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Spring 2013 Fear of Flying Seminar

At the end of May Dr. Ian Shulman and Capt. Marc-Antoine Plourde led a group of 10 people who were afraid to fly on a two-day workshop to help them with their phobia. We met at a small facility on the grounds of Toronto’s Pearson International Airport and spent two full days working on helping the seminar participants to cope with their fear and understand its origins. Most people believe that their fear of flying occurs because flying is dangerous. In fact, with all the safety mechanisms, regulations, standards and the double- and triple safeguards built into modern aircraft, being a passenger on a commercial aircraft is actually safer than driving on the highway. What we help our flight seminar participants to appreciate is that the fear of flying is actually more related to the fear of not having control.

Boarding Air Georgian's Beech 1900

In our experience, the one thing most fearful fliers have in common is a history of feeling truly alone or afraid at some time in their lives, usually in childhood or early adolescence. Some felt it because their parents were alcoholics or abusive; other parents were otherwise unavailable because of illness, depression, poverty, work, or when they had others in the family who demanded more of their attention. Some fearful fliers felt alone growing up in families that never talked about feelings, leaving them confused about how to make sense of their own emotions. Still, others felt alone or afraid when they were trapped in places or situations that they couldn’t escape from, like small spaces, near-drownings, or being too small to stop others from bullying or tormenting them. Those kinds of early-life experiences taught fearful fliers a powerful lesson: Remaining in emotionally intense situations is painful and to be avoided.

First Officer Andrew gives the safety briefing; Marc-Antoine Plourde listens in.

The 10 adults in our latest group were no different; all were able to identify challenges in their pre-adult years. Almost the entire group had flown before and only one had experienced a flight-related incident (like bad turbulence or a sudden loss of altitude) when on a plane. Instead, the most common story people told was of feeling anxious on and off over the course of their lives and using avoidance to manage it.

They all spoke of avoiding airplanes because they feared they would be unable to escape or do anything to manage their feelings if they began to feel afraid during the flight. When anxious in cars they would open windows, pull over or insist that they always drive; in elevators, they would get off at the next floor or take the stairs; or in crowded rooms they would sit by the door and ensure they knew all the exits – just in case. But on airplanes, they said, once they were in the air, they felt they couldn’t do anything to maintain that sense of control over their fears and feelings.

The keys to the success of our fear of flying workshop was that we helped the group to (a) develop realistic expectations of what would happen on an actual flight and (b) improve their ability to tolerate the anxious thoughts and feelings we knew they would experience when they took the chance of giving up their usual controls. Using group discussions, mindfulness meditation practice on board the aircraft, and showing our adult fliers that they had it in their ability to ask for the care and comfort they needed, we readied the group for the confirmation flight, a tour of the skies over Toronto.

Dr. Ian Shulman, after the flight.

In the end, 7 of the 10 decided to fly. All were nervous, but all found ways to cope that didn’t involve avoiding or procrastinating. It wasn’t easy, a few members of the group felt quite scared and needed reassurance, but Dr. Shulman, Capt. Plourde and the other members of the group were all there to provide it. The worst part for most, they said in the post-flight debriefing, was right before they stopped trying to control everything and gave in to their feelings. The best part was about 5 minutes after that, when they realized their fears were unwarranted and found themselves able to cope with whatever the experience gave them.

Let us know if you’re afraid to fly too, there are things we can do to help.

Genetic Testing for Postpartum Depression

Postpartum DepressionThe Toronto Star recently reported that “a simple blood test” done early in a woman’s pregnancy may soon be able to detect DNA changes that predict postpartum depression. According to the article, a study recently published in the journal Molecular Psychiatry examined blood samples of 93 pregnant women and found that approximately 80% of those who would later go on to develop postpartum depression shared a sensitivity to changes in estrogen at the level of their genes (that is, in their DNA). Estrogen, labeled by some as “the big kahuna” of the female hormones, is produced by both the ovaries and the placenta and is vital to pregnancy – basically, no estrogen means no pregnancy. The obvious implications of the research are that help for depression can be provided to women who are at risk before it settles in.

Postpartum depression is more serious than the typical “baby blues” that can occur within hours of delivering a baby, but requires no treatment and usually resolves within hours or days. Symptoms of postpartum depression can last longer and be more severe. It can also develop into a full-blown, major depression, which raises the risk of other depressive episodes throughout the lifespan.

The US National Institute of Health estimates that 1 in every 10 women may develop symptoms of postpartum depression in the year after childbirth.

 

 

www.shiftct.com
Call Shift Cognitive Therapy for non-medication help with depression in Oakville.

Canadian Economists Support Greater Access to Psychologists

The Canadian Psychological Association released a report today that it commissioned by an independent group of health service economists and health policy analysts. The report was critical of Canada’s current approach to mental health care, calling the lack of support for effective psychological services “a silent crisis.” It urges Canadian health policy makers to consider adopting strategies currently in place in other nations. One strategy involves working with insurers and employers to provide more realistic amounts of insurance coverage for psychological services, especially since insurers and employers both gain dramatically from having a healthy, well-functioning workforce.

Read the press release and access the full report here.

 

 

 

www.shiftct.com
Call Shift Cognitive Therapy for help with depression and anxiety in Oakville.

Rethinking Depression

This month, CBC Radio One has been airing a thought-provoking, 3-part series entitled “Rethinking Depression” on its program Ideas. With the help of a number of local and world-renowned experts in the field, producer Mary O’Connell explores what we know – and what we think we know – about depression and the medications we use so often to treat it. The patient and interested listener (the entire series runs for three hours) will be rewarded with some really fascinating but often not well-publicized facts about the social, commercial and political factors that are conspiring to make psychotropic medications “a $20billion per year industry worldwide” and have led the World Health Organization to predict that depression will be the second leading caused of global disability by 2020. This series is well worth the time to listen to!

Listen to part 1 here.

Listen to part 2 here.

Listen to part 3 here.

 

Some tidbits from the series…

Up until the 1950s, depression affected only about 1% of the population, and that was mostly middle-aged women. Back then, the term was used almost exclusively to refer to the serious condition that left sufferers barely able to function and often suicidal. However, in 1963, when pharmaceutical giant Hoffman-La Roche introduced its minor tranquilizer Valium, huge numbers of people began to use it to address their own ‘symptoms’ of feeling blue and overwhelmed. Whereas previous psychiatric drugs had mostly been reserved for use with the seriously mentally ill, Valium was seen as something any adult could use, just to ‘take the edge off’ everyday life. In 1966, The Rolling Stones wrote about its widespread acceptance in “Mother’s little helper” and its cultural relevance grew as it increasingly found its way into popular movies and television.

A second major societal shift that further increased the appearance of higher rates of depression occurred in 1980, with the publication of the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the so-called ‘bible’ every North American mental health provider relies on to distinguish what is and isn’t a psychiatric condition. Political infighting between the various high-powered authors resulted in the decision to lump into a single category both the major depression that truly incapacitated its sufferers and the milder, ‘reactive depression’ that resulted when people struggled to manage difficult life events and felt distressed, but were still able to go to work every day and function reasonably well. Suddenly, the size of the market for a medication that took away distress increased dramatically.

Newsweek: "A breakthrough drug for depression"While effective as a sedative, Valium wasn’t a great option for elevating low mood and it had some undesirable side effects as well. Pharmaceutical giant Eli Lilly resolved those problems when they brought Prozac to market in 1988. Compared to Valium, Prozac was easy for physicians to prescribe and monitor, and it was easy for consumers to take. It was quickly hailed as a breakthrough and a ‘magic bullet’ for depression. Prozac worked specifically on the neurotransmitter serotonin, and the pharmaceutical industry and its marketing partners insinuated and gradually solidified the idea that depression was the result of a chemical imbalance in the brain. Even though that idea has little empirical support it is still widely held to be true. It may be that the so-called Serotonin Hypothesis of depression is more a marketing coup than a scientific fact.

Some estimate that 75% – 80% of the effects of antidepressant medications may be due to placebo, meaning that the belief that the medication is helping to reduce symptoms may be more powerful than the medication itself. Noticeable impacts on other serotonin-related systems within the body (eg, sexual function, bowel function, and attention) may give the appearance that the drug is doing something, but scientists are still actively struggling to understand what the SSRI class of medications (that includes Prozac, Paxil, Celexa, Cipralex, Luvox and Zoloft) actually do. What is not under debate is the fact that huge amounts of money are available to be made as rates of depression continue to rise and as categories of users continue to expand. According to the series, senior citizens, children and teens are in the fastest growing group of antidepressant users in the past 10 years and manufacturers are now re-working their formulas for use with animal populations as well (see www.reconcile.com).

www.reconcile.com

One of the more challenging aspects of the series is the realization that as a society, we have medicalized unhappiness and other normal emotions. It invites us to question whether we’re better off for it, or if we might be shortchanging ourselves over the long-term by stepping away from the opportunities for positive growth that can come from personal struggle. What if depression and rumination can teach us how to function more effectively the next time a problem arises, much in the same way that we voluntarily expose ourselves to the flu viruses in the fall to inoculate ourselves against them over the winter? What if suffering can lead us to change dysfunctional aspects of our lives, perhaps through treatments like cognitive therapy, which is effective and has lower relapse rates than medication.

Rethinking Depression is an excellent documentary series and well worth the time.

Click here for other information on managing depression.

 

www.shiftct.com
Call Shift Cognitive Therapy for non-medication depression help in Oakville.

Students Highly Stressed: TDSB Survey

The Toronto District School Board recently released the findings of their 2011-12 Student Census (click here to download the survey) and the results suggest that a majority of students may be struggling with anxiety and depression. Believed to be the largest survey of its kind in Canada, the census explored how students feel about their in- and out-of school experiences and their general well-being. Almost 90% of all Toronto students in grades 7 through 12 (103,000 students) participated in the survey.

The study revealed that 63% of grade 7 and 8 students and 72% of those in high school felt nervous or anxious often or all of the time. Fully one-third of Toronto high schoolers reported feeling under a lot of stress and about three-quarters said they felt tired for no reason and struggled to concentrate and make decisions (see the table below). A significant source of their worry was how things might be in the future.

 

Student Experience Grades 7 – 8 Grades 9 – 12
Tired for no reason

58%

76%

Difficulty concentrating

56%

76%

Difficulty making decisions

56%

72%

Nervous/anxious

63%

72%

Under a lot of stress

40%

66%

% reporting All The Time/Often

These symptoms our teens and tweens are reporting are some of the same symptoms present in depression (follow this link for a complete list from the Canadian Mental Health Association), a debilitating condition that can develop when we feel unable to cope with prolonged stress. The results are upsetting because they suggest that while we’re giving our kids so many opportunities, we’re not teaching them enough about how to manage with the challenges and demands of everyday life.

Cognitive behaviour therapy is an important and effective tool in the fight against depression.

 

www.shiftct.com
Call Shift Cognitive Therapy for depression help in Oakville.

On Winning and Losing

The recent commotion about Lance Armstrong’s admission of cheating prompted a thought-provoking discussion about winning and losing between Jian Ghomeshi, host of the CBC Radio program “Q” and recurrent guest, actor/musician Torquill Campbell on January 24, 2013 (click here to download the podcast).

The thrust of the discussion was that it’s unfortunate that so many of us are trained to focus only on the importance of winning and being ‘The Best’ because the results seem to be feelings of aloneness and stress. Since there can only ever be one winner, Campbell suggested, winning is something we do alone; and because winning is made out to be of such great importance, the joy of winning at anything must be abandonned quickly in order to focus on trying to win the next thing. When we become convinced that the only thing that matters is whether we win, Campbell argued, we run the risk of being sucked into believing what he described as “the tragedy of the Lance Armstrongs of the world,” that winning must continue indefinitely for us to be okay as individual people.

By contrast, Campbell suggest, losing is a more collective experience because it is something that we all go through. Every single person has to face loss and struggle in his or her life and because of that, it is something that we do together. It may be that having things not work out as planned opens us up to empathy and wisdom because, he said, it forces us to accept our weaknesses and tune into our strengths in order to make it through the tough times. Campbell closed the discussion with the encouragement to strive to love and understand the weak things inside you because when you own those things as acceptable parts of yourself, you can take on bigger challenges more freely and with greater confidence that stumbles along the way are nothing more than just a part of the process.

Their discussion is an interesting one and occurs in the last 10 minutes of the show.

 

 

www.shiftct.com
Shift Cognitive Therapy Oakville is a psychology practice that helps people learn to manage anxiety, stress and depression.

Thirteen Healthy Ways to Comfort Yourself

By Margarita Tartakovsky, M.S., Associate Editor
PsychCentral.com

Whenever you’re anxious, sad or overwhelmed or simply need some soothing, it helps to have a collection of comforting — and healthy — tools to turn to.

But some calming activities don’t work for everyone.

For instance, some people are allergic to bath salts, while others can’t drink herbal tea because of possible drug interactions (e.g., blood thinners). Many of us also can’t afford manicures or massages. And most of us are pressed for time.

So we asked three experts for their take on how readers can truly soothe their minds and bodies without needing more money, time or anything else, for that matter. Below are 13 strategies anyone can use to comfort themselves when they’re having a bad day.

Read more …

 

 

 

www.shiftct.com
Shift Cognitive Therapy Oakville is a psychology practice that helps people learn to manage anxiety, stress and depression.

Shift Supports Oakville’s Fareshare Food Bank

At Christmas this year the staff at Shift Cognitive Therapy donated 100% of a day’s revenue to Oakville’s Fareshare Food Bank to support the work of that organization. According to their website, the Fareshare Food Bank is a not-for-profit organization run by volunteers that has been providing for needy members of the Halton community since 1988. They support approximately 1200 people each month and collect most of their non-perishable food items during the holidays. Monetary donations are used throughout the year to purchase perishables like milk, cheese, meat and vegetables. Their website provides information about how members of the community can host a successful food-drive.

The food bank is located at 1240 Speers Road in Oakville and can be reached by phone at 905-847-3988.

 

 

 

www.shiftct.com
Shift Cognitive Therapy Oakville is a psychology practice that helps people learn to manage anxiety, stress and depression.

Rates of Depression and Anxiety Rising in Ontario Young Adults

Findings released recently in the Monitor survey published by the Centre For Addiction and Mental Health (CAMH) revealed interesting facts about the mental health of young adults in Ontario. The latest findings, from 2011, come from the reports of more than 3000 adults in the province.

While the survey looked at the entire adult age range, the findings suggest that the group between the ages of 18 and 29 years may be struggling the most. For example, this group reported experiencing greater psychological distress than any other age group in the weeks just before the survey. And, while all age groups showed a trend of increased use of anti-depressant and anti-anxiety medications over time, this group had the greatest increase (see table below).

RATES OF MEDICATION USE AMONG 18 – 29 YEAR OLD ADULTS

1997

2011

Percentage Increase

Anti-Depressant Medications

2.0%

7.2%

360%

Anti-Anxiety Medications

1.7%

5.8%

341%

Unfortunately, statistics can’t tell us why young adults are reporting more distress or taking medications to cope so much more often. It may be that the stigma around acknowledging our feelings is decreasing and young people feel more comfortable telling it like it is, but it might also be that life just feels tougher, especially for this group, which is facing higher costs for post-secondary education and fewer job prospects than the generations who came before them.

Medications are only one option for treating depression, anxiety and stress. Cognitive behaviour therapy (CBT) is another and has been shown to be as or more effective than medication, especially when it comes to preventing relapse. CBT teaches skills to help manage depression and anxiety, like learning how to become more aware of and challenge ‘invisible’ thought patterns that can lead to feelings of hopelessness and being overwhelmed. CBT also helps people learn how to go about the process of changing behaviour to make their efforts at coping more effective.

 

 

 

www.shiftct.com
Shift Cognitive Therapy Oakville is a psychology practice that helps people learn to manage anxiety, stress and depression.

Treat Anxiety with Exposure Therapy

Exposure therapy is a cornerstone of the treatment of anxiety because it enables people who are afraid of something to gather realistic evidence about what that thing is REALLY like, and then make more thoughtful decisions about whether they want to continue being afraid. This is a difficult concept for most people because anxiety usually feels so automatic and scary that it seems odd to consider that we might be able to control it. However, it’s true.

As outlined in previous posts (see ‘The Trouble With Automatic Thoughts” and “Reacting AND Responding” for examples) the body is built to protect itself by acting without the need for conscious thought. When we’re young, our brain begins the lifelong process of developing models and understandings about what is ‘safe’ and ‘dangerous.’ We learn from direct experience, by watching others, and by putting two and two together that we should move towards some things stay away from others. Over time, these models become ingrained and we no longer need to spend much brainpower on figuring out what might happen, freeing the brain for other, more important activities. Whenever we see, hear, smell, taste or touch something, the brain consults these models and instantly prepares the body to fight or flee. The physical and emotional arousal that results is what we commonly refer to as ‘anxiety.’

Treating anxiety with exposure therapy involves gradually bringing yourself into contact with elements of the things, places or situations you fear. Over time, two important discoveries emerge: First, you learn that the situation isn’t as bad as you anticipated and, second, you learn that you can actually cope with it. As the body’s arousal comes down beliefs about being in danger are replaced with beliefs about coping (eg, ‘I can do this’). The act of facing your fears instead of running away gives you time to experience the feared object/situation realistically, as it truly is, instead of continuing to view it through the lens of the worst-case scenario.

Consider the case of a young woman on a camping trip who was afraid to swim in a lake. Her brain told her that the murky water was “gross” and “dirty” and full of animals that might be dangerous. She had heard tales of snapping turtles and knew that fish felt slimy when you touched them. She had also seen movies like “Jaws” and others that highlighted dangerous things that might lurk in the shadows. She was terrified of entering the water and avoided it even though her friends were having a great time swimming in the sun.

With encouragement and a strong desire to see what she could do, she broke the challenge of entering the lake into smaller, more manageable steps and began the process of exposing herself to her fear. First she sat with her legs in the water and waited about 10 minutes for her anxiety to come down. When she was comfortable with that she eased more of herself in and stopped when she felt to afraid to continue. Again, she waited about 10 minutes until her fear came down and asked her friends to stay close by, ‘just in case.’ When she felt comfortable with that, she pushed off the rocks and moved cautiously out into the lake. She left the water after only a few seconds on her first try, but calmed herself and tried again. Within a few minutes her anxiety came down and she was able to swim farther out.

Although the young woman never totally lost her fear and continued to dislike it whenever her feet touched the slippery rocks below, she took the time to believe in herself. With exposure and the support of those around her, she discovered that she could actually cope with something that scared her.

 

 

 

www.shiftct.com
Shift Cognitive Therapy Oakville is a psychology practice that helps people learn to manage anxiety, stress and depression.

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