As part of the Choosing Wisely Canada campaign, in June, 13 recommendations were made by the Canadian Psychiatric Association and its working group partners, the @Canadian Academy of Child and Adolescent Psychiatry (CACAP) and the Canadian Academy of Geriatric Psychiatry (CAGP) for the field of psychiatry. One of the main recommendations included how first-line treatments for insomnia should not include routine use of antipsychotics, and rather should be focused on non-pharmacological options including sleep hygiene and behavioural techniques. Other recommendations also comment on treatments for ADHD, depression, and dementia, as well as on using benzodiazepines in acute care, and ordering toxicology screens on psychiatric patients. For the full list check out the link here: http://www.cpa-apc.org/media.php?mid=2240 In this powerful story and video, we learn about Antonio Lambert, a man who had a difficult upbringing and childhood, and who has since had a long history battling dual diagnoses; both depression and addiction. Though Lambert's psychiatric history has had countless ups and downs and relapses, he has found a system that works for him; a combination of medication, faith, and most importantly companionship. In fact, Lambert is now a peer specialist who works at a local mental health clinic, connecting to and providing support for those who are battling the same demons he dealt with and continues to deal with. For Lambert though, his work in peer-support is more than just a one way street as he's found it not only to be therapeutic and beneficial for the individuals he works with, but for himself as well. "He feels he needs a peer himself, someone with a history who knows what it looks like — from the inside — to be struggling mentally, deep in trouble, and feeling dead out of options. Someone who can be an advocate, a companion, who can share his or her own story: who can simply be there, if that’s what it takes. Mental health researchers have tested the effect of peers in a variety of settings over the past decade. When they are “specialized” — that is, their history is similar to that of their clients, the way Mr. Lambert and others teach it — peers tend to reduce the rate of psychiatric hospitalizations and, where appropriate, increase the use of programs like Alcoholics Anonymous." In part three of our series on neurostimulation treatments for mental illness, we look at repetitive transcranial magnetic stimulation (rTMS), a form of treatment that first came into use in the 1980s and was approved by Health Canada in 2002 for treatment-resistant depression. At Toronto Western Hospital, part of the University Health Network, rTMS is offered to patients suffering from refractory depression, and is also being studied for its use in postpartum depression, OCD, bulimia, and is soon to be investigated for its use in the treatment of borderline personality disorder. Though it requires more of a time commitment than other treatments, rTMS is thought to be less invasive than DBS and ECT, and more tolerable than many treatments including traditional medications, as often the only side effect patients report is some scalp discomfort/headache during the procedure. "Unlike medications or therapy, rTMS treats these disorders by stimulating the brain’s neurons directly. It does this using pulsed magnetic fields that are as strong as the one in an MRI scanner, but focused into an area the size of a toonie. The pulses are applied non-invasively through a magnetic coil held against the scalp. By applying repeated pulses of magnetic stimulation over time, rTMS can gradually increase or decrease the activity in the region of the brain underneath the magnetic coil. In major depression, and many other kinds of psychiatric and neurological illnesses, there are parts of the brain that are abnormally underactive or overactive. Over a series of treatment sessions, rTMS can correct these abnormalities to restore normal patterns of brain activity, and thereby treat the illness." To find out more about rTMS check out these links and videos: http://www.rtmsclinic.ca/home For patients with moderate-severe depression that is refractory to traditional pharmacologics and psychotherapy, many struggle with what to offer next for treatment. However, recently there has been a growing trend towards investigating and using neurostimulation modalities, such as ECT and DBS (deep brain stimulation). While first used for treatment of Parkinson's, neuropsychiatrists and researchers at the University of Toronto and the Toronto Western Hospital are now studying the use and efficacy of DBS for patients with refractory depression, anorexia nervosa, and Alzheimer's. Find out more about DBS here: http://news.nationalpost.com/health/brain-surgery-for-severe-depression-may-be-treatment-breakthrough-say-canadian-researchers-and-other-experts In this eloquent, emotive, and incredibly personal TED talk below, Dr. Stephen Lewis tells his story of how being bullied in his youth led to #depression and self-loathing, which eventually led to self-harm behaviours in an effort to provide relief from his emotional pain. Through his vulnerability and honesty, Dr. Lewis hopes to enhance society's understanding of self-injury and connect to others experiencing similar mental health issues to offer support and hope. Dr. Lewis, who has since become a psychology professor at the University of Guelph, has used his personal experiences to direct his research, which particularly focuses on self-injury. More than that, Dr. Lewis has also co-founded Self-injury Outreach & Support, a collaboration between the University of Guelph and McGill University, "to provide information and resources about self-injury to those who need help, those who have recovered, and those who can help these individuals including families, schools and professionals." "With depression came daily bouts of intense and seemingly insurmountable emotional pain. Like anyone would in that circumstance I just yearned for relief, just a temporary break from the pain that I felt inside. And so, out of desperation and in an attempt to feel anything that was going on inside, I cut myself. For me, self-injury provided needed relief from that emotional turmoil I was feeling inside. And although temporary, it was still relief and relief at the time that was so desperately needed and desperately sought. And because my depression and the pain that it bestowed persisted, and because at the time I had no other way with which to cope, I continued to self-injure. Beyond the relief that it provided, self-injury conveyed the words that I could not, it communicated the depth of my sadness, it communicated the immense hatred I was now feeling toward myself, it communicated the pain I felt as a child and a teenager. And yet, as much as that self-injury seemed to say, it seemed to also take away my voice. Indeed the more that I did it, the less I felt I could talk about my pain, let alone my self-injury. The self-injury that seemed to say so much and speak so loudly had paradoxically silenced me." 21 year old photographer Edward Honaker was diagnosed with depression and anxiety almost two years ago, although he struggled with the confusing, dark, and melancholic emotions long before then.
After his diagnoses, Honaker turned to his camera to help him document his experiences and make sense of his emotions, through creating a series of powerful self-portraits. "Edward's face is blurred or covered in all of the haunting black and white photos, which are meant to portray the helplessness felt by someone who is battling a depressive disorder" or other mental illness. Honaker hopes that his art will move people, help combat stigma, and foster understanding and support for those who are suffering. "Your mind is who you are, and when it doesn't work properly, it's scary". You can check out his photos here: http://www.huffingtonpost.com/entry/edward-honaker-photography-mental-illness_55f0759ce4b03784e2777fbb |
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Supporting and enhancing students' and health professionals' knowledge and understanding of mental health and psychiatry
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