Saturday, October 23, 2010

Yoga and Mental Health

Last Friday my wife Sandy (Not Saffron anymore) and I went to a St Josephs Healthcare event entitled "Tackling Depression and Anxiety".

It was well attended and had some impressive speakers. Dr. Roberto Sassi, Assistant Professor at McMaster and St Josephs attending psychiatrist, Dr. Valerie Taylor, Assistant Professor at McMaster and Director of the Bariatric Surgery Psychiatry Program, and Dr. Randi McCabe Director of the Anxiety Treatment and Research Centre and Psychologist-in-Chief at St Josephs.

Dr. Sassi had a dense presentation outlining the prevalence of Mental Disorders in Children such as Selective Mutism (not speaking), Panic Disorder ( a specific fear episode with no reasonable cause), and Social Anxiety Disorder (being highly anxious in social environments like school or with groups of strange adults). Symptoms become important if they persist for 6 months or more and are distinct from normal life development. For instance children are commonly afraid of storms at certain ages and have panic attacks but this normally subsides over time and is not completely debilitating.

What made Dr. Sassi's lecture particularly relevant was the fact that he spoke of such highly beneficial Yoga techniques as Diaphragmatic Breathing, Mental Imagery, and Muscle Relaxation Exercises. We spoke to Dr. Sassi after the lecture and he said the reason Yoga is not seen or labeled in research studies as such is due to the wide variety of elements involved. One teachers Yoga can be so much different from another. Whereas isolating the specific techniques can help identify what is valuable. These techniques are often a successful part of a broader treatment plan including Cognitive Behavioral Therapy, Education, and in some cases where it is necessary medication.

Dr. Taylor started her presentation off with a picture of the "It's a small world" ride at Disneyland. Dr. Taylor told us how the ride had to be closed down recently due to problems in operation. The ride was built in 1969 and is a slow moving boat that travels through a tunnel while the theme "It's a small world afterall..." plays in the background. It seems that lately the maintenance crew had been having problems with the ride getting stuck at various points. The problem? The riders have been getting bigger and weighing the boats down on the tracks they followed. In fact, Disney will have to review all rides built before 2000 within the next 10 years for the very same issue. People getting too big.

Dr. Taylor's main talk was about how obesity is linked with mental illness. In particular, some drugs side effects are weight gain. She also noted how people with mental illness tend not to take care of themselves as well, eating less healthier food, and getting little exercise. This is a serious problem as many people stop taking their medication because of the weight gain. Clearly plenty of education needs to make its way to more people. Dr. Taylor was a little unclear on one point she presented. She said that one Tim Horton's muffin would add 3600 calories when eaten every 2 days, or 1/2 a muffin per day. She didn't state whether this was 3600 calories per week or per month. Tim Horton's Nutrition Guide is available online and shows values range from 290 to 430 calories depending on the muffin and there are also big variations in fat and sodium. 3600 calories is equivalent to 1 lb of body weight, so adding a Chocolate Chip muffin with 430 calories would add 3600 calories or 1 lb after 8.4 muffins or 17 days (at a 1/2 muffin per day). This is a simplistic evaluation of nutrition and her point was, I believe, that muffins from Tim Horton's can sneak in a lot of extra calories. Dr. Taylor's lecture had many excellent points relating the metal health, unfortunately she left the event early and we were not able to speak with her afterward.

The final speaker was Dr Randi McCabe. Dr. McCabe spoke about the success that she has seen using Cognitive Behavioral Therapy (CBT) to help people reduce or overcome their anxiety or panic when properly applied. CBT enjoys a fairly good grounding in scientific research where it has been shown to be successful helping people with a variety of mental issues. One area that CBT doesn't seem to be making a big impact is in Chronic Pain. I pointed this out to Dr. McCabe after her talk but she was quick to add that CBT can help with the persons experience of pain though not necessarily with the pain itself. Chronic pain is a many faced problem and effective treatment may still not result in elimination of pain but by adding coping strategies allows people to live full lives.

Dr. McCabe used a case study of how CBT was used to help with Panic Attacks. A patient (a teenage boy) had been having attacks in the classroom and before hockey games. The attacks became so severe that he would skip classes and miss hockey games because of them. The CBT approach helped him to write down Feelings, Thoughts, and Behaviors so as to become more aware of his inner environment. Even though it did not eliminate the attacks, his experience was greatly reduced or nullified because he had a form of control and self knowledge that empowered him.

Sessions can take any where from 10 - 20 weeks depending on the complexity of the issue and support available at home. The main issue faced now is that for OHIP covered treatment the waitlist is expanding beyond 7 months. Dr. McCabe has written several books that are now available for people to help themselves at home.

All in all the event was a very professional and much needed program. We hope to see more of these events in Hamilton in the future.

Thursday, October 14, 2010

Chronic Pain

A word about Chronic Pain.

It seems that today the most important thing for us physically these days (when we are not losing weight) is being pain free.
Billions of dollars are spent every year to eliminate pain from all of it's causes.
Got a headache? Take Excedrin.
Got a back ache? Physiotherapy or Pilates or Yoga will fix that up.
Painful divorce? Our Therapists will talk you through it.

Something is wrong with you today if, with all this help available, you are still in pain. Doesn't it seem that way?
I am entrenched in one side of this issue. I have chronic pain. I say chronic because it has been around since a 2002 car accident and it is showing no sign of letting up. I have done the exercises, seen the specialists, even taken the pills. So what do I do with this new friend of mine?

In the back of my mind there is this little voice saying "There is a solution, keep looking, try harder" and I really believe that voice. The problem has been, what do I do while I am searching / waiting for this solution?

The pain is stronger sometimes than others, something that is called a pain cycle. As I am writing this now it is in one of the most difficult phases. It is a frustrating, gnawing, withering type of pain. Not so much that I couldn't deal with it for an hour or even a day. But having the history that I have with it, some darkness can start to fall over my thoughts as it works away at me. It has been after me now in this phase for about 48 hours. I know it will start to lower to about half in a week or so. But there is never that release from it. Just less demanding of attention.
I can understand the frustration of other pain sufferers. Those who must toil away with no light at the end of the tunnel.

The important part of conquering pain is feeling like you have some control over it. Some influence. You would never know to look at me that I am in this pain unless you observed me for some time, since I have no choice but to soldier on.

The sad thing is, I know there are many many people in exactly this same situation. People who have to pay the bills, make dinner, take out the garbage, clean the floor, sometimes work on top of all of that.

The walking wounded a lawyer said as he told me there was no case for the automobile accident that started this pain.

Most people don't like to talk about their pain, mostly because none of us really want to hear about it. And you get tired of restating the same things over and over. But on the other side of the coin you need to have some way to discuss the frustrations with someone who will listen.

I plan to write some more about this topic in the coming weeks as a prelude to our upcoming workshop. And it has been too long since I added something to this Blog.