Categories
Emotions empowering patients stress management

Emotional Wellness

This is the Key Points handout from my Empowering Patients presentation on December 10th, 2020.

What is Emotional Wellness? 

A deep sense of meaning and purpose, an abiding sense of peace, the ability to manage the stress and transitions of life, awareness of your thoughts and feelings and the ability to manage them.

Why emotional health matters

  1. Emotions influence our behaviour, our relationships and our thinking.
  2. Anxiety holds us back from doing what we need to do, from moving forward, from reaching out, and from giving our best to the world.
  3. Depression is a major cause of disability and absenteeism from work or school.

Anxiety Disorders

When your anxiety has a significant impact on your function at work, school or home or in your social life.

  1. Generalized Anxiety: excessive worry about many things
  2. Panic Disorder: recurrent panic attacks (symptoms may include chest pain, a racing heart, sweats, shortness of breath and dizziness)
  3. Obsessive Compulsive Disorder: repetitive intrusive thoughts or recurrent compulsions to perform an act (e.g. checking, handwashing, rituals)
  4. Social Anxiety: excessive anxiety in specific social situations e.g. large groups, interviews, shopping
  5. Phobias: extreme specific fears e.g. spiders, heights, flying

Mood Disorders

The Symptoms of Depression: fatigue, change in sleep, change in appetite, impaired concentration, forgetfulness, thoughts of death or suicide, self-blame and guilt, feeling sad, hopelessness, lack of enjoyment or pleasure, loss of motivation.

Bipolar Disorder: episodes of depression and mania/hypomania (heightened mood and energy, overconfidence, decreased need for sleep, impaired judgment, decreased need for sleep, delusions of grandeur)

Psychotic Symptoms

 impaired reality testing, delusions (fixed false beliefs), hallucinations (seeing or hearing things that are not real), disorganized behaviour e.g. schizophrenia

KEY EMOTIONAL HEALTH SKILLS

1. A Meditative Practice

to calm your mind, centre your thoughts and reflect.

Recommended Reading on Mindfulness: Joseph Goldstein, Thich Nhat-Hahn, Jon Kabat-Zinn, Jack Kornfield. 

Podcasts/Websites: JackKornfield.com, TaraBrach.com

2. Cognitive Therapy

  • Reflect on the thoughts that trigger your emotions. Is there another way to look at the situation? 
  • Question the underlying beliefs behind unhealthy thinking.
  •  Identify your cognitive distortions: 

Emotional Reasoning: Inappropriately reasoning from how you feel e.g. “I feel something bad will happen; therefore, it will.”

Fortune Telling: Assuming that you really know how things will turn out e.g. “I’ll always feel this way.”

Mind-Reading: Believing you really know what another person is thinking e.g. ”I know why my friend didn’t call me back.” “I know they think I’m a loser.”

Overgeneralizing: Making broad assumptions based on the facts on hand e.g “No one cares about me.” “All men/women are the same.”

Polarizing: All or nothing, black or white, good or bad thinking e.g. “She used to be an angel; now she’s evil.” “Either you’re with me or against me.”

Shoulding: Inappropriate judgment e.g. “Everyone should always treat me nicely!” “I have to be perfect.”

Personalizing: Taking things too personally e.g. “He did that just to hurt me.”

Catastrophizing: Believing the worse things will happen e.g. “I’m going to fail and I’ll never be a success.” “This is the end of the world.”

Recommended Reading: Mind Over Mood by Padesky and Greenberger; Authentic Happiness by Martin Seligman.

3. Visualizing Your Goals

  • Turn your problems into goals. 
  • Instead of replaying the past or ruminating on the negative, think about what you want. 
  • When you are most relaxed, visualize yourself having achieved your goal. 
  • How do you feel? What do you see? What do you hear? Make it real!

4. MANAGING STRESS

Burnout: when the demands of work or life exceed our ability to manage them.

Seizing the Locus of Control

  • Identify your sources of stress.
  • Are you reacting in proportion to the stress?
  • Recognize what you can change or control.
  • Accept what you cannot change; assume responsibility for what you can.
  • Recognize your choices.

The 80/20 Rule: 20% of our reaction to a situation is related to the facts; 80% arises from what we bring from our past and how we conceptualize the present.

The Daily Management of Stress

Be a good parent to yourself:

  1. Go out and play. Have an exercise routine.
  2. Don’t skip meals. Schedule regular healthy meals.
  3. Go to bed. Get enough sleep and take regular breaks.
  4. Go to the doctor. See your own family doctor appropriately.

Express your emotions with those close to you with a group of confidantes. Form or join a support group.

Live in accord with your values.

Attend to Your Relationships

  1. Foster emotional intimacy. Agree on a habit of checking in with one another each day. How are you feeling? How was your day?
  2. Show your affection. Express your positive feelings. Remember the 5 languages of love and the human brain’s Negativity Bias: You need to see and say 5 positives for every negative.
  3. Schedule regular dates, family time and time with good friends. Commit your time to who matters most. Don’t wait ‘til there’s time; make time!
  4. Communicate in a healthy way. Take a breath and let anger cool before you react. Acknowledge the other’s feelings and point of view. Express how you feel without blame.

Right Speech: Is it true? Is it helpful? Is it kind?

Where to Find Help

Canadian Mental Health Association 

cmha.bc.ca

Courses, resources, cognitive therapy and support.

Burnaby Mental Health 

fraserhealth.ca (604) 453-1900

Assessment, treatment, counselling and crisis intervention.

Cameray Child & Family Services

203 – 5623 Imperial Street, Burnaby (604) 436-9449 cameray.ca

Counselling for children and families.

AnxietyBC 

anxietybc.com

Education, cognitive therapy courses.

BounceBackbc.ca a free online skill-building program for adults and youth over 15 years of age

Mood Disorders Association of BC

mdabc.net

Support groups, cognitive therapy and wellness programs.

SAFER  (604) 675-3985

Education, support and counselling for those who have suicidal thoughts, have attempted suicide. 

Support for family members.

Burnabycoronavirus.com for COVID information, social supports and Doc Talks

The Four Foundations of Self-Care

  • What you eat (what you put into your body). 
  • What you do (physical activity and rest). 
  • How you feel (emotional wellbeing). 
  • How you connect (healthy relationships).

Please share this information with your family, friends and anyone else who may find it helpful.

Together we’ll create a healthier community and a healthier future.

Categories
Emotions empowering patients Happiness Letting Go Meditation mindfulness Preventive Health Self-care stress management Wisdom

An Introduction to Mindfulness

by Davidicus Wong, M.D.

This is a handout I share with my patients to introduce them to the practice of mindfulness and principles of cognitive behavioural therapy. I consider these to be two fundamental emotional wellness skills that every adult and child should learn.

Like any other skills we wish to master, practice – particularly daily practice – is essential. Through the power of the human brain’s capacity for neuroplasticity (to change itself), we learn new skills – including new ways of thinking and feeling – through repeated practice. In the words of the pioneering Canadian neuropsychologist, Donald Hebb, “Neurons that fire together wire together.”

MINDFULNESS MEDITATION helps us to centre our minds, increase our awareness and calm the nervous system that modulates how we experience pain and other sensations. The practice of mindfulness teaches us a less reactive approach to the rest of our lives. We become open to accept and experience every aspect of our lives, our selves and our sensations, without clinging, aversion or judgment.

We begin meditation by spending 15 or 20 minutes each day just sitting in a quiet place in a comfortable position. We turn our attention to the natural flow and sensations of the breath without trying to control it in any way. This becomes a safe and calming anchor that we can return to at any time.

We can then turn our attention to sounds as they arise in our immediate environment, just attending to the arising and disappearance of different sounds as they come and go from our awareness. We don’t have to label or identify each sound. We simply remain aware of them as they arise.

We can centre our awareness on different physical sensations in the body, perhaps the pressure at points of contact, warmth, coolness, vibrations, pulsations, tingling and even pain. We can move awareness to different areas of the body, and if a sensation such as pain in one part of the body is difficult to manage, we can shift our attention elsewhere, to the part of the body that is most comfortable or back to the anchor of the breath.

With practice, we are able to maintain awareness and attention to every sensation without reacting to it, without aversion, clinging, judgment or identification. With time, we recognize that everything within our awareness is ever changing; nothing is constant – no sensation (not even pain), no mood, no emotion and no thought.

We are able to attend to each thought as it arises without getting carried away in a train of thoughts or a story in the remembered past or imagined future. We can note thoughts as they arise, without judgment or identification and let them go. We can do the same with the transient feelings and emotions that arise without getting caught up and carried away with them. We experience moods, feelings and emotions but we are not our moods, feelings or emotions. We can see them as transient, temporary conditions like a mist, a fog or a shower. They pass through us or we pass through them.

We can be mindful when walking, attending to the sensations of each step, the sounds and pressures on the feet and the movement of the legs. This becomes a mindful anchor from which what we hear, see, feel and think arises in our open and accepting awareness. 

Mindfulness can be practiced while eating, attending to the taste and texture of each bite of food; swimming, attending to the sensations of buoyancy, flowing water on the surface of the skin and rich sounds of moving water and air; and even driving. Mindfulness only begins with meditation. When you apply the healthy attitudes of non-reactive acceptance, gratitude and compassion to everything in your life throughout each day, you will discover a deeper level of peace, happiness and meaning. 

Mindfulness when diligently practiced can bring serenity to your mind and body throughout each day – an open, accepting and nonreactive approach to your life. It can foster in you greater compassion for others and yourself.

COGNITIVE BEHAVIOURAL THERAPY trains us to uncover our underlying beliefs and assumptions, choose our conscious thoughts, reframe our situation and shape our emotions. We can discover that we can improve our moods, thoughts and function in life through healthy self-care – eating regular healthy meals, ensuring adequate rest, daily appropriate physical activity and spending quality time with supportive friends and those loved ones who naturally lift our spirits. Mindfulness meditation can help us identify unskillful thoughts (those that increase suffering) and help us choose skillful ones.

MORE RESOURCES (I’ve put my favourites in bold)

MINDFULNESS MEDITATION

The Miracle of Mindfulness: An Introduction to the Practice of Mindfulness (Thich Nhat Hanh)

Insight Meditation: The Practice of Freedom (Joseph Goldstein)

Mindfulness: A Practical Guide to Awakening (Joseph Goldstein)

Radical Acceptance (Tara Brach)

True Refuge: Finding Peace and Freedom in Your Own Awakened Heart (Tara Brach)

JackKornfield.com, TaraBrach.com Jack Kornfield and Tara Brach’s videos, guided meditations and lectures are available for free on these websites. By listening to these teachers, you will quickly see how the attitude of mindfulness can be applied to your everyday life.

Local mindfulness retreats: Westcoast Dharma Society http://www.westcoastdharma.org

MicrodosingMindfulness.com will show you how to fit in routine mindfulness breaks in just a few minutes a day

THE PRACTICAL SCIENCE OF NEUROPLASTICITY

Hardwiring Happiness (Rick Hanson)

Buddha’s Brain: The Practical Neuroscience of Happiness, Love and Wisdom (Rick Hanson)

COGNITIVE BEHAVIOURAL THERAPY

Authentic Happiness: Using the New Positive Psychology to Realize Your Potential for Lasting Fulfillment(Martin E. P. Seligman)

Feeling Good: The New Mood Therapy (David D. Burns)

Mind Over Mood: Change How You Feel by Changing the Way You Think (Dennis Greenberger, Christine Padesky)

Anxietybc.ca has many useful resource including the Mindshift app for smart phones

Checkingin is a free mindfulness app for your smart phones

DIALECTICAL BEHAVIOURAL THERAPY (a synthesis of mindfulness and cognitive therapy)

            The Dialectical Behavior Therapy Skills Workbook for AnxietyBreaking Free From Worry, Panic, PTSD, & Other Anxiety Symptoms (Alexander L. Chapman)

For an effective technique for establishing healthy new habits, check out TINYHABITS.COM

Categories
Emotions Empowering Healthcare empowering patients Healthy Living

Maintaining Your Health During the Pandemic

In February, when celebrating her 100th birthday with her family, my patient, Helen (not her real name) continued to thrive while managing her chronic health conditions. 

The pandemic changed all that.

She wasn’t infected with COVID-19. Her assisted living facility made every effort to protect its residents. However, this meant an end to all social activities . . . and visitors.

By June, I learned of Helen’s profound functional decline. She had lost weight, fell frequently and was no longer able to stand on her own. Her daughter, an experienced nurse recognized that she was in a potentially irreversible decline.

Once we were able to get approval for weekly visits from her daughter (in full PPE to protect Helen and others at the facility), Helen progressively regained her strength and quality of life.

The pandemic has affected every one of us, but in addition to those infected with COVID-19 and their families, those suffering from social isolation have been the most vulnerable.

We are at a crucial crossroads in this pandemic. With the daily rise in new infections, we each have to double down on our efforts to reduce the spread. We can’t wait for the majority of Canadians to be vaccinated. Many more will become sick and die in the coming months.

Continue to keep your distance, wear a mask when you can’t, keep your hands clean and ask yourself whenever you leave your home, if you really need to. Is it worth the risk to yourself and your family?

In the meantime, we must work together to maintain our physical, social and emotional wellbeing. We can’t do this alone. 

Your family physician’s clinic is still open – at least to calls. Don’t neglect chronic conditions and proactive healthcare. Labs and x-ray clinics are also still open. We’ve all made changes to provide the care you need while reducing your infection risks. 

If you haven’t had your flu shot yet and your local pharmacy or family practice clinic has run out, Burnaby residents can book an appointment with https://www.burnabyflu.com

Stay connected to your family and friends with frequent calls or video chats. Reach out to those who are living alone and ask what you could do to help. 

If you are feeling stressed, frustrated, anxious and even depressed, you are not alone. You are not alone in how you are feeling, and there is help in our community for you. 

Every community has organized supports for those struggling socially, emotionally and financially. In Burnaby, we’re all working together through the Primary Care Network. Check the resources that are available at https://www.burnabycoronavirus.com/social-supports

On Thursday, December 10th, I’ll be giving a free online talk on behalf of the Burnaby Division of Family Practice’s Empowering Patients program. The topic: Emotional Wellness. I’ll be sharing key emotional health skills that we all need to manage the effects of this pandemic and community resources for help. For more information: https://divisionsbc.ca/burnaby/for-patients/empowering-patients

Dr. Davidicus Wong is a family physician.

Categories
COVID 19 Emotions empowering patients Self-care stress management

From Surviving to Thriving During the Pandemic: Managing Our Emotions and Stress

I recently gave a community webinar through Burnaby’s Primary Care Network.

I provided some practical strategies for managing the increased stress and difficult emotions we are all experiencing with all the changes of the Pandemic.

I also provided links to resources for the many of us who need more support.

Please share this information with anyone you know who may benefit.

Categories
COVID 19 Emotions Self-care stress management

Coping with the COVID-19 Crisis: You are not alone

DSC04772We live in an extraordinary time with nearly everyone on this planet profoundly affected by the pandemic.

During the COVID-19 crisis, communities around the world are collectively coping with a range of negative emotions: anxiety, panic, boredom, anger, depression and grief.

It reminds me of the Great Depression. My dad was born in 1930 – the first year of an economic disaster that shaped the mood of the world for a decade.

He is weathering the pandemic in his usual resilient way. His generation and the world survived the second world war, many economic downturns and the unpredictable unfolding of history.

He pays attention to the news and is taking the recommended precautions, but he has kept busy looking after himself, staying in touch with friends and family by phone and occupying himself with activities at home.

If you’re feeling stuck at home, try saying, “I’m safe at home”, “I get to stay at home” or “I get to stay at home, safe with my family.” Those who have jobs considered essential services, leave their families each morning and look forward to rejoining them for dinner.

None of us is alone. You are not alone if you need to work outside your home, if you can work from home or if you are out of work because of the pandemic.

You are not alone if you are self-isolating after a return from travel or because you have been diagnosed with COVID-19. Many others have shared or are sharing the challenges of your experience.

You are not alone if you are worried about money because your place of work has closed, you’ve lost your job or business is painfully slow.

One of the keys to managing the stress of difficult circumstances is to recognize where you do have a sense of control. As individuals, we can feel helpless in a pandemic, but there are many things that are still within your control.

By staying home as much as possible, keeping a safe distance from others and practicing good hand hygiene, we can protect ourselves, the people around us and collectively the health of everyone in our community.

We also have control of how we occupy our bodies with activity and our minds with helpful thoughts. We all feel compelled to follow the news, but if we left the TV on all day, we will soon be overwhelmed with bad news.

Take your daily news in small doses – maybe just an hour, when Dr. Bonnie Henry and our Minister of Health, Adrian Dix provide their daily updates.

If you’re at work, recognize that what you are doing is essential for our community and that you are making a difference.

If you are at home, recognize that you are doing your part in reducing the spread of infections in your community. Create meaningful structure to your day. Get up at the same time each morning, shower, change and make your bed. Plan healthy meals and find ways to get the exercise your body needs. Carefully choose the entertainment and information you are exposing to your mind. The goal is to inform and uplift.

Reach out online or by phone to your friends and family. Check up on those you know who need to hear your voice or could use your help.

Those of us in healthcare are committed to caring for our patients and our community. Our hospital healthcare teams have been actively preparing to provide the care that is needed.

We have your back, and we will be here whenever you need us.

Family physicians are still in their clinics each day, looking after our patients by phone or video and when required, seeing patients in person when necessary.

If you have symptoms that may be due to COVID-19, use the BC COVID-19 Symptom Self-Assessment Tool at bc.thrive.health. By completing it, you will be guided to the most appropriate care. If you are a Burnaby resident or a patient of a Burnaby family physician, use the burnabycoronavirus.com tool.

We are in this together. You are not alone.

Dr. Davidicus Wong is a family physician. He was the founding chair and lead physician of the Burnaby Division of Family Practice and continues to serve on the board. His Healthwise Column appears regularly in this paper. For more on achieving your positive potential in life, read his blog at davidicuswong.wordpress.com.

Categories
COVID 19 Emotions Happiness Self-care stress management

An Introduction to Mindfulness (and CBT)

Dr. Davidicus Wong

IMG_3680

MINDFULNESS MEDITATION helps us to centre our minds, increase our awareness and calm the nervous system that modulates how we experience pain and other sensations. The practice of mindfulness teaches us a less reactive approach to the rest of our lives. We become open to accept and experience every aspect of our lives, our selves and our sensations, without clinging, aversion or judgment.

We begin meditation by spending 15 or 20 minutes each day just sitting in a quiet place in a comfortable position. We turn our attention to the natural flow and sensations of the breath without trying to control it in any way. This becomes a safe and calming anchor that we can return to at any time.

We can then turn our attention to sounds as they arise in our immediate environment, just attending to the arising and disappearance of different sounds as they come and go from our awareness. We don’t have to label or identify each sound. We simply remain aware of them as they arise.

We can centre our awareness on different physical sensations in the body, perhaps the pressure at points of contact, warmth, coolness, vibrations, pulsations, tingling and even pain. We can move awareness to different areas of the body, and if a sensation such as pain in one part of the body is difficult to manage, we can shift our attention elsewhere, to the part of the body that is most comfortable or back to the anchor of the breath.

With practice, we are able to maintain awareness and attention to every sensation without reacting to it, without aversion, clinging, judgment or identification. With time, we recognize that everything within our awareness is ever changing; nothing is constant – no sensation (not even pain), no mood, no emotion and no thought.

We are able to attend to each thought as it arises without getting carried away in a train of thoughts or a story in the remembered past or imagined future. We can note thoughts as they arise, without judgment or identification and let them go. We can do the same with the transient feelings and emotions that arise without getting caught up and carried away with them. We experience moods, feelings and emotions but we are not our moods, feelings or emotions. We can see them as transient, temporary conditions like a mist, a fog or a shower. They pass through us or we pass through them.

We can be mindful when walking, attending to the sensations of each step, the sounds and pressures on the feet and the movement of the legs. This becomes a mindful anchor from which what we hear, see, feel and think arises in our open and accepting awareness.

Mindfulness can be practiced while eating, attending to the taste and texture of each bite of food; swimming, attending to the sensations of buoyancy, flowing water on the surface of the skin and rich sounds of moving water and air; and even driving. Mindfulness only begins with meditation. When you apply the healthy attitudes of non-reactive acceptance, gratitude and compassion to everything in your life throughout each day, you will discover a deeper level of peace, happiness and meaning.

Mindfulness when diligently practiced can bring serenity to your mind and body throughout each day – an open, accepting and nonreactive approach to your life. It can foster in you greater compassion for others and yourself.

COGNITIVE BEHAVIOURAL THERAPY trains us to uncover our underlying beliefs and assumptions, choose our conscious thoughts, reframe our situation and shape our emotions. We can discover that we can improve our moods, thoughts and function in life through healthy self-care – eating regular healthy meals, ensuring adequate rest, daily appropriate physical activity and spending quality time with supportive friends and those loved ones who naturally lift our spirits. Mindfulness meditation can help us identify unskillful thoughts (those that increase suffering) and help us choose skillful ones.

MORE RESOURCES

Mindfulness Meditation

The Miracle of Mindfulness: An Introduction to the Practice of Mindfulness (Thich Nhat Hanh)

Insight Meditation: The Practice of Freedom (Joseph Goldstein)

Mindfulness: A Practical Guide to Awakening (Joseph Goldstein)

Radical Acceptance (Tara Brach)

True Refuge: Finding Peace and Freedom in Your Own Awakened Heart (Tara Brach)

JackKornfield.com, TaraBrach.com Jack Kornfield and Tara Brach’s videos, guided meditations and lectures are available for free on these websites. By listening to these teachers, you will quickly see how the attitude of mindfulness can be applied to your everyday life.

Local mindfulness retreats: Westcoast Dharma Society http://www.westcoastdharma.org

The Practical Science of Neuroplasticity

Hardwiring Happiness (Rick Hanson)

Buddha’s Brain: The Practical Neuroscience of Happiness, Love and Wisdom (Rick Hanson)

Cognitive Behavioural Therapy

Authentic Happiness: Using the New Positive Psychology to Realize Your Potential for Lasting Fulfillment(Martin E. P. Seligman)

Feeling Good: The New Mood Therapy (David D. Burns)

Mind Over Mood: Change How You Feel by Changing the Way You Think (Dennis Greenberger, Christine Padesky)

Anxietybc.ca

Mindshift app for smart phones

Checkingin.co

Checkingin is a free self-awareness app for smart phones

Dialectical Behavioural Therapy (a synthesis of mindfulness and cognitive therapy)

The Dialectical Behavior Therapy Skills Workbook for Anxiety: Breaking Free From Worry, Panic, PTSD, & Other Anxiety Symptoms (Alexander L. Chapman)

Categories
Burnaby Division of Family Practice Emotions Empowering Healthcare empowering patients Healthy Living patient-doctor relationship Physical Activity Positive Change Positive Potential Preventive Health Screening Tests Self-care stress management

Free Public Health Talks for 2020: The Empowering Patients Program

Tapestry Talk

The Empowering Patients Free Public Talks for 2020

with Dr. Davidicus Wong

 

  • Monday, February 3rd, 2020 The Keys to Positive Change
    • Tommy Douglas Library in the Edmonds neighbourhood

 

  • Monday, February 24th, 2020  The Patient-Doctor Relationship
    • Bob Prittie Library in Metrotown

 

  • Thursday, March 12th, 2020  Emotional Wellbeing
    • Brentwood Community Resource Centre, 2055 Rosser Avenue

 

  • Wednesday, April 8th, 2020  Healthy Eating
    • McGill Library in North Burnaby)

 

  • To be scheduled: Healthy Relationships and Healthy Physical Activity

 

To register online lcullen@divisionsbc.ca or call (604) 259 4450

For more information about our Empowering Patients Public Health Education Program, please see the Burnaby Division of Family Practice’s website divisionsbc.ca/burnaby or Dr Davidicus Wong’s website https://davidicuswong.wordpress.com

inspiration-day

Categories
Burnaby Division of Family Practice Emotions Empowering Healthcare empowering patients Happiness Healthy Living Positive Potential Preventive Health Self-care stress management

Emotional Wellness (Davidicus Wong)

What is Emotional Wellness?

A deep sense of meaning and purpose, an abiding sense of peace, the ability to manage the stress and transitions of life, awareness of your thoughts and feelings and the ability to manage them.

 

Why emotional health matters

  1. Emotions influence our behaviour, our relationships and our thinking.
  2. Anxiety holds us back from doing what we need to do, from moving forward, from reaching out, and from giving our best to the world.
  3. Depression is a major cause of disability and absenteeism from work or school.

Video: Why Emotional Health Matters https://stage.divisionsbc.ca/Burnaby/emotionalhealth.

 

Anxiety Disorders

When your anxiety has a significant impact on your function at work, school or home or in your social life.

  1. Generalized Anxiety:excessive worry about many things
  2. Panic Disorder:recurrent panic attacks (symptoms may include chest pain, a racing heart, sweats, shortness of breath and dizziness)
  3. Obsessive Compulsive Disorder: repetitive intrusive thoughts or recurrent compulsions to perform an act (e.g. checking, handwashing, rituals)
  4. Social Anxiety: excessive anxiety in specific social situations e.g. large groups, interviews, shopping
  5. Phobias:extreme specific fears e.g. spiders, heights, flying

 

Mood Disorders

The Symptoms of Depression: fatigue, change in sleep, change in appetite, impaired concentration,  forgetfulness, thoughts of death or suicide, self-blame and guilt, feeling sad, hopelessness, lack of enjoyment or pleasure, loss of motivation.

 

Bipolar Disorder:episodes of depression and mania/hypomania (heightened mood and energy, overconfidence, decreased need for sleep, impaired judgment, decreased need for sleep, delusions of grandeur)

 

Psychotic Symptoms:impaired reality testing, delusions (fixed false beliefs), hallucinations (seeing or hearing things that are not real), disorganized behaviour e.g. schizophrenia

 

Video: 4 Key Emotional Health Skills https://www.youtube.com/watch?v=n4iPjKBOY-U&list=PLAWTWe0JNCdHMVTJSe4Jk_vhb53H2jk-b&index=1

Key Emotional Health Skills

  • A Meditative Practice to calm your mind, centre your thoughts and reflect.

Recommended Reading on Mindfulness: Joseph Goldstein, Thich Nhat-Hahn, Jon Kabat-Zinn.

 

Cognitive Therapy

  • Reflect on the thoughts that trigger your emotions. Is there another way to look at the situation?
  • Question the underlying beliefs behind unhealthy thinking.
    • Identify your cognitive distortions
    • all or nothing thinking – seeing all the bad in another person or situation; catastrophizing – imagining the worst;
    • excessive self-blame

Recommended Reading:Mind Over Mood by Padesky and Greenberger; Authentic Happiness by Martin Seligman.

 

Visualizing Your Goals

  • Turn your problems into goals.
  • Instead of replaying the past or ruminating on the negative, think about what you want.
  • When you are most relaxed, visualize yourself having achieved your goal.
  • How do you feel? What do you see? What do you hear? Make it real!

 

Managing Stress

  • Burnout: when the demands of work or life exceed our ability to manage them.

 

Seizing the Locus of Control

  • Identify your sources of stress.
  • Are you reacting in proportion to the stress?
  • Recognize what you can change or control.
  • Accept what you cannot change; assume responsibility for what you can.
  • Recognize your choices.

 

The 80/20 Rule: 20% of our reaction to a situation is related to the facts; 80% arises from what we bring from our past and how we conceptualize the present.

 

The Daily Management of Stress

Be a good parent to yourself:

  1. Go out and play.Have an exercise routine.
  2. Don’t skip meals.Schedule regular healthy meals.
  3. Go to bed.Get enough sleep and take regular breaks.
  4. Go to the doctor.See your own family doctor appropriately.

Express your emotions with those close to you with a group of confidantes. Form or join a support group.

Live in accord with your values.

Attend to your relationships.

  1. Foster emotional intimacy.Agree on a habit of checking in with one another each day. How are you feeling? How was your day?
  2. Show your affection. Express your positive feelings.
  3. Schedule regular dates.Commit your time to what matters most. Don’t wait ‘til there’s time; make time!
  4. Communicate in a healthy way.Take a breath and let anger cool before you react. Acknowledge the other’s feelings and point of view. Express how you feel without blame.
  5. When things get stale, have an affair. . . with your partner.

 

Video: Keys to Managing Stress https://www.youtube.com/watch?v=zoN-lIlx460&feature=youtu.be&list=PLAWTWe0JNCdHMVTJSe4Jk_vhb53H2jk-b

Where to Find Help

Canadian Mental Health Association

cmha.bc.ca

Courses, resources, cognitive therapy and support.

 

Burnaby Mental Health

fraserhealth.ca (604) 453-1900

Assessment, treatment, counselling and crisis intervention.

 

Cameray Child & Family Services

203 – 5623 Imperial Street, Burnaby (604) 436-9449 cameray.ca

Counselling for children and families.

 

AnxietyBC

anxietybc.com

Education, cognitive therapy courses.

 

 

Mood Disorders Association of BC

mdabc.net

Support groups, cognitive therapy and wellness programs.

 

SAFER  (604) 675-3985

Education, support and counselling for those who have suicidal thoughts, have attempted suicide.

Support for family members.

 

The Four Foundations of Self-Care

 

  • What you eat(what you put into your body).

 

  • What you do(physical activity and rest).

 

  • How you feel(emotional wellbeing).

 

  • How you connect(healthy relationships).

 

Please share this information with your family, friends and anyone else who may find it helpful.

Together we’ll create a healthier community and a healthier future.

Categories
Burnaby Division of Family Practice Emotions Empowering Healthcare empowering patients Happiness Healthy Living Love Relationships Uncategorized

Healthy Relationships (Davidicus Wong)

 

Why relationships matter

  1. Social support from friends, family and partners are key to your emotional health and resilience.
  2. Harmony in the home is essential to your wellbeing.
  3. Loving friends and family support your health.
  4. Conflicts at home, work or school are major sources of stress and contribute to anxiety and mood disorders.

The sources of conflict

  1. Incompatibility (religion, culture, language, introversion/extraversion, values and beliefs.)

Game changers: incompatible values (core beliefs about right and wrong)

                                     abuse(physical, emotional or sexual)

  1. Cognitive Distortions– When we start seeing each other differently.
  2. Mind reading: making negative assumptions about the other’s intentions without checking them out.
  3. Excessive blaming: when something goes wrong (or is left undone), it’s the other’s fault.
  4. All or nothing thinking: seeing all of the BAD (and none of the good) in the other, in your relationship and your situation.
  5. Neglect and loss of intimacy.Too often we can let the rest of our lives take over our life together.
  6. Feelings change.We mistake the inevitable fading of infatuation and romantic love with not being in love. With attention and commitment, we can transition into enduring love, from passion to compassion.

The quirks that endear us when we fall in love eventually irritate us when the honeymoon is over, but they are the things we’ll miss when our loved ones are gone.

The 5 Love Languages (Gary Chapman)

  1. Words of Affirmation
  2. Quality Time
  3. Receiving Gifts
  4. Acts of Service
  5. Physical Touch

The Qualities of Healthy Relationships

  1. Mutual respect– for our individuality, our feelings and our ideas
  2. Commitment to one another and to our relationship. We express our commitment with time, thought, patience, effort and a willingness to work together.
  3. Acceptance and management of the differences that make us unique– personality, passions, preferences, spirituality, customs. Extraverts are energized by people and parties; introverts need solitude to recharge. Extraverts need to speak to think; introverts think before they’ll speak. With acceptance and understanding, we complement one another.
  4. Unconditional love: mutual positive regard, compassion and good will.

Nurturing Your Relationship

  1. Foster emotional intimacy.Agree on a habit of checking in with one another each day. How are you feeling? How was your day?
  2. Show your affection.Express your positive feelings. Remember the 5 languages of love.
  3. Schedule regular dates. Commit your time to what matters most. Don’t wait ‘til there’s time; make time!
  4. Communicate in a healthy way.Take a breath and let anger cool before you react. Acknowledge the other’s feelings and point of view. Express how you feel without blame.
  5. When things get stale, have an affair . . . with your partner.

The Four Things That Matter Most (Dr. Ira Byock)

  1. “Please forgive me.”
  2. “I forgive you.”
  3. “Thank you.”
  4. “I love you.”

THE 4 FOUNDATIONS OF SELF-CARE

What you eat(What you put into your body). What you do(physical activity and rest).

How you feel(emotional wellbeing). How you connect(healthy relationships).

 

Categories
Burnaby Division of Family Practice Emotions Empowering Healthcare Forgiveness

Your Brain on Emotions

Your amazing brain is the product of evolution but still contains the vestiges of more primitive species.

The brainstem reflects the reptilian brain that is mainly concerned with survival. The midbrain or early mammalian brain is emotional, and the cerebral cortex represent the higher primate brain from which we can plan, reflect and manage our emotional states.

When life and limb are threatened, the reptilian brain takes over.

When we are overwhelmed by emotions, such as anger, anxiety or depression, our normal rational thinking is restricted and our thoughts both reflect and perpetuate our emotional state.

Cyclops at the CNE

For example, when angered, our thoughts obsess with how we have been threatened, insulted or harmed. It is much easier to see the negative aspects of the other person than our connection to them. If we continue this line of thinking, our anger continues to brew.

When we are overwhelmed with anxiety, our minds exaggerate the enormity of the challenges we face and minimize our strengths and resources. We may start thinking that we are going to die, fail or lose control when our rational minds know we really can manage.

When our brain is shaded by depression, we may only see the negative aspects of our reality. The triad of depressed thinking includes negative thoughts about our selves, our situation and the future.

We can move out of a depressed state by thinking about the very opposite – our personal strengths and accomplishments, the positive aspects of our situation and the people in our lives, and the positive potential of the future.

In Homer’s Iliad, the Sirens’ irresistible singing would lure sailors to their deaths as their ships crashed onto the rocky shores. Odysseus wanted to hear their beautiful songs without destroying his ship, so he commanded his crew to tie him to the mast and cover their own ears, ignoring his commands when he was in an altered mental state.

We could all use an Odysseus app – in our brains or smartphones – when we are overwhelmed by difficult situations and our emotional states. At those times, we need to see our reality from the perspective of our more rational and compassionate minds – the cerebral cortex.

DSC04853

From this perspective, we accept those aspects of our situation over which we have no control while recognizing what aspects we can positively change. What are the positive aspects of this situation? What resources do we have? In what other areas of life are things going well?

At these times, we need to be reminded of our personal strengths, our greatest goals and values, our connection to others, our best relationships, and the likelihood of a positive future.

This is when we can call upon special family members and best friends who can bring us back and remind us of who we really are and how we are loved, bring us to our senses and shine a fresh light on our perspective.

In an upcoming column, I’ll talk about what you can do when you can’t speak to a friend when you need one: what to pack in your emotional first aid kit.

Dr Davidicus Wong is a family physician in Burnaby, British Columbia. His Healthwise columns appear regularly in the Vancouver Courier, Burnaby Now, Royal City Record and Richmond News.

What You Need to Know About High Blood Pressure

Thursday, October 4
7:00 pm to 8:30 pm

Davidicus_Wong

Dr. Davidicus Wong, popular Burnaby family doctor and Burnaby Now columnist, will present a talk on high blood pressure.

Dr. Wong will cover the following topics:

• What is hypertension (high blood pressure) and how is it a silent cause of heart attacks and strokes?
• Are you at risk?
• What can you do to prevent high blood pressure?
• What do you need to know to effectively manage your blood pressure and remain healthy?

This free presentation is provided by Burnaby Public Library in collaboration with the Burnaby Divisions of Family Practice.

Free, but seating is limited. Please register by phone at: 604-522-3971, in-person, or online.

If you cannot attend the program, please contact the Library so someone else can have your spot. Thank you.