Many of those who work in the health professions can attest to the stress that comes with the job; the result of a combination of an environment involving sleep deprivation, high demands and responsibility, and pressure-fueled situations that are constantly changing and which we have limited control of. Due to this, physicians and medical trainees are at increased risk of burnout, depression and anxiety, and suicide. 

While there is a growing body of evidence that demonstrates the problem of stress among those who work in the healthcare industry, we haven't yet caught up with ways to tackle the problem. However, the Resident Doctors of Canada are implementing a new program that aims to improve physicians' resiliency and in doing so prevent burnout. Interestingly, the initiative is based on a training program utilized by the US Navy Seals and Canadian military to enhance the psychological and emotional strength of their troops. 

"The training consists of two key pillars.

Participants are taught to spot where they fall at any given time on a mental health "continuum" or colour-coded stress scale. 

Four zones — green, yellow, orange and red — represent escalating levels of stress and dysfunction and include recommended actions that doctors can take to reduce their levels of stress.
The second pillar consists of four skills that can control the body's hormonal response to stress, with the goal of overriding fear.

The skills seek to bypass the brain's amygdala — the emotional response centre that can stimulate a fight-or-flight response — and favour the frontal lobe, where rational decision-making occurs."

To find out more, click here:
http://www.cbc.ca/news/health/doctors-military-training-pressure-stress-1.3994718

Attention those interested in internal medicine, family medicine, cardiology and cardiac surgery! Did you know that there's a link between mental illness and cardiovascular disease?

While not entirely well understood, the link between mental illness and CVD goes both ways. Specifically those with mental illness are at higher risk of heart disease, likely secondary to substance use, unhealthy lifestyle behaviours, and side effects of certain psychotropic medications, as wellas higher rates of mortality and morbidity related to heart disease, perhaps due to noncompliance with medications, and physiologic effects of stress and low mood on the body.

However, those with heart disease are also at higher risk for depression and anxiety. In fact, growing evidence indicates that rates of depression are higher among those with CAD, as well as those who have had a history of MI and/or cardiac revascularization procedures compared to that of the general population. 

While new studies are being conducted to examine the use of certain medications, such as SSRIs in treating heart disease and statins for management of depression, our current focus should be on optimizing our patients' well-being and reminding ourselves of the connection between physical and mental health. As such, consider the emotional impact of a new diagnosis of CVD or recommendation of surgery, and consider screening for mental health conditions in patients with known heart disease as addressing both issues is important to a patient's overall function, longevity, and quality of life. 

"I’ve chatted with patients about the crippling demands that heart transplants or bypass surgeries place on them. I’ve listened as patients struggle to speak, breathing heavily, lungs filled with fluid from congestive heart failure. Some patients fall into despair after years of endless medications, hospitalizations and poor health. Others are petrified by the operating room and the long road to recovery that lies ahead...

...Depressed patients with cardiac disease have mortality rates twice as high as their non-depressed counterparts. Heart disease patients with depression are at higher risk of cardiac arrest, complications from surgery and hospital readmission after undergoing procedures than those without depression."​

To read more, visit:

• https://www.washingtonpost.com/national/health-science/mental-illness-and-heart-disease-are-often-found-in-the-same-patients/2017/02/17/665e5dd0-ee1d-11e6-9973-c5efb7ccfb0d_story.html?utm_term=.e2bf61573b2e
• https://well.blogs.nytimes.com/2015/11/05/ask-well-what-is-the-link-between-depression-and-heart-disease/?smid=pl-share&_r=1
  

Writer Julie Barton, was just 22 years old when she became wrapped in the grips of severe depression.  She and her family tried multiple avenues to get her the help that she needed including trials of medication and working with psychiatrists; however, it wasn't until she met a puppy named Bunker that she felt the strength she needed to go on.  

In her memoir Dog Medicine, Barton beautifully and accurately describes the dark depths of depression, from the relentless melancholy to the questioning of the importance of one's life; and expertly addresses themes of abuse, self-doubt, and family, touching on many aspects that add complexity to one's mental health. However, readers can feel a shift in her writing upon meeting Bunker, illustrating just how powerful and life-saving a connection between animal and human can be.  With Bunker at her side, Barton is able to find herself and move forward; a true story of hope and resilience that encourages self-acceptance and forgiveness.


Recommended for:
​Dog lovers, those who have struggled with depression

Last week, millions of Canadians rallied together to raise money for mental health initiatives around the country through Bell Let's Talk. 
​
While this annual event has led to millions of dollars being raised, encouraged individuals to share their stories of lived experiences with mental illness, and helped to combat stigma in our society, there is still a great deal of work that needs to be done to make meaningful changes that improve access to much needed public mental health services. 

Dr. Catherine Zahn, President and CEO of CAMH - Centre for Addiction and Mental Health, speaks just to this. In a recent article, she calls on us to take action and continue working towards change at the governmental level. As she states, it's time we advocate for political efforts and policies that prioritize mental health care, which would mean increased funding for more mental health services and programs, reducing long wait times and high rates of untreated patients, and increased support for mental health research and innovation.

"We need to question a publicly funded national health care system that does not cover effective treatments for mental illness—especially when governments of all levels claim that mental health is central to all health. Currently, there is no mechanism for Canadians, especially those with limited means, to access some of the most effective interventions. A commonly recommended form of structured psychotherapy, cognitive behavioural therapy, is generally covered in Canada through a third party insurance provider, or at a public hospital like CAMH. A good third-party insurance policy covers about one and a half sessions per year. Think about the absurdity of covering only one and a half sessions of chemotherapy or palliative care. Why should a lower standard for mental health care be acceptable to us? Access to evidence-based treatment like structured psychotherapy is a healthcare right—not a luxury—for the thousands of Canadians living with mental illness."

http://torontoist.com/2017/01/fund-mental-health/