduces feelings of loneliness. Mild to moderate exercise can be helpful for depression; a brisk walk three to four times per week is beneficial.

Yoga and Depression

Yoga is an ancient exercise philosophy that provides a gentle form of exercise and stress management. It consists of postures known as asanas that are held for a short period of time and are synchronized with your breathing. Yoga is very helpful for reducing stress and anxiety, which are often precursors to depression. Studies have shown that yoga breathing exercises are beneficial for depression.

Meditation and Depression

Mindfulness meditation is a form of self-awareness training. Mindfulness is about being in the present moment, without making a judgment. It allows us to experience our body and feelings in each moment with acceptance.

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Mindfulness meditation can help to stop getting caught up in thinking about the past or worrying about the future. Practicing meditation on a regular basis can change the way our brain and nervous system function; it decreases stress and improves mood.

Treating Depression

Untreated clinical depression is a serious problem. Many people who are seriously depressed wait too long to seek treatment or they may not seek treatment at all. They may not realize that they have a treatable illness, or they may be concerned about getting help because of the negative attitudes held by society towards this type of illness.

Untreated depression increases the chance of developing a drug or alcohol addiction, it can ruin relationships, create problems at work, make it difficult to overcome serious illnesses and even result in suicide. Without proper treatment untreated clinical depression can last for weeks, months, or years.

Who’s The Boss?

Blog PostBefore making big decisions, many people consult with others first, people who they believe are qualified to help them weigh their options. In the workplace, you might seek the opinion of a particular person because they have the most knowledge about other employees or the customers, or about the workplace culture. Or, you might ask a friend because you view that person as level-headed, or as having your back. However, when it comes to personal issues I often see people consulting a decision maker who demonstrates very few of the skills we would want in a good decision maker: People let Anxiety be the boss.

I’ll point out that Anxiety (and other strong emotions, for that matter) has a really poor track record of accuracy and success when it comes to predicting what might happen. It’s great when it comes to anticipating the worst, but more often than not, those things it says we should fear usually don’t happen as often as Anxiety say they will. When the doom and gloom does happen, it usually isn’t as bad as Anxiety leads us to believe it’ll be. If weather forecasts were as inaccurate as Anxiety is, we wouldn’t rely on them, but we continue to do so, often.

Most commonly, what Anxiety wants is for us to avoid something, and it’s hard to resist doing that because Anxiety uses the intimate knowledge it has of our own thoughts and fears to get what it wants. It’s important to remember that, while potent, Anxiety is not a qualified decision maker. Strong emotions rarely consider all the relevant data when weighing the options, so decisions based mostly on anxiety are probably not well informed. Just as I wouldn’t let a kindergartener be the sole decision maker for what my family should eat for dinner (cookies anyone?), it would be similarly ill advised to let Anxiety rule.

Truly effective decision making involves a balance of multiple factors that usually does include some element of emotion. Just as I might consult with the kindergartener about what to eat and take that input under advisement, I can also check-in on my feelings to help inform my decisions. But that shouldn’t be where the conversation ends. Your life might feel (and function) better when you challenge yourself to be the boss and find ways to balance anxiety and strong emotions with other information to help you make decisions for your life. The most likely truth is that you are far stronger and more capable than you’ve given yourself credit for being. Tap into that strength and see what you can do.

Get in touch if you want to learn how to deal with your Anxiety.

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Dr. Kristina Wilder
Shift Cognitive Therapy + Assessment
Oakville, Ontario

What’s True and What’s Just a Habit?

Blog PostWe humans have amazing brains! Most of us know that, but we often don’t spend much time thinking about why that’s so. One of the amazing things our brain does is automate common processes so we don’t need to waste the very precious and limited conscious awareness we have on mundane activities we’ve done hundreds of times before. Consciousness brings one’s full attention to some aspect of a task or situation. It would be both a huge waste and terribly overwhelming if we had full and complete awareness of every aspect of our experience. How would you get anything done if you were constantly distracted by sensation each time your clothes moved against your skin or by the individual movements of every single hair on your head! Automation allows us to do even highly complex things, like driving, grasping and manipulating objects, and walking on ‘auto-pilot’ so we can save our keenest focus for the really important stuff. This is truly an amazing ability, but it can become a problem when we some allow automated processes to continue simply because they’re already in place.

Belief systems are a good example of this because many of them are automated processes that that we assume are valid even when they’re inaccurate. We are forever taking information from the outside world, comparing it to what we think we know and then adapting, somehow. We say we’ve “learned something” when we consciously change a pre-existing belief to fit with new information. We say we’re “biased” when we discount, dismiss, or outright ignore new information that doesn’t fit with those existing beliefs. Sometimes, we simply stop even thinking that something else might be possible when we’ve been in the habit of believing it to be a certain way for a long time. We call some of these “core beliefs” because they can become fundamental to who we accept ourselves to be as people.

Core beliefs develop early in life and are usually pretty black-or-white. They can include ideas that “I’m not good enough”, “I’m weak”, or “There’s something wrong with me”. Even though they tend to generate a lot of feelings and can have a big influence on the decisions we make (for example, deciding to avoid doing something difficult because we don’t think we can do it), they usually don’t reflect the whole story of who or what a person is. At this time of year, when so many people rethink the ways they’re living and begin to plot a course for the future, it becomes important to really look at those ideas we have about ourselves. Who knows, you might be far more than you’ve been giving yourself credit for?

Dr. Ian Shulman, Psychologist

We can help you explore and change your core beliefs. Contact Shift Cognitive Therapy + Assessment to learn how.

What Are Smartphones Doing to Young People?

Last week, the wonderful, CBC radio program The Sunday Edition  featured a discussion Blog Postbetween host Michael Enright and guests, psychologist Jean Twenge and Canadian technology writer Clive Thompson entitled “What Are Smartphones Doing to Young People?”. Dr. Twenge is the author of iGen: Why today’s super-connected kids are growing up less rebellious, more tolerant, less happy and completely unprepared for adulthood and Mr. Thompson is the author of Smarter than you think: How technology is changing our minds for the better.

They talked about a growing body of data showing that by 2012, about 2 years after smartphones and tablets had saturated the consumer market, research was showing clear spikes in the numbers of teenagers reporting increased loneliness, depression, suicide and self-harming behaviours, as well as decreased reports of happiness and life satisfaction. There remains no clear evidence that any of those challenges are caused directly by cell phone use (or, that any of them directly cause teens to use their phones more often!) but the relationship is now considered to be fact. Until researchers can identify absolute reasons to explain what is happening to our teens, the speakers were left to speculate on their ideas about how the technology might be impacting teens so dramatically.

One possible cause mentioned was that teen users, many of whom spend between 6 and 8 hours each day ‘on screens’ might be leaving themselves too little time to engage in other activities that actually boost resilience and good mental health, like having face-to-face interactions and sleeping. It is well-known that sleep has a clear benefit on resistance to stress and depression, and close, intimate relationships provide great personal support. They also discussed how the technology giants behind smartphones and the apps they support are motivated to earn profit and not necessarily to do what is in the best interests of teen users and families.

The speakers offered important tips for parents, including the very basic, but potent direction to simply insist that teens “put it down” and give themselves time to do non-screen activities. They discussed setting daily time limits and tech-free zones, and noted how parents themselves get to make the decisions about at what age they will give their younger children access to their own smartphones and devices. The speakers encouraged parents to be critical consumers of technology themselves and to never forget that they are themselves the primary models their children will look to when seeking examples of hope to use a smartphone.

Dr. Ian Shulman is a clinical psychologist and is the Clinic Director of Shift Cognitive Therapy + Assessment in Oakville, Ontario.

Teens and Anxiety

Denizet-Lewis, Benoit. “Why Are More American Teenagers Than Ever Suffering From Severe Blog PostAnxiety.” The New York Times Magazine, 11 Oct. 2017.

The New York Times Magazine recently featured and article asking the question why so many teens seem to be as anxious as they are. The author cites the National Institute of Mental Health in describing anxiety as “the most common mental-health disorder in the United states” and reports that the American College Health Association found that 62% of undergraduate students felt “overwhelming anxiety” at some time in the previous year. Parents want to know: What’s going on with our kids and what can we do about it?

The Times article goes on to distinguish between the anxiety we all have that functions as a warning system for danger and the overwhelming experience of fear many have that can interfere with daily living. The former is quite normal: When we perceive a threat, the body activates to provide sufficient resources (like, attention, focus and strength) needed to address the problem, then settles back down to rest once the danger has passed. The latter results when people get into the mental habits of over-estimating the dangerousness of situations and under-estimating their own ability to cope. This can contribute to situations where adolescents are “driving themselves crazy”, always scanning for threats and trying to avoid anything that looks like it might be overwhelming. And that’s where the author suggests social media and smartphones play a role.

Social media, like Twitter, Facebook, Instagram and Snapchat all provide anxious teenagers with limitless opportunities to compare themselves and their lives against their peers — or at least what their peers say their lives are. People are notorious for curating what they post, selecting only the perfect photo, showing the perfect moment and attaching the perfect comment. Even though many teens know (from their own experience) that what they see on other people’s social media feeds isn’t completely ‘real’, it does become the benchmark against what anxious teens try to compare themselves.

Smartphones and other tech also allow worried teens ample opportunity to avoid the direct interactions they fear even though it’s direct experience with social interactions that actually teach teenagers how to manage socially.

This is an interesting article and worth reading. Parents and teens wanting to learn more about how to cope with anxiety and worry can contact us here at Shift. We see more anxiety than any other clinical issue and teach proven strategies to help people cope with fear and worry.

Dr. Ian Shulman
Shift Cognitive Therapy + Assessment

Fruit Expectations

It can be really frustrating when other people do things we don’t agree with and we can find Blog Postourselves wishing they would just ‘get with the program’ and do as we expect them to. It’s way too easy to fall into the trap of blaming the other person in moments like that, but staying in a place of blame doesn’t get rid of frustrations and can hurt relationships when resentment creeps in. Clients often ask me for dating advice about how to change their partners and, believe it or not, I often tell them to look at changing their own beliefs and expectations first. Your expectations of the people you love might be the thing contributing most to your own frustrations.

I often explain this using the example of fruit. When you go to eat a piece of fruit, you pretty much know what to expect because of past experiences with other pieces of that same type of fruit. Your history guides your expectations of the future and sets the stage for what you believe will happen each time you peel a banana or bite into an apple. Your satisfaction, your pleasure, even your sense of comfort is directly related to how good the fit is between your expectation of what will happen and whatever actually does happen. We feel reassured and good when there’s a good match and dissatisfied or cautious when there isn’t.

People tend to feel most ready to change themselves when they feel good enough exactly as they are!

The same can be said about relationships. I often see clients setting expectations for the other people in their lives based on what the clients think makes the most sense — that is, basically, what a person thinks someone else ‘should’ do in a given moment. Not surprisingly, when those others behave differently, clients tell me they feel frustrated, disappointed and often hurt. Its at moments like that when couples are most likely to argue. As a result, I regularly hear clients wishing that their partner would change, and saying that all the problems between them would just be gone if only the other person behaved differently. While that would be nice, it’s probably not realistic. We have very little ability to control what other people do. We get way more traction by changing ourselves and the expectations we have of others. While it’s true that your unreliable friend might continue to be unreliable, you might suffer less (and contribute to fewer arguments) by expecting that instead of setting yourself up for continued disappointment by hoping that person will suddenly be different.

This doesn’t mean that we should give in or give up on expecting those people in our lives to ever change or evolve. Change does happen, it just happens over time, and when we wait for and allow that gradual evolution to occur, we (and our important people) can feel happier together in the meantime. Interestingly enough, people tend to feel most ready to change themselves when they feel good enough exactly as they are! Returning to the example of fruit, my expectation of what apples should taste like now is different from what I knew apples to taste like years ago. As the flavours changed over the years, my expectations changed with them — I allowed that mutual evolution to occur by saying “Yep, that’s a bit different from the last one I ate, but that’s still an apple”. So, a piece of advice I can offer on how to improve your relationships is to work at accepting those important people in your life exactly as they are right now, even when they do things that differ from what you want. When your loved ones feel like they’re good enough in your eyes, they’ll be most likely to volunteer to change themselves to make you even happier!

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Dr. Kristina Wilder
Shift Cognitive Therapy + Assessment
We help people make their relationships more successful.

What I Say and What I Mean

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Which way I go depends on me.

The human body’s ability to survive is an amazing thing. So many different systems all work together to alert us to possible dangers, trigger instantaneous reactions that automatically sound the alarm, activate the body to deal with threats, then gradually settle everything down and reset it all so the entire system is ready to go the very next time anything seems amiss. Spoken language and logic are important parts of this alarm and defence system, but ones that regularly seem to fade into the background and operate outside of our conscious awareness. This means there can be huge differences between what I say and what I actually communicate to myself.

A trap of language and logic that is typically hidden from view but can activate the body’s alarm systems and cause panic occurs with what I call conditional statements. Conditionals refer to situations that can go one way or another, depending on some other variable. You’ll know one when you see one because of telltale words like “WHEN” and “BECAUSE”.

For example, in a moment of tension, a person who is afraid of flying might say to herself:

“I will be safe WHEN this plane lands.”

If she accepts that statement as true, then the conditional trap means she must also, automatically accept the opposite as true, namely:

“I am not safe UNTIL this plane lands.”

If she’s not safe UNTIL her plane lands, then her brain will immediately conclude:

I am not safe NOW!

and her body’s anxiety and panic alarms will instantly fire, even when the flight she’s on is actually quite safe and fine. All it takes is that one moment of automatic thinking to set off the alarms.

You can learn to cope with your own anxiety and worry by paying attention to the language you use to talk with yourself. Practice noticing when your mind is making conditional statements like these; notice how they activate your body’s arousal systems and then decide — really consciously decide — whether you want to allow yourself to panic or regain your sense of calm. You can’t stop your body’s alarm systems from turning on automatically, but you can learn to ride out those moments of fear and build better coping skills by paying attention to what you’re really saying to yourself.

Let us help you learn to cope better with anxiety, panic and worry.

Shift Cognitive Therapy + Assessment
Dr. Ian Shulman