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Phobias and Panic Disorders
Everyone feels scared at times, and it is a normal and good thing. But sometimes, fear becomes too much. This fear stops us from going about our usual routines or working towards our goals. Phobias and panic disorder are two examples of mental illnesses that can lead to these problems.
What are phobias?
A phobia is an intense fear of a specific thing like an object, animal, or situation. Two common phobias include heights and needles.
We all feel scared of certain things at times in our lives, but phobias are different. People change the way they live in order to avoid the feared object or situation. For example, many people feel nervous about flying, but they will still go on a plane if they need to. Someone who experiences a phobia around flying may not even go to an airport. Phobias can affect relationships, school, work or career opportunities, and daily activities.
What is panic disorder?
Panic disorder involves repeated and unexpected panic attacks. A panic attack is a feeling of intense fear or terror that lasts for a short period of time. It involves physical sensations like a racing heart, shortness of breath, chest pain, dizziness, shaking, sweating or nausea. A panic attack goes away on its own.
Panic attacks can be a normal reaction to a stressful situation or a part of another mental illness. With panic disorder, panic attacks seem to happen for no reason. People who experience panic disorder fear more panic attacks and may worry that something bad will happen as a result of the panic attack. They may avoid places, sensations, or activities that remind them of a panic attack.
Some people avoid any situation where they can’t escape or find help. They may avoid public places or even avoid leaving their home. This is called agoraphobia.
Who do they affect?
Anyone can experience panic disorder or a phobia. No one knows exactly what causes phobias or panic disorder, but they are likely caused by a combination of life experiences, family history, and experiences of other physical or mental health problems.
What can I do about it?
Most people who experience problems with anxiety recognize that their fears are irrational but don’t think they can do anything to control them. The good news is that anxiety disorders are treatable. Recovery isn’t about eliminating anxiety. It’s about managing anxiety so you can live a fulfilling life.
Your doctor will look at all possible options to make sure that another medical problem isn’t behind your experiences.
Counselling and support
Counselling can be very helpful in managing anxiety, and it’s often the first treatment to try if you experience mild or moderate problems. Cognitive-behavioural therapy (or ‘CBT’) is shown to be effective for many anxiety problems. CBT teaches you how thoughts, feelings and behaviours all work together. Counselling for panic disorder and phobias, in particular, may also include exposure. Exposure slowly introduces feared things or situations.
Support groups may be a good way to share your experiences, learn from others, and connect with people who understand what you’re experiencing.
There are many self-help strategies to try at home. Small steps like eating well, exercising regularly, and practicing healthy sleep habits can really help. You can practice many CBT skills, like problem-solving and challenging anxious thoughts, on your own. Ask your support team about community organizations, websites, or books that teach CBT skills. And it’s always important to spend time on activities you enjoy and connect with loved ones.
Medication
Antianxiety medication may be helpful. Some types of antidepressants can help with anxiety, and they can be used for longer periods of time. Some people take medication until their anxiety is controlled enough to start counselling.
How can I help a loved one?
Many people who experience anxiety disorders like panic disorder or phobias can feel ashamed about their experiences. They may blame themselves or see their experiences as a problem with their personality rather than an illness. It’s important to recognize the courage it takes to talk about difficult problems.
Supporting a loved one in distress can be difficult, especially if you don’t fear the object or situation yourself. You may also be affected by a loved one’s anxiety. For example, some people seek constant reassurance from family and friends, or demand that they follow certain rules. These behaviours can lead to stress and conflict in relationships. But with the right tools and supports, people can manage anxiety well and go back to their usual activities. Here are some tips for supporting a loved one:
- Remember that thoughts and behaviours related to anxiety disorders are not personality traits.
- A loved one’s fears may seem unrealistic to you, but they are very real for your loved one. Instead of focusing on the thing or situation itself, if may be more helpful to focus on the anxious feelings that they cause. It may also help to think of times you have felt intense fear to empathize with how your loved one is feeling.
- People naturally want to protect a loved one, but ‘helping’ anxious behaviours (like taking care of everyday tasks that a loved one avoids) may make it harder for your loved one to practice new skills.
- If a loved one’s behaviours are affecting you or your family, it’s a good idea to seek family counselling. Counsellors can help with tools that support healthy relationships.
- Be patient—it takes time to learn and practice new skills. Take time to congratulate a loved when you see them using skills or taking steps forward.
- Set your own boundaries, and seek support for yourself if you need it. Support groups for loved ones can be a good place to connect with others and learn more.
Coronavirus or Something Else? Symptom Comparison Chart
*This chart does not replace receiving a diagnosis or a test result, but is meant for you to assess your own symptoms if you’re unsure of what you may have.*
See more here: https://www.adventhealth.com/blog/coronavirus-vs-flu-or-common-cold-know-difference
What to do when you accidentally use the wrong pronouns
Last week we discussed gender pronouns, and how when someone shares their pronouns with you, you should try your best to remember what they are and use them appropriately. Of course, we’re all human, and sometimes mistakes happen. You may accidentally use “he” or “she” when referring to someone who’s told you they use “they” pronouns, for example. This is also called misgendering someone.
Consider these tips if you make a mistake:
1. When someone shares their pronouns with you, actively listen to what they are. Try to repeat them in your brain in a way that you will remember.
2. If you accidentally use the wrong pronouns when speaking about that person, calmly apologize, correct yourself, and continue speaking.
Do this even if they’re not around. This will help you to remember to use the right pronoun in the future, will help others to remember, and will communicate your allyship (support) to the LGBTQ2S+ community. There is no need to excessively apologize, justify why you made the mistake, or defend yourself. Doing this only centers your own needs and feelings over the persons who has been misgendered.
3. Commit to doing better. On your own time, take time to reflect on why you made that mistake and think about how you can prevent yourself from making it again. This may even involve practicing using pronouns you are less familiar with so you can be more confident using them in a sentence.
The general consensus is that if you misgender someone, it should never be the person who you misgendered’s responsibility to make you feel better about it or to help you do better at respecting their identity. Language can make such a huge impact on mental health and self-esteem, so we should all do what we can to communicate our respect to others with our words and reactions!
Gender pronouns
Gender pronouns are words someone would like others to use when talking about or referring to them. They are almost like a replacement in a sentence for your name. The most common pronouns used are “he, him, his” and “she, her, hers”. When someone is transgender or gender nonconforming, they may prefer to use different pronouns, such as “they, them, theirs”. There are many other pronouns someone may choose to use – check the graphic below to see what some of them are.
If you are cisgender, which means your gender identity matches the sex you were assigned at birth (i.e. born a female and gender identity is female), you may have not given much thought to pronouns before. People can typically guess what a cisgender person’s pronouns are by looking at them. Not everybody has this privilege! People who are transgender or gender nonconforming may use pronouns that you wouldn’t guess just by looking at them.
The pronouns a person uses are an important part of their identity. For people who are transgender, the shift in pronouns can be an important part of their transition. So, how can you be supportive? Stating your own gender pronouns and asking for other people’s gender pronouns when you meet them is a great way to communicate that you are supportive of all identities. Once someone tells you their gender pronouns, try your best to remember what they are and use them appropriately.
Tube Feeds
What is tube feeding?
Tube feeding can be a very effective therapy for people with irritable bowl disease. It can heal intestine damage, reduce swelling, make symptoms improve, and help you gain weight and height.
Tube feeding is a treatment that involves taking some or all of your daily nutrition in a liquid formula. In other words, it’s a way of giving your body the nutrition it needs. The doctors decide how much formula you must consume to stay healthy. Partial enteral nutrition (PEN) means you consume 30-50% of your calories from formula. Exclusive enteral nutrition (EEN) means you receive all your calories from formula and do not eat regular meals. The formula enters your body through a tube, such as a nasogastric (NG) tube, which is a soft and flexible tube that goes from your nose into your stomach.
How does the tube get put in?
The tube is put in for the first time in the hospital, and this is where they teach you about what it is and how to continue them at home. Most kids say that having the tube put in is uncomfortable, but not painful. That uncomfy feeling starts to go away soon, too, as your body becomes used to having the tube there. It won’t be there forever.
Eating or drinking while tube feeding?
A lot of kids wonder if they can eat or drink anything while on tube feeds. This depends on your specific treatment plan and how much of your total calories you are consuming via the tube. Even when you are receiving all your calories from the formula (EEN), you may still be allowed to drink clear fluids or even chew gum. Ask your dietician what’s allowed for you and your body before trying anything at home ?
Here are a couple videos about feeding tubes:
Brief description of nutritional support & IBD: https://www.youtube.com/watch?v=6tbq_Lp7wnY
Getting an NG tube in: https://www.youtube.com/watch?v=M2bbyFFVtnc
Vlog from a teen girl about adjusting to life with a feeding tube: https://www.youtube.com/watch?v=ZUEL8yiEKEY
Valvular Stenosis
Anatomy of the Heart
The heart has four chambers. The two upper chambers are called the left and right atriums, and the two lower chambers are called the left and right ventricles. There is a valve at the exit of each chamber that ensures one-way continuous flow of blood through the heart.
The four valves are the tricuspid valve, pulmonary valve, mitral valve and aortic valve. These valves open and close to prevent blood from flowing backwards.
- Oxygen-poor blood coming into your heart from your body flows into the right atrium. The tricuspid valve is the valve between the right atrium and the right ventricle. It opens so blood can be pumped to the right ventricle.
- The pulmonary valve controls blood flow between the right ventricle and the lungs. It opens to let the heart pump blood out of the ventricles into the pulmonary artery toward the lungs so it can pick up oxygen. The oxygen-rich blood flows back from the lungs into the left atrium.
- The mitral valve lies between the left atrium and the left ventricle. It opens so the oxygen-rich blood from the left atrium can be pumped into the left ventricle.
- The aortic valve controls blood flow from the left ventricle into the aorta (the main artery in your body). When this valve opens, the oxygen-rich blood is pumped to the aorta and then out to fuel the rest of your body.
Stenosis
Stenosis is when the valve opening becomes narrow and restricts blood flow.
- Tricuspid valve stenosis: If your tricuspid valve narrows, blood is not able to fully move from the right atrium to the right ventricle. This can cause the atrium to enlarge, affecting pressure and blood flow in the surrounding chambers and veins. It can also cause the right ventricle to become smaller, so less blood circulates to your lungs to pick up oxygen.
- Pulmonary valve stenosis: If your pulmonary valve narrows, the flow of oxygen-poor blood from the right ventricle through the pulmonary arteries to the lungs is restricted. This affects your blood’s ability to pick up oxygen and deliver oxygen-rich blood to the rest of your body. With pulmonary valve stenosis, the right ventricle has to work harder to pump blood through the narrowed pulmonary valve and the pressure in the heart is often increased.
- Mitral valve stenosis: When the mitral valve narrows, blood flow from the left atrium to the left ventricle is reduced. This can cause fatigue and shortness of breath because the volume of blood carrying oxygen from the lungs is reduced. Pressure from the blood that has stayed in the left atrium can cause the atrium to enlarge and fluid to build up in the lungs.
- Aortic valve stenosis: When the aortic valve narrows, blood flow from your heart to your aorta (the main artery to your body) and onwards to the rest of your body is restricted. As a result, the left ventricle has to contract harder to try to push blood across the aortic valve. This can often lead to thickening of the left ventricle (left vernacular hypertrophy) which eventually makes the heart less efficient.
Causes
Valvular heart disease can develop before or at birth (congenital causes) or normal valves may become damaged during one’s lifetime (acquired causes). The cause of valvular heart disease is not always known.
Symptoms
Many people do not notice any symptoms until their blood flow has been significantly reduced by valvular heart disease. Symptoms can include:
- Chest discomfort, pressure or tightness (angina)
- Palpitations (irregular or rapid heartbeats caused by problems with the heart’s electrical system) can sometimes be a symptom of valvular heart disease. Your heart may be working harder.
- Shortness of breath – especially when you are active. Valvular heart disease reduces the amount of oxygen available to fuel your body and that causes breathlessness.
- Fatigue or weakness. You may find it harder to do routine activities such as walking or housework.
- Light-headedness, dizziness or near fainting (most common with aortic stenosis).
- Swelling can occur when valve problems cause blood to back up in other parts of the body, leading to fluid buildup and swollen abdomen, feet and ankles.
If you don’t have many symptoms or if they are mild and not affecting you too much, your doctor may choose to monitor your condition carefully and wait until it is necessary to treat your symptoms. It is important to understand that the symptoms of valvular heart disease may not necessarily reflect the seriousness of the problem. Regular check-ups are recommended.
Treatment
Treatment will depend on the severity of your disease! If it’s minor, you may not need treatment at all. You and your doctor will discuss your options based on your condition.
Options include:
- Medication: It cannot cure stenosis, but it may relieve the symptoms.
- Surgeries or other procedures: Such as valve repair or replacement.
- Lifestyle changes: Such as being smoke-free, active, a healthy weight, eating a balanced diet.
Ostomy
WHAT IS AN OSTOMY?
An ostomy is a temporary or permanent opening created through surgery that brings a part of the bowel from inside the body to the outside of the body on the abdomen. Ostomies are typically needed when stool can no longer pass the normal way though the digestive system and out the rectum. This procedure can be an option for people with Crohn’s or Colitis, for example, who have inflamed sections in their bowels.
WHAT IS A STOMA?
The opening of the bowel on the outside of the body is called a stoma. Stoma’s are usually pink or red in colour, moist, and round or oval in shape. Stoma’s become the new place that the body gets rid of solid waste. People with ostomies do not have control over passing gas or stool because there is no muscle at the opening of the stoma like there is in the rectum. The stool output that comes out of the stoma will look different than the stool a person may be used to seeing from their rectum because the stool is bypassing certain parts of the digestive tract.
Stool comes out of the stoma into a pouch that sticks to the skin around the opening. Pouches come in different sizes and different options to best suit each person’s needs. Part of getting an ostomy is learning how to care for your stoma, empty, and change your pouches!
TYPES OF OSTOMIES
Colostomy: Created when a part of the large intestine (AKA the colon) is brought to the surface of the abdomen. Stool output may be thicker, since the large intestine absorbs water.
Ileostomy: Created when the end of the small intestine is brought to the surface of the abdomen. Stool output may be loose since less water is absorbed in the small intestine.
WHAT CAN/CAN’T YOU DO WITH AN OSTOMY?
If you have an ostomy you can eat whatever you want, although some people will find certain foods make them gassier than others (and this may be different from how your body reacted before having an ostomy). People with ostomies can do most activities that other people can do once their body has healed from the initial surgery! Caution should be exercised with heavy contact sports, though, as they could cause damage to the stoma. You can wear any clothes you want, although some may be more comfortable than others (i.e. tight waistbands). With a little pre-planning, you can also go wherever you want!
Types of Post-Secondary Degrees
It may be helpful to know the different types of degrees you can get when you’re deciding what you want to do after high school. Here is a description of each:
Diploma/Certificate Programs: Degree programs may be two-year or four-year degrees. Community colleges are government-regulated post-secondary institutions offering one- to two-year certificates, diplomas, two-year associate’s degrees (i.e. Early Childhood Education) and even three- and four-year specialized degrees (i.e. Engineering). You can also usually transfer a Certificate Degree from a Community College to a different institution if you want to study further or get more qualifications.
Undergraduate – Bachelor’s Degree: These may be anywhere between three-five years, and take place at a university. Some universities offer partnerships with colleges, where you usually spend 2 years with the college and 2 years with the university to get your Bachelor’s Degree. A high school diploma is required to apply to these types of programs. If you are applying to university from high school, you will be looking in to undergraduate programs.
Postgraduate – Master’s Degree/Doctoral Degree: A master’s degree in Canada typically requires two years of study after successful completion of a 4 year bachelor’s degree. A doctoral program usually requires successful completion of a master’s degree. A doctoral degree, AKA a PhD, will take a minimum of three years and up to four or five years of study and research.
Obsessive Compulsive Disorder (OCD)
What is OCD?
Obsessive-compulsive disorder is a mental illness. It’s made up of two parts: obsessions and compulsions. People may experience obsessions, compulsions, or both, and they cause a lot of distress.
Obsessions are unwanted and repetitive thoughts, urges, or images that don’t go away. They cause a lot of anxiety. For example, someone might worry about making people they love sick by bringing in germs. Obsessions can focus on anything. These obsessive thoughts can be uncomfortable. Obsessions aren’t thoughts that a person would normally focus on, and they are not about a person’s character. They are symptoms of an illness.
Compulsions are actions meant to reduce anxiety caused by obsessions. Compulsions may be behaviours like washing, cleaning, or ordering things in a certain way. Other actions are not obvious to others. For example, some people may count things or repeat phrases in their mind. Some people describe it as feeling like they have to do something until it feels ‘right.’ It’s important to understand that compulsions are a way to cope with obsessions. Someone who experiences OCD may experience distress if they can’t complete the compulsion.
People who experience OCD usually know that obsessions and compulsions don’t make sense, but they still feel like they can’t control them. Obsessions and compulsions can also change over time.
Who does it affect?
OCD can affect anyone. Researchers don’t know exactly what causes OCD, but there are likely many different factors involved, such as family history, biology, and life experiences.
What can I do about it?
Obsessive-compulsive disorder can be very challenging and hard to explain to other people. You may feel embarrassed, ashamed, or guilty. These feelings can make it hard to seek help. Because obsessions and compulsions take a lot of time, it can be hard to go about your daily life. Many people describe OCD as something that takes over their life, and this is not easy to deal with. But the good news is that OCD is treatable. It’s important to talk to a health professional.
Counselling and support
A type of therapy called cognitive-behavioural therapy (or ‘CBT’) is shown to be effective for helping people with OCD. It teaches you how your thoughts, feelings, and behaviours work together, and teaches skills like solving problems, managing stress, realistic thinking and relaxation. For OCD, therapy may also include a strategy called exposure and response prevention, which helps you learn new ways to look at obsessions and compulsions.
Support groups can also be very helpful. They are a good place to share your experiences, learn from others, and connect with people who understand what you’re going through. OCD can make people feel very isolated and alone, so support groups can be a good way to build a support network.
There are many self-help strategies to try at home. Small steps like eating well, exercising regularly, and practicing healthy sleep habits can really help. You can practice many CBT skills, like problem-solving and challenging anxious thoughts, on your own. Ask your support team about community organizations, websites, or books that teach CBT skills. And it’s always important to spend time on activities you enjoy and connect with loved ones.
Medication
Antidepressants are the most common medication for OCD.
How can I help a loved one?
Supporting a loved one who experiences OCD can be challenging. Many people feel like they have to follow along with a loved one’s compulsions. Some people who experience OCD avoid certain things or activities, and other people may feel like they have to do everyday things for a loved one.
You may have many different complicated feelings. You may feel upset when a loved one is experiencing distressing symptoms of OCD, but you may not see why a normal task could be a problem. You may want a loved one to be more independent, but see how challenging certain things can seem. If a loved one’s experiences with OCD affects others, especially young people, it’s a good idea to seek counselling for everyone. Family counselling is a good option for the entire family. Here are more tips to help you support someone you love: